Department of Maxillofacial Surgery, University of Torino, Torino, Italy.
Clin Oral Implants Res. 2010 May;21(5):490-6. doi: 10.1111/j.1600-0501.2009.01886.x. Epub 2010 Mar 11.
The aim of this study was to compare the long-term outcomes of implants placed in patients treated for periodontitis periodontally compromised patients (PCP) and in periodontally healthy patients (PHP) in relation to adhesion to supportive periodontal therapy (SPT).
One hundred and twelve partially edentulous patients were consecutively enrolled in private specialist practice and divided into three groups according to their initial periodontal condition: PHP, moderate PCP and severe PCP. Perio and implant treatment was carried out as needed. Solid screws (S), hollow screws (HS) and hollow cylinders (HC) were installed to support fixed prostheses, after successful completion of initial periodontal therapy (full-mouth plaque score <25% and full-mouth bleeding score <25%). At the end of treatment, patients were asked to follow an individualized SPT program. At 10 years, clinical measures and radiographic bone changes were recorded by two calibrated operators, blinded to the initial patient classification.
Eleven patients were lost to follow-up. During the period of observation, 18 implants were removed because of biological complications. The implant survival rate was 96.6%, 92.8% and 90% for all implants and 98%, 94.2% and 90% for S-implants only, respectively, for PHP, moderate PCP and severe PCP. The mean bone loss was 0.75 (+/- 0.88) mm in PHP, 1.14 (+/- 1.11) mm in moderate PCP and 0.98 (+/- 1.22) mm in severe PCP, without any statistically significant difference. The percentage of sites, with bone loss > or =3 mm, was, respectively, 4.7% for PHP, 11.2% for moderate PCP and 15.1% for severe PCP, with a statistically significant difference between PHP and severe PCP (P<0.05). Lack of adhesion to SPT was correlated with a higher incidence of bone loss and implant loss.
Patients with a history of periodontitis presented a lower survival rate and a statistically significantly higher number of sites with peri-implant bone loss. Furthermore, PCP, who did not completely adhere to the SPT, were found to present a higher implant failure rate. This underlines the value of the SPT in enhancing the long-term outcomes of implant therapy, particularly in subjects affected by periodontitis, in order to control reinfection and limit biological complications.
本研究旨在比较牙周炎患者（牙周病受损患者，PCP）和牙周健康患者（PHP）中植入物的长期结果，以及与支持性牙周治疗（SPT）的依从性相关。
112 名部分缺牙患者连续纳入私人专科诊所，并根据初始牙周状况分为三组：PHP、中度 PCP 和重度 PCP。根据需要进行牙周和种植治疗。在初始牙周治疗完成后（全口菌斑评分<25%，全口出血评分<25%），安装固位螺钉（S）、空心螺钉（HS）和空心圆柱（HC）以支持固定义齿。在治疗结束时，要求患者遵循个体化的 SPT 计划。在 10 年时，由两名经过校准的操作员记录临床测量和影像学骨变化，操作员对初始患者分类不知情。
11 名患者失访。在观察期间，18 个种植体因生物并发症而被取出。种植体存活率为所有种植体的 96.6%、92.8%和 90%，仅 S 种植体的存活率为 98%、94.2%和 90%，分别为 PHP、中度 PCP 和重度 PCP。PHP 的平均骨损失为 0.75(+/-0.88)mm，中度 PCP 为 1.14(+/-1.11)mm，重度 PCP 为 0.98(+/-1.22)mm，无统计学差异。骨损失>或=3mm 的位点百分比分别为 PHP 为 4.7%，中度 PCP 为 11.2%，重度 PCP 为 15.1%，PHP 和重度 PCP 之间存在统计学差异（P<0.05）。对 SPT 的依从性差与更高的骨损失和种植体损失发生率相关。
有牙周炎病史的患者存活率较低，且与种植体周围骨丢失相关的位点数量统计学上显著较高。此外，未完全遵守 SPT 的 PCP 患者发现种植体失败率更高。这强调了 SPT 在增强种植体治疗的长期效果方面的价值，特别是在受牙周炎影响的患者中，以控制再感染并限制生物并发症。
