Restorative Dentistry, National Dental Centre Singapore, Singapore, Singapore.
National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore, Singapore.
Clin Oral Implants Res. 2020 Aug;31(8):727-736. doi: 10.1111/clr.13621. Epub 2020 Jul 6.
To investigate the effect of defined versus undefined periodontal maintenance after implant therapy on the prevalence of peri-implant complications.
Two hundred patients who underwent dental implant therapy in the National Dental Centre Singapore (NDCS) from 2005 to 2012 were recruited. One hundred patients had regular periodontal maintenance (defined maintenance programme group, DMP), and the other 100 patients had no documentation of periodontal maintenance (undefined maintenance programme group, UMP). Full-mouth bleeding scores (FMBS), periodontal probing depths (PPD) and peri-implant probing depths (PiPD) were evaluated within 6 months of prostheses delivery (T ) and at re-examination (T ). Peri-implant bone level changes were analysed radiographically.
The mean follow-up time was 6.8 years. Five out of 289 implants were lost (cumulative survival rate = 98.3%). 6.0% of DMP patients and 20.0% of UMP patients had peri-implantitis (p = .003). Peri-implantitis was defined as bleeding on probing, increase in PiPD and peri-implant bone loss ≥ 0.5 mm. At the implant level, 4.0% of the DMP group implants and 17.2% of the UMP group implants were diagnosed with peri-implantitis (p = .0003). One implant in the DMP group and 13 implants in the UMP group had bone loss ≥ 2 mm (p < .0001). Multivariate regression showed that absence of regular maintenance (OR = 0.24, p = .003) was significantly associated with peri-implantitis.
Regular periodontal maintenance was associated with a lower prevalence of peri-implantitis and peri-implant bone loss. Patients with treated periodontitis without regular maintenance after implant placement were at higher risk for developing peri-implantitis.
研究种植治疗后定期和不定期牙周维护对种植体周围并发症发生率的影响。
本研究纳入了 2005 年至 2012 年在新加坡国立牙科中心接受牙种植治疗的 200 名患者。其中 100 名患者接受了定期牙周维护（定义性牙周维护方案组，DMP），另外 100 名患者未记录牙周维护情况（未定义性牙周维护方案组，UMP）。在修复体交付后 6 个月内（T0）和复查时（T1），评估全口出血评分（FMBS）、牙周探诊深度（PPD）和种植体探诊深度（PiPD）。通过影像学分析种植体周围骨水平变化。
平均随访时间为 6.8 年。289 个种植体中有 5 个脱落（累积存活率为 98.3%）。DMP 组中有 6.0%的患者和 UMP 组中有 20.0%的患者患有种植体周围炎（p=0.003）。种植体周围炎的定义为探诊出血、PiPD 增加和种植体周围骨丧失≥0.5mm。在种植体水平上，DMP 组中有 4.0%的种植体和 UMP 组中有 17.2%的种植体被诊断为种植体周围炎（p=0.0003）。DMP 组中有 1 个种植体和 UMP 组中有 13 个种植体的骨丧失≥2mm（p<0.0001）。多变量回归显示，不定期的常规维护（OR=0.24，p=0.003）与种植体周围炎显著相关。
定期牙周维护与种植体周围炎和种植体周围骨丧失的发生率较低相关。种植体放置后治疗过的牙周炎患者，如果没有定期进行维护，发生种植体周围炎的风险更高。
