Department of Oral Implants, School of Stomatology, State Key Laboratory of Military Stomatology, The Fourth Military Medical University, 145 West Changle Road, Xi'an, China.
Clin Implant Dent Relat Res. 2017 Aug;19(4):654-662. doi: 10.1111/cid.12503. Epub 2017 May 29.
The hypothesis of bacterial infection initiating marginal bone loss around dental implant in analogy with natural tooth is still in debate.
The aim of this retrospective study was to investigate the effects of uncontrolled periodontitis on marginal bone alterations around implants compared with the periodontal health group at a mean follow-up of at least 6 years.
Thirty consecutive uncontrolled periodontally compromised patients (PCP) and 30 periodontally healthy patients (PHP), with a total of 96 Straumann implants (PCP = 55, PHP = 41) were matched for age, gender, smoking, and implant characteristics. The inclusion criteria for PCPs were continuing tooth loss due to uncontrolled periodontal disease and no supportive periodontal maintenance after implant therapy. Peri-implant conditions were examined and the number of teeth lost during the follow-up periods was recorded in both groups. Radiographic marginal bone loss of implants and adjacent teeth was calculated having the restoration time point as baseline.
No implant loss occurred in both groups. The mean number of teeth lost during the follow-up periods was 0.67 ± 0.80 in the PHP group, 3.93 ± 2.36 in the PCP group with statistical significance. The average overall bone loss was significantly greater at teeth than that around implants in the PCP group (0.54 ± 0.27 versus 0.22 ± 0.25 mm, P < .001), while no statistically significant differences were observed in the PHP group (0.18 ± 0.08 versus 0.22 ± 0.18 mm, P = .317). No statistically significant differences were observed between PC and PH patients when comparing the peri-implant marginal bone loss. No significant correlations were found between teeth loss and crestal bone loss at implants sites in both groups.
This study indicated that the marginal bone level around implants seemed more stable in comparison to that around the natural teeth when exposed to uncontrolled periodontal disease.
细菌感染引发种植牙周围边缘骨丧失的假说与天然牙类似，目前仍存在争议。
本回顾性研究旨在比较 6 年以上的牙周健康组和未经控制的牙周炎组，探讨未经控制的牙周炎对种植体周围边缘骨改变的影响。
选择 30 例未经控制的牙周炎患者（PCP）和 30 例牙周健康患者（PHP）作为研究对象，每组各有 96 例 Straumann 种植体（PCP 组：55 例，PHP 组：41 例）。PCP 组纳入标准为患有牙周病且无法控制，种植体治疗后未进行牙周维护，导致牙齿不断缺失。对两组患者的种植体和邻牙进行了牙周检查，并记录了随访期间的牙齿缺失数量。以修复开始时为基线，计算种植体和邻牙的边缘骨丧失量。
两组均未发生种植体丢失。在 PHP 组，随访期间平均失牙数为 0.67±0.80 颗，PCP 组为 3.93±2.36 颗，差异具有统计学意义。PCP 组邻牙的总体平均骨丢失量明显大于种植体（0.54±0.27 毫米比 0.22±0.25 毫米，P<0.001），而 PHP 组差异无统计学意义（0.18±0.08 毫米比 0.22±0.18 毫米，P=0.317）。比较两组患者的种植体周围边缘骨丧失量，PC 和 PH 患者之间差异无统计学意义。两组患者的牙齿缺失量与种植体周围牙槽骨丧失量之间均无显著相关性。
本研究表明，与天然牙相比，在暴露于未经控制的牙周病时，种植体周围的边缘骨水平似乎更稳定。
