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采用自体骨和脱矿异种骨移植物联合治疗种植体周围炎骨缺损的再生治疗:一系列 36 例缺损。

Regenerative treatment of peri-implantitis bone defects with a combination of autologous bone and a demineralized xenogenic bone graft: a series of 36 defects.

机构信息

Department of Oral and Maxillofacial Surgery, Christian-Albrechts University Kiel, Kiel, Germany.

出版信息

Clin Implant Dent Relat Res. 2012 Jun;14(3):421-7. doi: 10.1111/j.1708-8208.2009.00264.x. Epub 2010 Feb 3.

Abstract

AIM

As the treatment of peri-implantitis-induced bone loss is still a problem, we studied the regenerative treatment of these defects with a mix of autologous bone and a new type of bone graft substitute (demineralized xenogenic bone graft) including growth factors.

MATERIAL AND METHODS

In a prospective manner, 36 cases of peri-implantitis-induced bone loss (depth >4 mm) in 22 patients were followed for 1 year. After resolving the acute infection by local rinsing, granulation tissue was removed. The implants were decontaminated with etching gel and the defects were filled with autologous bone mixed 1:1 with a xenogenic bone graft. The prosthetic reconstructions did not have to be removed. Values of probing depths as well as bone defects were analyzed.

RESULTS

The radiologic evaluation of the bone defects after regenerative treatment revealed a mean reduction of 3.5 mm comparing the values from 5.1 mm prior to surgery to 1.6 mm 1 year after treatment. Average reduction of the probing depth was 4 mm. The remaining bone defects were larger than 3 mm in 4 out of 36 implants 1 year after treatment. Probing depths of more than 4 mm were present in seven implants.

CONCLUSION

Within the limits of the study, we conclude that for bone defects larger than 4 mm in case of peri-implantitis, this single surgical intervention provided a reliable method to reduce bone defects.

摘要

目的

由于种植体周围炎导致的骨缺损的治疗仍然是一个问题,我们研究了使用自体骨和新型骨移植替代物(脱矿异体骨移植)混合生长因子对这些缺损进行再生治疗的方法。

材料和方法

前瞻性地对 22 名患者的 36 例种植体周围炎导致的骨缺损(深度>4mm)进行了为期 1 年的随访。通过局部冲洗消除急性感染后,清除肉芽组织。用蚀刻凝胶对种植体进行消毒,并将自体骨与异体骨以 1:1 的比例混合填充到缺损处。无需拆除修复体。分析了探诊深度和骨缺损值。

结果

再生治疗后骨缺损的影像学评估显示,与术前的 5.1mm 相比,治疗后 1 年的平均值减少了 3.5mm。探诊深度的平均减少量为 4mm。治疗后 1 年,36 个种植体中有 4 个的剩余骨缺损仍大于 3mm。7 个种植体的探诊深度仍大于 4mm。

结论

在研究范围内,我们得出结论,对于种植体周围炎导致的大于 4mm 的骨缺损,这种单一的手术干预为减少骨缺损提供了可靠的方法。

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