Clin Oral Implants Res. 2012 Apr;23(4):389-95. doi: 10.1111/j.1600-0501.2011.02309.x. Epub 2011 Sep 28.
The aim of this study was to compare long-term outcomes of implants placed both in patients treated for periodontitis and in periodontally healthy patients (PHP).
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, moderately periodontally compromised patients (PCP) and severely PCP. Implants were placed to support fixed prostheses, after successful completion of initial periodontal therapy [full-mouth plaque score (FMPS) <25%, full-mouth bleeding score (FMBS) <25%]. At the end of active periodontal treatment (APT), patients were asked to follow an individualized supportive periodontal therapy (SPT) program. Diagnosis and treatment of peri-implant biological complications was performed according to cumulative interceptive supportive therapy. At 10 years, clinical measures were recorded by two calibrated operators, blinded to the initial patient classification, on 101 patients, as 11 were lost to follow-up. The number of sites treated according to therapy modalities C and D (antibiotics and/or surgery) during the 10 years was registered.
Eighteen implants were removed for biological complications. Antibiotic and/or surgical therapy was performed in 10.7% of cases in PHP, in 27% of cases in moderate PCP and in 47.2% cases in severe PCP, with a statistically significant differences between PHP and severe PCP (P = 0.002). At the final examination, the percentage of implants, with at least one site which presented a PD ≥6 mm, was respectively 1.7% for PHP, 15.9% for moderate PCP and 27.2% for severe PCP, with a statistically significant difference between PHP and moderate PCP (P = 0.005) and PHP and severe PCP (P = 0.0001).
Patients with a history of periodontitis presented a statistically significant higher number of sites which required additional treatment. Therefore, patients with a history of periodontitis should be informed that they are more at risk for peri-implant disease. This underlines the value of the SPT in enhancing long-term outcomes of implant therapy, particularly in subjects affected by periodontitis. Therefore, the approach for multiple preventive dental extractions and implant placement, based on the assumption the implants perform better than teeth, should be followed with extreme caution.
本研究旨在比较牙周炎治疗患者和牙周健康患者（PHP）中植入物的长期疗效。
112 名部分缺牙患者连续纳入私人专科诊所，根据初始牙周状况分为三组：PHP、中度牙周受损患者（PCP）和重度 PCP。植入物被放置以支持固定义齿，在初始牙周治疗成功完成后[全口菌斑评分（FMPS）<25%，全口出血评分（FMBS）<25%]。在主动牙周治疗（APT）结束时，要求患者遵循个体化支持性牙周治疗（SPT）方案。根据累积截短支持性治疗，对种植体周围生物并发症进行诊断和治疗。在 10 年时，由两名经过校准的操作员记录临床测量结果，操作员对初始患者分类不知情，101 名患者中有 11 名失访。记录了 10 年内根据治疗模式 C 和 D（抗生素和/或手术）治疗的部位数量。
18 个种植体因生物并发症而被取出。在 PHP 中，抗生素和/或手术治疗的比例为 10.7%，在中度 PCP 中为 27%，在重度 PCP 中为 47.2%，PHP 与重度 PCP 之间存在统计学显著差异（P=0.002）。在最终检查时，至少有一个位点 PD≥6mm 的种植体百分比分别为 PHP 为 1.7%，中度 PCP 为 15.9%，重度 PCP 为 27.2%，PHP 与中度 PCP 之间存在统计学显著差异（P=0.005）和 PHP 与重度 PCP（P=0.0001）。
有牙周炎病史的患者需要额外治疗的位点数量明显更高。因此，有牙周炎病史的患者应被告知他们更容易发生种植体周围疾病。这突出了 SPT 在增强种植体治疗长期效果方面的价值，特别是在受牙周炎影响的患者中。因此，基于植入物比牙齿表现更好的假设，对多颗预防性牙齿拔除和植入物放置的方法应谨慎采用。
