Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain.
Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
J Periodontol. 2021 Mar;92(3):389-399. doi: 10.1002/JPER.20-0193. Epub 2020 Aug 18.
Dental plaque biofilm is considered to be the underlying cause of peri-implant diseases. Moreover, it has been corroborated recently the association between the presence of these diseases and deficiently designed implant-supported prostheses. In this regard, professional-administered oral hygiene measures have been suggested to play a dominant role in prevention.
A cross-sectional study was conducted in dental implant patients according to accessibility for self-performed oral hygiene using a 0.5 mm interproximal brush. Periodontal and peri-implant status were assessed based on clinical and radiographic variables to determine the prevalence of peri-implant diseases. In addition, the participants completed a questionnaire on the efficiency and accessibility for self-performed proximal hygiene. Associations of descriptive data were analyzed using the chi-squared test and Mann-Whitney U-test. Correlations of the variables with the primary outcome (accessibility) were assessed by means of generalized estimation equations and multilevel logistic regression models.
Based on an a priori power calculation, a total of 50 patients (171 implants) were consecutively recruited. From these, 46% of the prostheses allowed proper access for performing proximal hygiene whereas 54% of the prostheses precluded proper access. Poor access for proximal hygiene displayed tendency towards statistical significance with peri-implant disease (OR = 2.31; P = 0.090), in particular with peri-implant mucositis (OR = 2.43; P = 0.082) when compared to good access. In addition, an association was observed to increased levels of mucosal redness (P = 0.026) and the full-mouth bleeding score (P = 0.018). On the other hand, the presence of peri-implant disease was related to self-reported assessment of oral hygiene measures (P = 0.015) and to patient perception of gingival/mucosal bleeding when performing oral hygiene (P = 0.026). In turn, the diagnosis of peri-implant disease was significantly associated to the quantity and quality of information provided at the time of implant therapy (P = 0.004), including the influence of confounders upon disease occurrence (P = 0.038) CONCLUSIONS: To a certain extent, accessibility for self-performed proximal hygiene is associated to the peri-implant condition. On the other hand, the information received by the patient from the dental professional is essential for self-monitoring of the peri-implant conditions and for alerting to the possible presence of disorders.
牙菌斑生物膜被认为是引发种植体周围疾病的根本原因。此外，最近有研究证实，这些疾病的发生与设计不当的种植体支持的修复体有关。在这方面，专业的口腔卫生措施已被建议在预防中发挥主导作用。
根据可及性，对接受种植治疗的患者进行了一项横断面研究，以进行自我实施的口腔卫生（使用 0.5 毫米的邻间牙刷）。根据临床和影像学变量评估牙周和种植体周围状况，以确定种植体周围疾病的患病率。此外，参与者完成了一份关于自我实施近中清洁效率和可及性的问卷。使用卡方检验和曼-惠特尼 U 检验分析描述性数据的相关性。通过广义估计方程和多水平逻辑回归模型评估变量与主要结果（可及性）的相关性。
基于事先计算的功效，连续招募了 50 名患者（171 个种植体）。其中，46%的修复体允许进行近中清洁，而 54%的修复体则不允许进行近中清洁。较差的近中清洁可及性与种植体周围疾病呈统计学趋势（OR=2.31；P=0.090），尤其是与种植体周围黏膜炎（OR=2.43；P=0.082）相比，当与良好的可及性相比时。此外，还观察到黏膜发红（P=0.026）和全口出血评分（P=0.018）增加与较差的近中清洁可及性有关。另一方面，种植体周围疾病与自我报告的口腔卫生措施评估（P=0.015）以及患者在进行口腔卫生时对牙龈/黏膜出血的感知（P=0.026）有关。反过来，种植体周围疾病的诊断与种植治疗时提供的信息量和质量显著相关（P=0.004），包括疾病发生时的混杂因素的影响（P=0.038）。
在一定程度上，自我实施近中清洁的可及性与种植体周围状况有关。另一方面，患者从牙科专业人员那里获得的信息对于自我监测种植体周围状况以及提醒可能存在的疾病至关重要。
