Evaluation of Forensic Dental Cases Related with Oral Implantology

Öz

Objective: Oral implantology is a multidisciplinary field aimed at rehabilitating patients' missing teeth using dental implants, which includes surgical and prosthetic phases. Although numerous studies in the literature have demonstrated the successful application of implants over the years, the recent surge in implant procedures has also led to an increase in failures. The purpose of this study is to examine the failures occurring in oral implantology practices. Methods: 235 cases were examined related to oral implantology that were referred to XXX between February 2018 and December 2023 retrospectively. Cases were evaluated by dividing them into two main groups: surgical and prosthetic failures, with each group further subdivided into subcategories. The demographic characteristics of the patients included in the study, as well as the demographic characteristics of the treating physicians, the status of the centers where the treatment was applied (public/private), and the complications/malpractice decisions made by the board regarding the failures were also evaluated. Results: Out of the total 235 cases examined, 75.3% were female, while the proportion of male patients was 24.7%. The average age of the patients was determined to be 45.59 ± 13.02 years. The ratio of female physicians was 38.3%, while the ratio of male physicians was 61.7%, with a mean age of 39.79 ± 11.21 years. Regarding the centers involved in the cases, 28.5% were public institutions, while 71.5% were private clinics. The rate of surgical cases among failure types was 70.2%, while the rate of prosthetic cases was 29.8%. The board ruled complications in 62.1% of cases and malpractice in 37.9% of cases (p<0.05). Among surgical procedures, cases involving paresthesia received the highest malpractice decision (59.1%), while in prosthetic procedures, cases involving aesthetic failures were predominant (65.20%) (p<0.05). Conclusion: While oral implantology is successful in compensating for patients' missing teeth from both aesthetic and functional perspectives, it also entails certain failures. To minimize these failures, detailed anamnesis and examination, proper indication, and adherence to medical principles in treatment are crucial factors to consider.

Anahtar Kelimeler

• Oral implantology
• complication
• malpractice

Adli Tıp Kurumuna İntikal Etmiş Oral İmplantoloji ile İlgili Vakaların Değerlendirilmesi

Öz

Amaç: Oral implantoloji, hastaların diş eksikliklerinin dental implantlarla rehabilitasyonunu hedefleyen, cerrahi ve protetik fazları içerisinde barındıran multidisipliner bir bilim dalıdır. İmplantların uzun yıllardır başarıyla uygulandığına dair literatürde birçok çalışma olmakla birlikte son dönemde implant uygulamalarındaki büyük artış beraberinde başarısızlıkları da getirmektedir. Bu çalışmanın amacı oral implantoloji uygulamalarında meydana gelen başarısızlıkların incelenmesidir. Yöntem: Çalışmada Adli Tıp Kurumu diş hekimliği bölümüne Şubat 2018-Aralık 2023 tarihlerinde intikal etmiş oral implantoloji ile ilişkili 235 vaka geriye dönük olarak incelenmiştir. Vakalar cerrahi ve protetik başarısızlıklar olarak iki ana grup ve her grup da kendi içerisinde alt sınıflara ayrılarak değerlendirilmiştir. Çalışmaya dahil edilen hastaların ve işlemi uygulayan hekimlerin demografik özellikleri, tedavinin uygulandığı merkezlerin statüsü (kamu/özel) ve ortaya çıkan başarısızlıklara kurul tarafından verilen komplikasyon/malpraktis kararları değerlendirilmiştir. Bulgular: İncelenen toplam 235 vakanın %75,3’ü kadın iken erkek hastaların oranı %24,7’dir. Hastaların yaş ortalaması 45,59 ± 13,02 olarak belirlenmiştir. Kadın hekimlerin oranı %38,3 erkek hekimlerin oranı ise %61,7, hekimlerin yaş ortalaması ise 39,79 ± 11,21’dir. Davaya konu olan merkezlerin %28,5'i kamu kurumu, %71,5'i ise özel kliniklerdir. Başarısızlık tipleri arasında cerrahi vakaların oranı %70,2 iken protetik vakaların oranı %29,8 olarak belirlenmiştir (p<0.05). Kurul tarafından vakaların %62,1'ine komplikasyon, %37,9'una ise malpraktis kararı verilmiştir (p<0.05). Cerrahi işlemlerde en fazla malpraktis kararı verilen parestezi olan vakalar (%59,1), protetik işlemlerde ise estetik başarısızlıklardır (%65,20) (p<0.05). Sonuç: Oral implantoloji hastaların diş eksikliklerinin estetik ve fonksiyonel açıdan telafi edilmesinde başarılı bir disiplin olsa da bir takım başarısızlıkları da barındırdığı, bu başarısızlıkları asgari düzeye indirmek için detaylı anamnez ve tetkik, doğru endikasyon ve tıp kurallarına uygun teknik ile tedavi planlamasının önemli olduğu akıldan çıkartılmamalıdır.

Anahtar Kelimeler

• Oral implantoloji
• komplikasyon
• malpraktis

Destekleyen Kurum

Adli Tıp Kurumu

Teşekkür

Çalışmam süresince desteğini esirgemeyen Sn. Dr. Öğr. Üyesi Hızır Aslıyüksek ve Dr. Caner Beşkoş'a teşekkürlerimi sunarım.

Kaynakça

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