Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA.
J Dent Res. 2013 Dec;92(12 Suppl):131S-8S. doi: 10.1177/0022034513509279. Epub 2013 Oct 24.
This review aimed at evaluating the effectiveness of reconstructive procedures for treating peri-implantitis. Searches of electronic databases and cross-referencing were performed for human comparative clinical trials with ≥ 10 implants for ≥ 12 months of follow-up, reporting radiographic defect fill and at least one of the following parameters: probing depth reduction, clinical attachment level gain, bleeding on probing reduction, and mucosal recession. The searches retrieved 430 citations. Only 1 randomized controlled trial was identified, which compared reconstructive therapy and open flap debridement. Case series studies were also included to evaluate the overall performance of the reconstructive procedures. Twelve studies were finally included. Meta-analysis revealed that the weighted mean radiographic defect fill was 2.17 mm (95% confidence interval [CI]: 1.46-2.87 mm), probing depth reduction was 2.97 mm (95% CI: 2.38-3.56 mm), clinical attachment level gain was 1.65 mm (95% CI: 1.17-2.13 mm), and bleeding on probing reduction was 45.8% (95% CI: 38.5%-53.3%). Great variability in reparative outcomes was found, attributed to patient factors, defect morphology, and reconstructive agents used. Currently, there is a lack of evidence for supporting additional benefit of reconstructive procedures to the other treatment modalities for managing peri-implantitis.
本综述旨在评估治疗种植体周围炎的重建手术的效果。对至少 10 个种植体、至少 12 个月随访期、报告放射影像学缺损填充以及以下至少一个参数的人类对照临床试验进行了电子数据库检索和交叉引用：探诊深度减少、临床附着水平增加、探诊出血减少和黏膜退缩。检索到 430 篇参考文献。仅确定了一项比较重建治疗和开放式翻瓣清创术的随机对照试验。还纳入了病例系列研究，以评估重建手术的总体表现。最终纳入了 12 项研究。Meta 分析显示，加权平均放射影像学缺损填充为 2.17mm（95%置信区间[CI]：1.46-2.87mm），探诊深度减少为 2.97mm（95%CI：2.38-3.56mm），临床附着水平增加为 1.65mm（95%CI：1.17-2.13mm），探诊出血减少 45.8%（95%CI：38.5%-53.3%）。发现修复结果存在很大的变异性，这归因于患者因素、缺损形态和使用的重建剂。目前，尚无证据支持重建手术对其他治疗种植体周围炎的方法有额外益处。
