Schou Søren, Berglundh Tord, Lang Niklaus P
Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, Aalborg, Denmark.
Int J Oral Maxillofac Implants. 2004;19 Suppl:140-9.
Surgical treatment of peri-implantitis lesions can be performed in cases with considerable pocket formation (larger than 5 mm) and bone loss after the acute infection has been resolved and proper oral hygiene has been instituted. A literature review was conducted to ascertain current knowledge about surgical treatment options for peri-implantitis around commercially pure titanium implants. Recently reported animal studies involving implants with a rough surface indicate that considerable bone regeneration and re-osseointegration can be obtained by using membrane-covered autogenous bone graft particles. However, comparisons of the treatment outcomes in studies involving humans and animals are difficult because of differences in implant type, graft type, and evaluation protocols. In addition, different treatment procedures, including implant surface decontamination methods, have been used. Therefore, further long-term studies in humans involving sufficient numbers of subjects are needed to provide a solid basis for recommendations regarding the surgical treatment of peri-implantitis. Moreover, the encouraging treatment outcomes of regenerative procedures recently revealed in animal experiments and applied in the treatment of peri-implantitis around implants with sandblasted/acid-etched surfaces have not yet been documented for implants with other surfaces, especially turned surfaces. Numerous implant surface decontamination methods have been suggested as part of the surgical treatment of peri-implantitis. Decontamination of affected implants with titanium plasma-sprayed or sandblasted/acid-etched surfaces may most easily and effectively be achieved by applying gauze soaked alternately in chlorhexidine and saline.
在急性感染得到解决且建立了适当的口腔卫生措施后,对于形成了较深牙周袋(大于5mm)且伴有骨吸收的种植体周围炎病变,可进行外科治疗。我们进行了一项文献综述,以确定关于商业纯钛种植体周围种植体周围炎外科治疗选择的现有知识。最近报道的涉及粗糙表面种植体的动物研究表明,使用膜覆盖的自体骨移植颗粒可实现显著的骨再生和再骨结合。然而,由于种植体类型、移植类型和评估方案的差异,很难比较涉及人类和动物的研究中的治疗结果。此外,还使用了不同的治疗程序,包括种植体表面去污方法。因此,需要在人类中进行更多涉及足够数量受试者的长期研究,为种植体周围炎外科治疗的建议提供坚实基础。此外,最近在动物实验中揭示并应用于喷砂/酸蚀表面种植体周围种植体周围炎治疗的再生程序的令人鼓舞的治疗结果,尚未在其他表面的种植体,特别是车削表面的种植体中得到证实。作为种植体周围炎外科治疗的一部分,已经提出了许多种植体表面去污方法。对于钛等离子喷涂或喷砂/酸蚀表面的受影响种植体,交替用洗必泰和盐水浸泡纱布进行去污可能是最容易和有效的方法。