Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany.
Oral Medicine and Periodontology Department, Faculty of Oral and Dental Medicine, Cairo University, Giza, Egypt.
Clin Oral Investig. 2018 Jan;22(1):235-244. doi: 10.1007/s00784-017-2104-4. Epub 2017 Mar 28.
The aim of this retrospective study was to evaluate the long-term implant survival in patients with a history of chronic periodontitis, during supportive periodontal therapy (SPT), compared to periodontally healthy patients.
Twenty-nine periodontitis patients (test) with SPT for ≥9 years and implant-supported restorations (≥5 years follow-up) were recruited and pair-matched with 29 periodontally healthy patients (control). Subjects in both groups were examined following active periodontal therapy and/or implantation (T1) (test 69 implants, control 76 implants) and at end of SPT or supportive postimplant therapy (T2). Differences between the groups in implant survival (primary outcome), mean marginal bone loss (MBL) and pocket probing depths (PPDs) (secondary outcomes) were evaluated.
Implant survival over 5 years was 97.1% in test compared to 97.4% in control group (p = 0.562). MBL was significantly different (test 18.7 ± 18.2%; control 12.5 ± 21.3%) (p < 0.05). PPDs increased at T2 in both groups (test: T1 3.4 ± 1.0 mm; T2 4.2 ± 1.6 mm; control: T1 1.0 ± 1.2 mm; T2 2.9 ± 0.8 mm; p < 0.05 between groups). Prognostic factors for implant loss appeared to be the presence of residual periodontal pockets of ≥4 mm (OR 1.90), bone height (OR 1.81) and age (OR 1.16) at T1.
In terms of implant survival, no differences were observed between periodontitis and periodontally healthy patients. However, patients with history of periodontitis showed higher MBL and PPDs compared to periodontally healthy patients.
The presence of a good periodontal maintenance program with preceding successful active periodontal treatment seems to be indispensable components of successful implant treatment in patients with history of chronic periodontitis.
本回顾性研究旨在评估慢性牙周炎患者在牙周支持治疗(SPT)期间的长期种植体存活率,并与牙周健康患者进行比较。
共招募了 29 名接受 SPT 治疗≥9 年且有种植体支持修复(≥5 年随访)的牙周炎患者(试验组),并与 29 名牙周健康患者(对照组)进行配对。两组患者均在接受积极牙周治疗和/或种植治疗后(T1)(试验组 69 个种植体,对照组 76 个种植体)和 SPT 结束或支持性种植后治疗时(T2)进行检查。评估了两组在种植体存活率(主要结局)、平均边缘骨丧失(MBL)和牙周袋探诊深度(PPD)(次要结局)方面的差异。
试验组 5 年的种植体存活率为 97.1%,对照组为 97.4%(p=0.562)。MBL 差异显著(试验组 18.7±18.2%;对照组 12.5±21.3%)(p<0.05)。两组在 T2 时 PPD 均增加(试验组:T1 为 3.4±1.0mm;T2 为 4.2±1.6mm;对照组:T1 为 1.0±1.2mm;T2 为 2.9±0.8mm;组间差异有统计学意义,p<0.05)。T1 时存在≥4mm 的残余牙周袋(OR 1.90)、骨高度(OR 1.81)和年龄(OR 1.16)是种植体丢失的预测因素。
在种植体存活率方面,牙周炎患者与牙周健康患者之间无差异。然而,与牙周健康患者相比,患有牙周炎病史的患者 MBL 和 PPD 更高。
有良好的牙周维护计划和先前成功的积极牙周治疗似乎是慢性牙周炎患者成功进行种植体治疗不可或缺的组成部分。