Coli Pierluigi, Sennerby Lars
Edinburgh Dental Specialists, Edinburgh EH2 4BA, UK.
Department of Maxillofacial Surgery, University of Gothenburg, 413 90 Gothenburg, Sweden.
J Clin Med. 2019 Jul 29;8(8):1123. doi: 10.3390/jcm8081123.
Pocket probing depth (PPD) and bleeding on probing (BOP) measurements are useful indices for the assessment of periodontal conditions. The same periodontal indices are commonly recommended to evaluate the dental implant/tissue interface to identify sites with mucositis and peri-implantitis, which, if not treated, are anticipated to lead to implant failure. The aim of the present narrative review is to discuss the available literature on the effectiveness of probing at dental implants for identification of peri-implant pathology. There is substantial clinical evidence that PPD and BOP measurements are very poor indices of peri-implant tissue conditions and are questionable surrogate endpoints for implant failure. On the contrary, the literature suggests that frequent disturbance of the soft tissue barrier at implants may instead induce inflammation and bone resorption. Moreover, over-diagnosis and subsequent unnecessary treatment may lead to iatrogenic damage to the implant-tissue interface. Despite this, the recommendations from recent consensus meetings are still promoting the use of probing at dental implants. For evaluation of implants, for instance at annual check-ups, the present authors recommend a clinical examination that includes (i) a visual inspection of the peri-implant tissues for the assessment of oral hygiene and the detection of potential redness, swelling, (ii) palpation of the peri-implant tissues for assessment of the potential presence of swelling, bleeding, suppuration. In addition, (iii) radiography is recommended for the assessment of crestal bone level for comparison with previous radiographs to evaluate potential progressive bone loss even if there is a need for more scientific evidence of the true value of the first two clinical testing modes.
牙周袋探诊深度（PPD）和探诊出血（BOP）测量是评估牙周状况的有用指标。通常推荐使用相同的牙周指数来评估牙种植体/组织界面，以识别发生黏膜炎和种植体周围炎的部位，若不进行治疗，预计会导致种植失败。本叙述性综述的目的是讨论关于在牙种植体上进行探诊以识别种植体周围病变有效性的现有文献。有大量临床证据表明，PPD和BOP测量对于种植体周围组织状况而言是非常差的指标，并且作为种植失败的替代终点存在疑问。相反，文献表明，种植体处软组织屏障的频繁干扰反而可能诱发炎症和骨吸收。此外，过度诊断及随后不必要的治疗可能导致种植体 - 组织界面的医源性损伤。尽管如此，近期共识会议的建议仍在推动在牙种植体上进行探诊。例如，在年度检查时评估种植体，作者建议进行临床检查，包括：（i）对种植体周围组织进行视觉检查，以评估口腔卫生状况并检测潜在的发红、肿胀情况；（ii）触诊种植体周围组织，以评估是否存在潜在的肿胀、出血、化脓情况。此外，（iii）建议进行影像学检查以评估嵴顶骨水平，并与先前的X光片进行比较，以评估是否存在潜在的进行性骨丢失，即便前两种临床检测方式的真正价值还需要更多科学证据。
