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种植体周围炎的非增强技术外科治疗。

Surgical Treatment of Periimplantitis With Non-Augmentative Techniques.

机构信息

Private Practice, Hameln, Germany.

Head, Department of Periodontology, Private Dental Clinic Schloss Schellenstein, Olsberg, Germany.

出版信息

Implant Dent. 2019 Apr;28(2):177-186. doi: 10.1097/ID.0000000000000838.

DOI:10.1097/ID.0000000000000838
PMID:30475243
Abstract

OBJECTIVES

The aim of this review was to systematically screen the literature on surgical non-regenerative treatments of periimplantitis, especially for radiologic and clinical outcomes, and to determine predictable therapeutic options for the clinical management of periimplantitis lesions.

MATERIAL AND METHODS

The potentially relevant literature was assessed independently by 2 reviewers to identify clinical studies, trials, and case series in humans describing the surgical non-regenerative treatment outcomes of periimplantitis with a follow-up of at least 6 months. MEDLINE, EMBASE, and the Cochrane Library were searched for studies reporting changes in probing depth (PD) and/or bleeding on probing (BOP) and/or radiologic marginal bone-level changes.

RESULTS

A total of 10 publications were included: 6 prospective randomized controlled trials, 1 prospective cohort study, 2 retrospective controlled studies, and 1 case series. Clinical parameters can be reduced by surgical non-regenerative treatments. Concerning 3 year follow-ups, BOP and PD values decreased more efficiently after implantoplasty than using systematic administration of antibacterials. Adjunctive local chemical irrigations or diode laser have no long-term effects. The non-regenerative surgical approach in combination with implantoplasty also shows improved radiographic parameters.

CONCLUSIONS

Surgical non-regenerative treatment of periimplantitis can reduce the amount of inflammation in the short-term follow-up. Using implantoplasty may result in the improvement of clinical and radiographic parameters. Because of limited evidence and heterogeneity in study design, there is a need for randomized controlled studies with proper design and powerful sample size in the future.

摘要

目的

本综述的目的是系统筛选关于种植体周围炎的非再生性手术治疗的文献,特别是影像学和临床结果,并确定可预测的治疗选择,以临床管理种植体周围炎病变。

材料与方法

两名评审员独立评估潜在相关文献,以确定描述非再生性手术治疗种植体周围炎的临床研究、试验和病例系列研究,随访时间至少为 6 个月。检索 MEDLINE、EMBASE 和 Cochrane 图书馆,以报告探测深度(PD)和/或探诊出血(BOP)和/或影像学边缘骨水平变化的研究。

结果

共纳入 10 项研究:6 项前瞻性随机对照试验、1 项前瞻性队列研究、2 项回顾性对照研究和 1 项病例系列研究。非再生性手术治疗可减少临床参数。在 3 年随访中,与系统使用抗菌药物相比,使用种植体成形术可更有效地降低 BOP 和 PD 值。辅助局部化学冲洗或二极管激光没有长期效果。非再生性手术方法结合种植体成形术也显示出改善的影像学参数。

结论

种植体周围炎的非再生性手术治疗可在短期内减少炎症程度。使用种植体成形术可能会改善临床和影像学参数。由于研究设计的证据有限且存在异质性,未来需要进行设计合理、样本量大的随机对照研究。

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