Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus, Haifa, Israel.
Periocenter Ltd., Haifa, Israel.
Clin Exp Dent Res. 2020 Aug;6(4):478-485. doi: 10.1002/cre2.286. Epub 2020 Mar 17.
The study's aim was to assess the clinical outcome 6 and 12 months after a nonsurgical treatment of peri-implantitis per se or in conjunction with a combination of local antiseptic and anti-inflammatory treatment.
Included were 69 patients with periodontitis, with 106 implants, diagnosed with peri-implantitis. Peri-implantitis was defined as radiographic bone loss ≥3 mm, probing depth (PD) ≥ 6 mm, with bleeding on probing. Group M peri-implantitis was treated with ultrasonic debridement and soft tissue curettage. Group P had additional implant surface treatment with rotatory hand piece composed of chitosan bristle, soft tissue curettage combined with application of 0.95% hypochlorite and 1 mg minocycline HCl.
After 6 months, both groups demonstrated significant reduction of mean plaque index, PD, and clinical attachment level (0.71 ± 0.57, 0.81 ± 0.55; 4.77 ± 0.73 mm, 4.42 ± 0.5 mm; 5.03 ± 0.86 mm, 5.13 ± 0.73 mm; respectively) and bleeding on probing. After 6 and 12 months, group P showed significantly better PD results compared to group M. The bleeding was significantly less in group P after 12 months (15.3% ± 6.2, 25.1% ± 8.2, respectively).
Adjunctive treatment with local antiseptic and anti-inflammatories during mechanical phase was positively associated with inflammation reduction and connective tissue reattachment.
本研究旨在评估单纯非手术治疗或联合局部抗菌和抗炎治疗对种植体周围炎的临床疗效，评估时间为治疗后 6 个月和 12 个月。
纳入 69 名患有牙周炎、106 个种植体、诊断为种植体周围炎的患者。种植体周围炎的定义为影像学骨丧失≥3mm，探诊深度（PD）≥6mm，探诊出血。M 组种植体周围炎采用超声清创和软组织刮治治疗。P 组采用壳聚糖毛刷旋转器械进行种植体表面处理，同时联合应用 0.95%次氯酸钠和 1mg 盐酸米诺环素。
治疗后 6 个月，两组菌斑指数、PD 和临床附着水平均显著降低（0.71±0.57、0.81±0.55；4.77±0.73mm、4.42±0.50mm；5.03±0.86mm、5.13±0.73mm），探诊出血也显著减少。治疗后 6 个月和 12 个月，P 组 PD 结果显著优于 M 组。治疗后 12 个月，P 组探诊出血明显减少（15.3%±6.2、25.1%±8.2）。
在机械治疗阶段联合使用局部抗菌和抗炎药物有助于减轻炎症和促进结缔组织附着。
