Froum Stuart J, Dagba Alex S, Shi Ye, Perez-Asenjo Alejandro, Rosen Paul S, Wang Wendy C W
*Clinical Professor and Director of Clinical Research, Department of Periodontology and Implant Dentistry, New York University College of Dentistry, New York, NY; Private Practice, New York, NY. †Former Resident, Department of Periodontology and Implant Dentistry, New York University College of Dentistry, New York, NY; Private Practice, Paris, France. ‡Resident, Department of Periodontology and Implant Dentistry, New York University College of Dentistry, New York, NY. §Visiting Clinical Instructor, Department of Periodontology and Implant Dentistry, New York University College of Dentistry, New York, NY. ¶Clinical Professor of Periodontics, Department of Periodontology, Baltimore College of Dental Surgery, University of Maryland, Baltimore, MD; Private Practice, Yardley, Pennsylvania.
Implant Dent. 2016 Jun;25(3):416-26. doi: 10.1097/ID.0000000000000428.
The aim was to identify and evaluate those surgical protocols reporting on positive clinical outcomes for treating peri-implantitis with 12 or more months of follow-up. Method of surface decontamination (SDC) was evaluated for any correlation with outcomes.
A literature search was performed of all articles published in English between January 1, 2001 and April 30, 2015. Of the 639 identified, 26 satisfied the inclusion criteria. Outcomes reported on included reductions in bleeding on probing (BoP) and probing depth (PD), mean radiographic bone fill (RBF), and mean change in marginal soft tissue levels (MR±). Methods of SDC included mechanical debridement (MD) with and without saline use, MD plus laser or photodynamic therapy, MD with air powder abrasion, MD with chemotherapeutic implant surface decontamination, and combination approaches. The results suggested that various methods of SDC were effective. Heterogeneity of the studies made it impossible to determine correlations between clinical outcome and SDC method. Most studies over 12 months reporting better treatment outcomes employed a bone replacement. Additionally, studies where patients with periodontitis were treated before their peri-implantitis care also had better outcomes.
The current review failed to reveal any correlation between any particular method for SDC or defect treatment protocol and positive clinical outcomes. Further comparative studies are warranted to determine the most appropriate approach for both of these topics.
目的是识别和评估那些报告了随访12个月及以上治疗种植体周围炎临床阳性结果的手术方案。评估表面去污（SDC）方法与结果之间的任何相关性。
对2001年1月1日至2015年4月30日期间以英文发表的所有文章进行了文献检索。在识别出的639篇文章中，26篇符合纳入标准。报告的结果包括探诊出血（BoP）和探诊深度（PD）的降低、平均影像学骨填充（RBF）以及边缘软组织水平的平均变化（MR±）。SDC方法包括使用和不使用生理盐水的机械清创（MD）、MD加激光或光动力疗法、MD加空气粉末研磨、MD加化学治疗性种植体表面去污以及联合方法。结果表明各种SDC方法均有效。研究的异质性使得无法确定临床结果与SDC方法之间的相关性。大多数超过12个月且报告治疗效果较好的研究采用了骨替代。此外，在种植体周围炎治疗前先治疗牙周炎患者的研究也有更好的结果。
当前综述未能揭示任何特定的SDC方法或缺损治疗方案与临床阳性结果之间的相关性。有必要进行进一步的比较研究以确定这两个主题的最合适方法。
