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种植体周围炎的干预措施及其对进一步骨丧失的影响:基于注册队列的回顾性分析。

Interventions for peri-implantitis and their effects on further bone loss: A retrospective analysis of a registry-based cohort.

机构信息

Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.

Health Metrics, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.

出版信息

J Clin Periodontol. 2019 Aug;46(8):872-879. doi: 10.1111/jcpe.13129. Epub 2019 Jun 18.

Abstract

OBJECTIVE

The aim of the present study was to assess interventions and their consequences with regard to further bone loss at sites diagnosed with peri-implantitis.

MATERIALS AND METHODS

In 2017, records of 70 patients diagnosed with moderate/severe peri-implantitis at ≥1 implant sites 4 years earlier were obtained. Changes of marginal bone levels during the study period assessed on radiographs and predictors of disease progression were identified by Cox regression and mixed linear modelling. Patient files were analysed for professional interventions related to the treatment of peri-implantitis.

RESULTS

Mean bone loss (±SD) at implants diagnosed with moderate/severe peri-implantitis was 1.1 ± 2.0 mm over the observation period of 3.3 years. While non-surgical measures including submucosal and/or supra-mucosal cleaning of implants were provided to almost all patients, surgical treatment of peri-implantitis was limited to a subgroup (17 subjects). Surgically treated implant sites demonstrated a mean bone loss of 1.4 ± 2.4 mm prior to surgical intervention, while only minor changes (0.2 ± 1.0 mm) occurred after therapy. Clinical parameters (bleeding/suppuration on probing and probing depth) assessed at diagnosis were statistically significant predictors of disease progression.

CONCLUSIONS

Non-surgical procedures were insufficient to prevent further bone loss at implant sites affected by moderate/severe peri-implantitis. Surgical treatment of peri-implantitis markedly diminished the progression of bone loss. Clinical assessments of bleeding on probing and probing depth at diagnosis predicted further bone loss.

摘要

目的

本研究旨在评估针对诊断为种植体周围炎的部位进一步骨丢失的干预措施及其后果。

材料和方法

2017 年,获取了 70 名在 4 年前至少有 1 个种植体部位被诊断为中重度种植体周围炎的患者的记录。通过 Cox 回归和混合线性模型,确定了研究期间在影像学上评估的边缘骨水平变化和疾病进展的预测因素。对患者的病历进行了分析,以确定与种植体周围炎治疗相关的专业干预措施。

结果

在 3.3 年的观察期内,被诊断为中重度种植体周围炎的种植体的平均骨丢失(±SD)为 1.1±2.0mm。虽然几乎所有患者都接受了包括种植体黏膜下和/或黏膜上清洁在内的非手术治疗,但种植体周围炎的手术治疗仅限于一个亚组(17 名患者)。接受手术治疗的种植体部位在手术干预前的平均骨丢失为 1.4±2.4mm,而治疗后仅发生了较小的变化(0.2±1.0mm)。在诊断时评估的临床参数(探诊时出血/溢脓和探诊深度)是疾病进展的统计学显著预测因素。

结论

非手术治疗不足以防止中重度种植体周围炎影响的种植体部位的进一步骨丢失。种植体周围炎的手术治疗显著减少了骨丢失的进展。诊断时探诊出血和探诊深度的临床评估预测了进一步的骨丢失。

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