Khammissa R A G, Feller L, Meyerov R, Lemmer J
Department of Periodontology and Oral Medicine, University of Limpopo, South Africa.
SADJ. 2012 Apr;67(3):122, 124-6.
Osseointegrated dental implants are used routinely in dentistry in the confidence of predictable success. However, if the implant surfaces become colonised by pathogenic bacteria, the plaque-induced inflammation around the implants may cause peri-implant tissue destruction. Peri-implant mucositis is a reversible, plaque-induced inflammatory lesion confined to the peri-implant soft tissue unit and clinically is characterised by redness, swelling and bleeding on gentle probing. Peri-implantitis is an extension of peri-implant mucositis to involve the bone supporting the implant: it is characterised by loss of osseointegration of the coronal part of the implant, by increased probing depth and by bleeding and/or suppuration on probing. Established peri-implantitis does not respond predictably to treatment. The best management of plaque-induced peri-implant inflammatory diseases is prevention. Regular personal and professional cleaning of the implant is mandatory to minimise bacterial load. Despite our best efforts, plaque-induced peri-implant inflammatory diseases will occur frequently, and as these diseases respond best to early treatment, early detection of peri-implant mucositis by regular assessment will permit timely treatment. Peri-implant mucositis is readily treated non-surgically. Peri-implantitis is more difficult to treat largely because of the problem of decontamination of the roughened, threaded surfaces of exposed implants. As a rule, surgical treatment will be necessary, and even then success is not assured.
骨结合牙种植体在牙科领域被常规使用，人们坚信其成功率可预测。然而，如果种植体表面被病原菌定植，种植体周围由菌斑引发的炎症可能会导致种植体周围组织破坏。种植体周围黏膜炎是一种可逆的、由菌斑引发的炎症性病变，局限于种植体周围软组织单位，临床上表现为发红、肿胀以及轻探时出血。种植体周围炎是种植体周围黏膜炎的扩展，累及支持种植体的骨组织：其特征为种植体冠部骨结合丧失、探诊深度增加以及探诊时出血和/或化脓。已确诊的种植体周围炎对治疗的反应不可预测。对菌斑引发的种植体周围炎性疾病的最佳管理是预防。定期进行个人和专业的种植体清洁是必需的，以尽量减少细菌负荷。尽管我们已竭尽全力，但菌斑引发的种植体周围炎性疾病仍会频繁发生，由于这些疾病对早期治疗反应最佳，通过定期评估早期发现种植体周围黏膜炎将有助于及时治疗。种植体周围黏膜炎很容易通过非手术方法治疗。种植体周围炎更难治疗，主要是因为暴露种植体粗糙螺纹表面的去污问题。通常，手术治疗是必要的，即便如此，也不能保证成功。
