Canullo Luigi, Peñarrocha Miguel, Monje Alberto, Catena Andres, Wang Hom-Lay, Peñarrocha David
Int J Oral Maxillofac Implants. 2017 Sep/Oct;32(5):1054-1064. doi: 10.11607/jomi.6043.
The correlation between associated local factors and peri-implantitis remains unknown. The aim of this study was to investigate the association between the clinical and microbiologic profiles and peri-implantitis to eventually categorize different groups of this disease.
Subjects with at least one implant presenting signs of peri-implantitis were selected. The clinical, radiographic, occlusal, and microbiologic profiles of these infected implants were collected. Cases were classified into five peri-implantitis groups according to potential disease-triggering factors: surgically, prosthetically, biomechanically, purely plaque-associated, and a combination of them. Generalized estimating equations models were used to study differences among the potential risk factors. Cluster analyses were applied to investigate the correlation between clinical and microbiologic profiles and diseased implant samples.
Overall, 110 diseased and 121 healthy implants were included. The biomechanically associated group showed higher levels of microbiologic contamination inside the connection; however, the plaque-associated group had a higher level of microbial variety in the peri-implant sulcus. Cluster analyses demonstrated a significant ability to predict the associated factor of peri-implantitis. Moreover, radiographic marginal bone loss and implant width demonstrated the largest influence on the model.
While peri-implantitis represents a plaque-induced inflammatory condition, certain local factors might be associated with this biologic complication, as they imply plaque retention. Therefore, disease classification could be further implemented with the associated surgical, prosthetic, and biomechanical factors to better target the etiology.
相关局部因素与种植体周围炎之间的相关性尚不清楚。本研究的目的是调查临床和微生物学特征与种植体周围炎之间的关联，最终对该疾病的不同组进行分类。
选择至少有一颗种植体出现种植体周围炎迹象的受试者。收集这些感染种植体的临床、影像学、咬合和微生物学特征。根据潜在的疾病触发因素，病例被分为五个种植体周围炎组：手术相关、修复相关、生物力学相关、单纯菌斑相关以及它们的组合。使用广义估计方程模型研究潜在风险因素之间的差异。应用聚类分析来研究临床和微生物学特征与患病种植体样本之间的相关性。
总体而言，纳入了110颗患病种植体和121颗健康种植体。生物力学相关组在连接部位内部显示出更高水平的微生物污染；然而，菌斑相关组在种植体周围沟中的微生物种类水平更高。聚类分析显示出显著的预测种植体周围炎相关因素的能力。此外，影像学边缘骨吸收和种植体宽度对模型的影响最大。
虽然种植体周围炎是一种由菌斑引起的炎症状态，但某些局部因素可能与这种生物学并发症有关，因为它们意味着菌斑的滞留。因此，可以进一步结合相关的手术、修复和生物力学因素进行疾病分类，以更好地针对病因。
