Haas R, Baron M, Dörtbudak O, Watzek G
Department of Oral Surgery, Dental School, University of Vienna, Austria.
Int J Oral Maxillofac Implants. 2000 May-Jun;15(3):374-82.
This clinical study reports on the results of a new method in the treatment of peri-implantitis. The surfaces of 24 plasma flame-sprayed cylindric implants in 17 patients who were diagnosed with peri-implantitis were decontaminated with a combination of toluidine blue (100 micrograms/mL) and laser irradiation at a wavelength of 906 nm. Bone defects were filled with autogenous bone using e-PTFE membranes for retention of the grafting material. Premature membrane exposure occurred in all patients after an average of 3 weeks (+/- 10 days), which required immediate removal of the exposed membrane in 1 patient. Since the soft tissue showed minimal signs of inflammation, the membranes were left in situ for another 6 weeks in all other patients. The mean radiographic peri-implant bone gain was 2 mm +/- 1.90 mm after 9.5 months (maxilla 2.5 mm +/- 2.38 mm; mandible 1.9 mm +/- 1.87 mm). Two implants around which the initial bone defect had already reached the basket had to be removed after 10 months and 35 months, respectively, despite radiographic evidence of improvement of the peri-implant defect. The longer the membrane stayed in situ, the more bone was gained, as long as the membrane was covered by soft tissue (P = .01). However, the longer an exposed membrane was left in place, the smaller the resultant bone gain (P = .0001). Therefore, despite the absence of clinical signs of inflammation, exposed membranes should be removed immediately. The short-term results of this study corroborate the efficacy of the applied treatment method in prolonging the service time of dental implants involved with peri-implantitis.
本临床研究报告了一种治疗种植体周围炎的新方法的结果。对17例被诊断为种植体周围炎患者的24个等离子火焰喷涂圆柱形种植体表面，采用甲苯胺蓝（100微克/毫升）和波长906纳米的激光照射相结合的方法进行去污处理。使用e-PTFE膜保留移植材料，用自体骨填充骨缺损。所有患者平均在3周（±10天）后均出现膜过早暴露，其中1例患者需要立即移除暴露的膜。由于软组织炎症迹象轻微，其他所有患者的膜均保留原位6周。9.5个月后，种植体周围骨平均影像学增益为2毫米±1.90毫米（上颌骨2.5毫米±2.38毫米；下颌骨1.9毫米±1.87毫米）。尽管影像学显示种植体周围缺损有所改善，但分别在10个月和35个月后，仍有两个种植体周围最初的骨缺损已达牙槽嵴顶，不得不将其移除。只要膜被软组织覆盖，膜在原位保留的时间越长，骨增益就越多（P = 0.01）。然而，暴露的膜保留原位的时间越长，最终的骨增益就越小（P = 0.0001）。因此，尽管没有炎症的临床体征，暴露的膜也应立即移除。本研究的短期结果证实了所应用的治疗方法在延长患有种植体周围炎的牙种植体使用寿命方面的有效性。
