Department of Prosthodontics, University of Rome Tor Vergata, School of Dentistry, Rome, Italy.
Int J Immunopathol Pharmacol. 2013 Jul-Sep;26(3):825-31. doi: 10.1177/039463201302600332.
This study was designed as a retrospective analysis of clinical outcomes of cases of periimplantitis treated by mechanical debridement and the administration of antibiotics combined or not with the administration of either the proteolytic enzyme serratiopeptidase (SPEP) or non-steroidal anti-inflammatory drugs (NSAIDs). Clinical charts of 544 partially edentulous patients treated for periimplantitis between June 1996 and December 2010 were analyzed to obtain clinical data of the affected implants just before the beginning of treatment and 12 months later to evaluate the outcomes of combined mechanical antibiotic treatment alone or in combination with the co-administration of the anti-inflammatory SPEP or NSAIDs. The comparative analysis revealed that therapeutic outcomes were significantly different in the three groups. Failure rate in the group that received SPEP (6 percent) was significantly lower compared to the group that received NSAIDS (16.9 percent; P less than 0.01) and to the group that received no anti-inflammatory therapy (18.9 percent; P less than 0.01). Treatment including SPEP was associated with significantly better healing also when successful treatments alone were considered. The data reported in this paper strongly support the hypothesis that SPEP is a valid addition to protocols for the combined therapy of peri-implantitis. In fact, it allows to enhance success rates significantly and also favors better tissue repair around successfully treated implants as compared to other regimens.
本研究旨在对采用机械清创术联合或不联合应用蛋白水解酶（丝氨酸蛋白酶）或非甾体类抗炎药（NSAIDs）治疗的种植体周围炎病例的临床结果进行回顾性分析。对 1996 年 6 月至 2010 年 12 月期间因种植体周围炎接受治疗的 544 名部分无牙颌患者的临床资料进行分析，以获取治疗前和治疗后 12 个月时受影响种植体的临床数据，评估单纯机械抗生素治疗联合或不联合应用抗炎丝氨酸蛋白酶或 NSAIDs 的治疗效果。对比分析显示，三组的治疗效果存在显著差异。接受丝氨酸蛋白酶治疗的患者（6%）的失败率明显低于接受 NSAIDs 治疗的患者（16.9%；P ＜0.01）和未接受抗炎治疗的患者（18.9%；P ＜0.01）。即使仅考虑成功治疗的情况，联合应用丝氨酸蛋白酶治疗也与更好的愈合相关。本研究报告的数据强烈支持丝氨酸蛋白酶是种植体周围炎联合治疗方案的有效补充的假设。事实上，与其他方案相比，它可以显著提高成功率，并有利于成功治疗的种植体周围更好的组织修复。
