Korsch Michael, Robra Bernt-Peter, Walther Winfried
Int J Prosthodont. 2015 Jan-Feb;28(1):11-8. doi: 10.11607/ijp.4043.
Excess cement left in the peri-implant sulcus after the placement of prosthetic restorations risks inflammation in the peri-implant tissue. While many current studies deal with the question of how to avoid undetected excess cement, relatively little is known about the clinical consequences of this complication. This study analyzed the clinical findings associated with excess cement. Further, the influence of the sojourn time of undetected excess cement in the peri-implant pocket on clinical findings was investigated.
Within the scope of a retrospective clinical follow-up, the suprastructures that were originally cemented with a methacrylate cement were revised in 93 patients (171 implants). The patients were split into two groups according to the time between placement of the prosthetic restoration and revision. Group 1 (G1) had treatment revisions within 2 years of restoration placement (71 patients with 126 implants); in group 2 (G2), treatment revisions were conducted at a later time (22 patients with 45 implants). For the purpose of statistical analysis, both groups were further analyzed based on the presence/absence of excess cement at the time of revision.
By definition, the average time to revision in G1 was shorter than in G2 (0.71 years versus 4.07 years). There was no significant difference in the frequency of excess cement at revision between G1 (59.5%) and G2 (62.2%). The clinical findings around the implants in G1 were significantly less severe than in G2 (bleeding on probing: G1 without excess cement--17.6%, G1 with excess cement--80%, G2 without excess cement--94.1%, G2 with excess cement--100%; suppuration: G1 without excess--0%, G1 with excess cement--21.3%, G2 without excess cement--23.3%, G2 with excess cement--89.3%). After removing the excess cement, cleaning and disinfecting the implant abutment and restoration, and using a different cement, significantly fewer signs of inflammation were found at further follow-up in both groups.
Within the limitations of this retrospective observational study, excess cement was present in a high number of cement-retained implant restorations. Signs of inflammation were present in a large proportion of implants at short- to medium-term follow-up. At the time of restoration revisions, the clinical observation of previously undetected excess cement was associated with increased prevalence of inflammation. Removal of excess cement significantly reduced the signs of inflammation.
在进行修复体修复后，种植体周围沟内残留过多的黏固剂会增加种植体周围组织发生炎症的风险。虽然目前许多研究都在探讨如何避免未被发现的多余黏固剂，但对于这种并发症的临床后果却知之甚少。本研究分析了与多余黏固剂相关的临床发现。此外，还研究了种植体周围袋内未被发现的多余黏固剂的存留时间对临床发现的影响。
在一项回顾性临床随访研究中，对93例患者（171颗种植体）最初用甲基丙烯酸酯黏固剂黏固的上部结构进行了修复。根据修复体放置与修复之间的时间将患者分为两组。第1组（G1）在修复体放置后2年内进行治疗修复（71例患者，126颗种植体）；第2组（G2）在较晚时间进行治疗修复（22例患者，45颗种植体）。为了进行统计分析，根据修复时是否存在多余黏固剂对两组进行了进一步分析。
根据定义，G1组的平均修复时间比G2组短（0.71年对4.07年）。G1组（59.5%）和G2组（62.2%）修复时多余黏固剂的出现频率没有显著差异。G1组种植体周围的临床发现明显比G2组轻（探诊出血：G1组无多余黏固剂——17.6%，G1组有多余黏固剂——80%，G2组无多余黏固剂——9
4.1%，G2组有多余黏固剂——100%；化脓：G1组无多余黏固剂——0%，G1组有多余黏固剂——21.3%，G2组无多余黏固剂——23.3%，G2组有多余黏固剂——89.3%）。在去除多余黏固剂、清洁和消毒种植体基台及修复体并使用不同的黏固剂后，两组在进一步随访中发现的炎症迹象明显减少。
在这项回顾性观察研究的局限性内，大量黏固剂固位的种植体修复体中存在多余黏固剂。在短期至中期随访中，很大一部分种植体出现了炎症迹象。在修复体修复时，对先前未被发现的多余黏固剂的临床观察与炎症发生率增加有关。去除多余黏固剂显著减少了炎症迹象。
