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结扎诱导的种植体周围炎晚期缺损的外科治疗:锥形束 CT 和组织学分析。

Surgical therapy of advanced ligature-induced peri-implantitis defects: cone-beam computed tomographic and histological analysis.

机构信息

Department of Oral Surgery, Heinrich Heine University, Düsseldorf, Germany.

出版信息

J Clin Periodontol. 2011 Oct;38(10):939-49. doi: 10.1111/j.1600-051X.2011.01739.x. Epub 2011 Aug 31.

Abstract

OBJECTIVES

To evaluate radiological bone level (RBL) (i.e. cone-beam computed tomography) and histological bone levels (HBL) as well as re-osseointegration [bone-to-implant contact (BIC)] after surgical resective (i.e. implantoplasty) and/or regenerative therapy of advanced ligature-induced peri-implantitis in dogs.

MATERIAL AND METHODS

At all defect sites (n=6 dogs, n=48 implants), the intrabony component was filled with a particulate bovine-derived natural bone mineral (NBM). The supracrestal component was treated by either the application of an equine bone block (EB) or implantoplasty. In a split-mouth design, NBM and EB were soak-loaded with recombinant human bone morphogenetic protein (rhBMP)-2 or sterile saline. All sites were covered by a native collagen membrane and left to heal in a submerged position for 12 weeks.

RESULTS

A premature wound exposure was observed at nine defect sites. Mean RBL and HBL values were lowest in the P+rhBMP-2 group, reaching statistical significance when compared with the EB group. Mean BIC values were comparable in all groups. Within-group comparisons commonly revealed a close correlation between RBL and HBL values.

CONCLUSIONS

It was concluded that (i) in all groups the investigations failed to predictably obtain complete defect resolution, (ii) the surgical procedure was associated with high exposure rates, and (iii) RBL was closely correlated with HBL.

摘要

目的

评估影像学骨水平(RBL)(即锥形束计算机断层扫描)和组织学骨水平(HBL)以及在手术切除(即植入物成形术)和/或再生治疗狗的结扎诱导的晚期种植体周围炎后的再骨整合[骨与种植体接触(BIC)]。

材料和方法

在所有缺陷部位(n=6 只狗,n=48 个种植体),骨内部分用颗粒状牛源性天然骨矿物质(NBM)填充。骨上部分通过应用马骨块(EB)或植入物成形术进行治疗。在半口设计中,NBM 和 EB 分别用重组人骨形态发生蛋白(rhBMP)-2或无菌盐水浸泡加载。所有部位均覆盖天然胶原膜,并在淹没位置愈合 12 周。

结果

9 个缺陷部位观察到过早的伤口暴露。P+rhBMP-2 组的平均 RBL 和 HBL 值最低,与 EB 组相比具有统计学意义。所有组的平均 BIC 值相当。组内比较通常显示 RBL 和 HBL 值之间存在密切相关性。

结论

研究表明,(i)所有组均未能可预测地获得完全的缺陷愈合,(ii)手术程序与高暴露率相关,(iii)RBL 与 HBL 密切相关。

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