Int J Oral Maxillofac Implants. 2014;29 Suppl:325-45. doi: 10.11607/jomi.2014suppl.g5.3.
To evaluate the success of treatments aimed at the resolution of peri-implantitis in patients with osseointegrated implants.
The potentially relevant literature was assessed independently by two reviewers to identify case series and comparative studies describing the treatment of peri-implantitis with a follow-up of at least 3 months. Medline, Embase, and The Cochrane Library were searched. For the purposes of this review, a composite criterion for successful treatment outcome was used which comprised implant survival with mean probing depth < 5 mm and no further bone loss.
A total of 43 publications were included: 4 papers describing 3 nonsurgical case series, 13 papers describing 10 comparative studies of nonsurgical interventions, 15 papers describing 14 surgical case series, and 11 papers describing 6 comparative studies of surgical interventions. No trials comparing nonsurgical with surgical interventions were found. The length of follow-up varied from 3 months to 7.5 years. Due to the heterogeneity of study designs, peri-implantitis case definitions, outcome variables, and reporting, no meta-analysis was performed. Eleven studies could be evaluated according to a composite success criterion. Successful treatment outcomes at 12 months were reported in 0% to 100% of patients treated in 9 studies and in 75% to 93% of implants treated in 2 studies. Commonalities in treatment approaches between studies included (1) a pretreatment phase, (2) cause-related therapy, and (3) a maintenance care phase.
While the available evidence does not allow any specific recommendations for the therapy of peri-implantitis, successful treatment outcomes at 12 months were reported in a majority of patients in 7 studies. Although favorable short-term outcomes were reported in many studies, lack of disease resolution as well as progression or recurrence of disease and implant loss despite treatment were also reported. The reported outcomes must be viewed in the context of the varied peri-implantitis case definitions and severity of disease included as well as the heterogeneity in study design, length of follow-up, and exclusion/inclusion criteria.
评估针对骨整合种植体周围炎的治疗方法的成功率。
两位审查员独立评估潜在相关文献，以确定描述用至少 3 个月随访治疗种植体周围炎的病例系列和对照研究。检索了 Medline、Embase 和 The Cochrane Library。在本次综述中，使用了复合治疗成功标准，该标准包括种植体存活，平均探诊深度<5mm，且无进一步骨丧失。
共纳入 43 篇文献：4 篇文章描述了 3 项非手术病例系列，13 篇文章描述了 10 项非手术干预的对照研究，15 篇文章描述了 14 项手术病例系列，11 篇文章描述了 6 项手术干预的对照研究。未发现比较非手术与手术干预的试验。研究设计、种植体周围炎病例定义、结局变量和报告的随访时间长短不一，从 3 个月到 7.5 年不等。由于研究设计、种植体周围炎病例定义、结局变量和报告的异质性，未进行荟萃分析。根据复合成功标准，11 项研究可进行评估。9 项研究中，12 个月时报告的治疗成功率为 0%至 100%，2 项研究中报告的治疗成功率为 75%至 93%。研究之间的治疗方法有共同之处，包括（1）预处理阶段，（2）病因相关治疗，和（3）维护护理阶段。
虽然现有证据不允许对种植体周围炎的治疗提出任何具体建议，但在 7 项研究中，大多数患者在 12 个月时报告了治疗成功。尽管许多研究报告了短期治疗结果良好，但仍有疾病未得到缓解，以及尽管治疗后疾病仍进展或复发，种植体仍丧失。必须在不同的种植体周围炎病例定义和包括的疾病严重程度以及研究设计、随访时间、排除/纳入标准的异质性的背景下看待报告的结果。
