骨质疏松患者使用双膦酸盐去除牙种植体的后果：一项全国性队列研究

IF 3.7 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Implant Dentistry and Related Research Pub Date : 2025-06-11 DOI:10.1111/cid.70062

Jung-Hyun Park, Heon-Young Kim, Jae-Ryun Lee, Hyo-Jung Lee, Jin-Woo Kim

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引用次数: 0

摘要

这项基于全国人群的队列研究旨在调查骨质疏松患者使用双膦酸盐（BP）与牙种植体拔除之间的关系。方法选取2014 - 2018年间接受种植牙手术的年龄≥65岁骨质疏松症患者389 226例。根据处方记录将患者分为BP组和对照组。使用2019年至2020年的程序代码确定植入物移除。采用多变量logistic回归分析来检验血压与植入物移除之间的关系。亚组分析评估了降压给药途径（口服vs静脉注射）、降压类型和累计限定日剂量（DDD）对植入物移除风险的影响。结果与对照组相比，BP组植入物移除的风险略有增加(校正优势比[OR]: 1.09；95%置信区间[CI]: 1.05-1.15)。牙周炎患者的种植体移除风险明显高于无牙周炎患者(调整OR: 1.87；95% ci: 1.63-2.15)。在降压药使用者中，亚组分析显示静脉降压药比口服降压药与较低的植入物移除风险相关(调整OR: 0.87；95% ci: 0.80-0.94)。此外，植入物移除的风险随着累积DDDs的增加而逐渐增加，这突出了总血压暴露的重要性。结论：本研究强调了累积BP暴露在植入物移除风险中的关键作用，这挑战了传统的给药途径假设。未来的研究应探索优化骨质疏松患者种植体效果的策略。

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Consequence of Bisphosphonate Use on Dental Implant Removal in Osteoporotic Patient: A Nationwide Cohort Study

Introduction

This nationwide population-based cohort study aimed to investigate the relationship between bisphosphonate (BP) use and dental implant removal in patients with osteoporosis.

Methods

A total of 389 226 individuals aged ≥ 65 years with osteoporosis who underwent dental implant surgery between 2014 and 2018 were included. Patients were classified into BP and control groups based on their prescription records. Implant removal was identified using the procedural codes from 2019 to 2020. Multivariate logistic regression analysis was performed to examine the association between BP and implant removal. Subgroup analyses evaluated the impact of the BP administration route (oral vs. intravenous), BP type, and cumulative defined daily dose (DDD) on the risk of implant removal.

Results

The BP group demonstrated a modestly increased risk of implant removal compared to the control group (adjusted odds ratio [OR]: 1.09; 95% confidence interval [CI]: 1.05–1.15). Participants with periodontitis had a significantly higher risk of implant removal than participants without periodontitis (adjusted OR: 1.87; 95% CI: 1.63–2.15). Among BP users, the subgroup analysis revealed that intravenous BP administration was associated with a lower risk of implant removal than oral administration (adjusted OR: 0.87; 95% CI: 0.80–0.94). In addition, the risk of implant removal increased progressively with higher cumulative DDDs, highlighting the importance of total BP exposure.

Conclusion

This study underscores the critical role of cumulative BP exposure in the risk of implant removal, which challenges conventional assumptions regarding administration routes. Future research should explore strategies to optimize implant outcomes in patients with osteoporosis.

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来源期刊

Clinical Implant Dentistry and Related Research 医学-牙科与口腔外科

CiteScore

6.00

自引率

13.90%

发文量

103

审稿时长

4-8 weeks

期刊介绍： The goal of Clinical Implant Dentistry and Related Research is to advance the scientific and technical aspects relating to dental implants and related scientific subjects. Dissemination of new and evolving information related to dental implants and the related science is the primary goal of our journal. The range of topics covered by the journals will include but be not limited to: New scientific developments relating to bone Implant surfaces and their relationship to the surrounding tissues Computer aided implant designs Computer aided prosthetic designs Immediate implant loading Immediate implant placement Materials relating to bone induction and conduction New surgical methods relating to implant placement New materials and methods relating to implant restorations Methods for determining implant stability A primary focus of the journal is publication of evidenced based articles evaluating to new dental implants, techniques and multicenter studies evaluating these treatments. In addition basic science research relating to wound healing and osseointegration will be an important focus for the journal.