Berglundh T, Gotfredsen K, Zitzmann N U, Lang N P, Lindhe J
Department of Periodontology, Göteborg University, Göteborg, Sweden.
Clin Oral Implants Res. 2007 Oct;18(5):655-61. doi: 10.1111/j.1600-0501.2007.01397.x. Epub 2007 Jun 30.
Peri-implantitis is associated with the presence of submarginal plaque, soft-tissue inflammation and advanced breakdown of the supporting bone. The progression of peri-implantitis following varying periods of continuing plaque accumulation has been studied in animal models.
The aim of the current experiment was to study the progression of peri-implantitis around implants with different surface roughness.
In five beagle dogs, three implants with either a sandblasted acid-etched surface (SLA) or a polished surface (P) were installed bilaterally in the edentulous premolar regions. After 3 months on a plaque control regimen, experimental peri-implantitis was induced by ligature placement and plaque accumulation was allowed to progress until about 40% of the height of the supporting bone had been lost. After this 4-month period, ligatures were removed and plaque accumulation was continued for an additional 5 months. Radiographs of all implant sites were obtained before and after 'active' experimental peri-implantitis as well as at the end of the experiment. Biopsies were harvested and the tissue samples were prepared for light microscopy. The sections were used for histometric and morphometric examinations.
The radiographic examinations indicated that similar amounts of bone loss occurred at SLA and P sites during the active breakdown period, while the progression of bone loss was larger at SLA than at polished sites following ligature removal. The histological examination revealed that both bone loss and the size of the inflammatory lesion in the connective tissue were larger in SLA than in polished implant sites. The area of plaque was also larger at implants with an SLA surface than at implants with a polished surface.
It is suggested that the progression of peri-implantitis, if left untreated, is more pronounced at implants with a moderately rough surface than at implants with a polished surface.
种植体周围炎与龈下菌斑的存在、软组织炎症以及支持骨的严重破坏有关。在动物模型中,已经研究了在不同时间段持续菌斑堆积后种植体周围炎的进展情况。
本实验的目的是研究不同表面粗糙度的种植体周围种植体周围炎的进展情况。
在5只比格犬的无牙前磨牙区域双侧植入3枚表面为喷砂酸蚀(SLA)或抛光(P)的种植体。在菌斑控制方案下3个月后,通过结扎诱导实验性种植体周围炎,并允许菌斑堆积进展,直到支持骨高度约40%丧失。在这4个月的时间段后,去除结扎线并继续菌斑堆积5个月。在“活跃”的实验性种植体周围炎前后以及实验结束时,获取所有种植体部位的X线片。采集活检组织,将组织样本制备用于光学显微镜检查。切片用于组织计量学和形态计量学检查。
X线检查表明,在活跃的骨吸收期,SLA和P部位发生的骨吸收量相似,而在去除结扎线后,SLA部位的骨吸收进展比抛光部位更大。组织学检查显示,SLA种植体部位的骨吸收和结缔组织中炎症病变的大小均大于抛光种植体部位。SLA表面种植体的菌斑面积也大于抛光表面种植体。
提示如果不进行治疗,种植体周围炎在表面适度粗糙的种植体上比在表面抛光的种植体上进展更明显。