透射性炎性种植体根尖周病变：文献综述

Radiolucent inflammatory implant periapical lesions: a review of the literature.

作者信息

Feller Liviu, Jadwat Yusuf, Chandran Rakesh, Lager Ilan, Altini M, Lemmer J

机构信息

*Professor and Head, Department of Periodontology and Oral Medicine, University of Limpopo, Medunsa Campus, Pretoria, South Africa. †Lecturer, Department of Periodontology and Oral Medicine, University of Limpopo, Medunsa Campus, Pretoria, South Africa. ‡Registrar, Department of Periodontology and Oral Medicine, University of Limpopo, Medunsa Campus, Pretoria, South Africa. §Periodontist, Private Practice, Grayston Medical Mews, Sandown, South Africa. ‖Professor, Department of Anatomical Pathology, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa. ¶Honorary Professor, Department of Periodontology and Oral Medicine, University of Limpopo, Medunsa Campus, Pretoria, South Africa.

出版信息

Implant Dent. 2014 Dec;23(6):745-52. doi: 10.1097/ID.0000000000000140.

DOI:10.1097/ID.0000000000000140

PMID:25290277

Abstract

PURPOSE

To discuss the terminology, etiopathogenesis, and treatment of radiolucent inflammatory implant periapical lesions.

MATERIALS AND METHODS

An electronic search for relevant articles published in the English literature in the PubMed database.

RESULTS

Bacterial contamination of the apical portion of the implant either from a preexisting dental periapical infection or from a periapical lesion of endodontic origin of an adjacent tooth is the probable causative factor. Aseptic bone necrosis owing to overheating of the bone during preparation of osteotomies, or compression of the bone at the apex of the implant owing to excessive tightening, may also play a role. The histopathological features are of a mixed inflammatory cell infiltrate on a background of granulation tissue consistent with either a granuloma or an abscess as may be found at the apex of a nonvital tooth. Treatment consists of immediate and aggressive surgical debridement, chemical detoxification of the apical portion of the exposed implant surface, and systemic antibiotics with or without a bone regenerative procedure.

CONCLUSION

A radiolucent inflammatory implant periapical lesion is analogous to either a granuloma or an abscess as may be found at the apex of a nonvital tooth.

摘要

目的

探讨种植体根尖周透射性炎性病变的术语、病因及治疗方法。

材料与方法

在PubMed数据库中对英文文献发表的相关文章进行电子检索。

结果

种植体根尖部的细菌污染可能是致病因素，其来源可以是既存的牙髓根尖周感染，也可以是相邻牙齿牙髓源性根尖周病变。在截骨术制备过程中因骨过热导致的无菌性骨坏死，或因过度拧紧导致种植体根尖部骨受压，也可能起一定作用。组织病理学特征为在肉芽组织背景上有混合性炎性细胞浸润，与无活力牙齿根尖处可能出现的肉芽肿或脓肿一致。治疗包括立即进行积极的外科清创、对暴露的种植体表面根尖部进行化学解毒，以及使用或不使用骨再生程序的全身抗生素治疗。