Uribe Roberto, Peñarrocha Miguel, Sanchis Jose María, García Oscar
Master de Cirugía e Implantología Oral, Universidad de Valencia, Spain.
Med Oral. 2004 Mar-Apr;9(2):160-2, 159-60.
The etiology of marginal peri-implantitis describes an infectious factor and a biomechanical factor resulting from occlusal overload. Clinical and experimental articles oriented to the biomechanical factor are scarce, so as the studies about the histology associated to periimplantitis. We present a case of marginal peri-implantitis on an implant in the mandibular molar zone caused by occlusal overload, which led to an osseous defect on the marginal crest. The treatment was composed of occlusal adjustment, removal of contaminated surgical tissue, and autogenous bone graft, which varies from the common treatment of infectious peri-implantitis. Histologic analysis of peri-implantitis tissue reveals a juxtaepithelial lympho-plasmocytorious infiltrate and a central zone of dense fibro-connective tissue with scanty inflammatory cells, which differs from the chronic inflammatory tissue associated with infectious peri-implantitis. Clinical and radiographic followup control after 12 months evidenced the remission of the symptoms and bone regeneration on the marginal crest. We consider that in the treatment of marginal peri-implantitis, it is necessary to continue the studies on the histological differences between the infectious types and those that are caused by occlusal overload.
种植体周围边缘性炎的病因包括感染因素和由咬合负荷过重导致的生物力学因素。针对生物力学因素的临床和实验性文章较为匮乏，与种植体周围炎相关的组织学研究亦是如此。我们呈现了一例下颌磨牙区种植体因咬合负荷过重导致的种植体周围边缘性炎病例，该病例致使边缘嵴出现骨缺损。治疗措施包括咬合调整、去除受污染的手术组织以及自体骨移植，这与感染性种植体周围炎的常规治疗不同。种植体周围炎组织的组织学分析显示，其为上皮下淋巴细胞 - 浆细胞浸润，以及中央致密纤维结缔组织带，炎症细胞稀少，这与感染性种植体周围炎相关的慢性炎症组织有所不同。12个月后的临床和影像学随访证实症状缓解，边缘嵴有骨再生。我们认为，在种植体周围边缘性炎的治疗中，有必要继续研究感染性类型与由咬合负荷过重导致的类型之间的组织学差异。
