化脓作为种植体周围炎的诊断标准。

Suppuration as diagnostic criterium of peri-implantitis.

机构信息

Department of Periodontology, School of Dental Medicine, University of Michigan, Ann Arbor, Michigan, USA.

Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain.

出版信息

J Periodontol. 2021 Feb;92(2):216-224. doi: 10.1002/JPER.20-0159. Epub 2020 Aug 21.

DOI:10.1002/JPER.20-0159

PMID:32729628

Abstract

BACKGROUND

Suppuration (SUP) as a diagnostic parameter for monitoring dental implants is not yet well understood. The retrospective clinical and radiographic study was therefore performed to investigate the patient, implant, and site characteristics among individuals exhibiting SUP.

METHODS

Demographic characteristics and clinical parameters were recorded. Radiographic features were analyzed using cone-beam computed tomography. Peri-implantitis was defined based on the consensus report of Workgroup 4 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions: probing depth (PD) ≥6 mm, presence of bleeding and/or SUP on gentle probing, and radiographic marginal bone loss (MBL) ≥3 mm. SUP was graded according to profuseness (dot versus line/drop) and time after probing (≥15 seconds versus <15 seconds after probing versus spontaneous). Simple binary logistic regression models were estimated using generalized estimation equations to explain the probability of SUP based on demographic, clinical, and radiographic variables.

RESULTS

A total of 111 eligible patients (n = 501) were assessed. Of them, 57 (n = 334) were diagnosed with peri-implantitis according to the established case definition, and of these individuals, 31 (n = 96) presented SUP. Therefore, the prevalence of SUP was 27.92% in the total sample size and 54.38% in peri-implantitis patients. Overall, 28.74% implants displayed SUP within patients with peri-implantitis. SUP was more frequently found at buccal sites (51%) and proved less prevalent at mesio-lingual sites (16.7%). Defect morphology (OR = 6.59; P = 0.004), PD (OR = 1.63; P = 0.024), and MBL (OR = 1.35; P = 0.010) were significantly associated with the presence of SUP. Likewise, defect morphology (P = 0.02), PD (P = 0.003), and MBL (P = 0.01) were significantly correlated with the grade of SUP.

CONCLUSION

The presence and grade of SUP are associated with peri-implant bone loss, probing depth, and defect morphology in patients with peri-implantitis.

摘要

背景

化脓（SUP）作为监测牙种植体的诊断参数尚不完全清楚。因此，进行了这项回顾性临床和放射学研究，以调查表现出 SUP 的个体的患者、植入物和部位特征。

方法

记录人口统计学特征和临床参数。使用锥形束计算机断层扫描分析放射学特征。根据 2017 年牙周病和种植体疾病与状况分类世界工作会议第 4 工作组的共识报告，将种植体周围炎定义为探诊深度（PD）≥6mm、探诊时出血和/或有 SUP 以及放射状边缘骨丧失（MBL）≥3mm。根据丰富度（点状与线状/滴状）和探诊后时间（探诊后≥15 秒与<15 秒与自发性）对 SUP 进行分级。使用广义估计方程估计简单二元逻辑回归模型，根据人口统计学、临床和放射学变量解释 SUP 的概率。

结果

共评估了 111 名符合条件的患者（n=501）。其中，57 名（n=334）根据既定的病例定义被诊断为种植体周围炎，其中 31 名（n=96）表现出 SUP。因此，在总样本量中，SUP 的患病率为 27.92%，在种植体周围炎患者中为 54.38%。总体而言，在患有种植体周围炎的患者中，28.74%的种植体显示出 SUP。SUP 更常见于颊侧部位（51%），而在近中舌侧部位则较少见（16.7%）。缺损形态（OR=6.59；P=0.004）、PD（OR=1.63；P=0.024）和 MBL（OR=1.35；P=0.010）与 SUP 的存在显著相关。同样，缺损形态（P=0.02）、PD（P=0.003）和 MBL（P=0.01）与 SUP 的程度显著相关。