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种植体周围病的流行率及风险/保护因素:一项以大学为代表的横断面研究。

Prevalence and risk/protective indicators of peri-implant diseases: A university-representative cross-sectional study.

机构信息

Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain.

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

出版信息

Clin Oral Implants Res. 2021 Jan;32(1):112-122. doi: 10.1111/clr.13684. Epub 2020 Dec 29.

Abstract

AIM

To evaluate the prevalence of peri-implant diseases and to identify risk/protective indicators of peri-implantitis.

MATERIALS AND METHODS

Two hundred and forty randomly selected patients from a university clinic database were invited to participate. Those who accepted, once data from their medical and dental history were collected, were examined clinically and radiographically to assess the prevalence of peri-implant health and diseases. Peri-implantitis was defined as the presence of BoP/SoP together with radiographic bone levels (BL) ≧2 mm. An intermediate peri-implant health category between peri-implant mucositis and peri-implantitis was also identified, defined by the presence of BoP/SoP together with 1 mm ≦BL < 2 mm. A multilevel multivariate logistic regression analysis was carried out to identify those factors associated either positively (risk) or negatively (protective) with peri-implantitis.

RESULTS

Ninety-nine patients with a total of 458 dental implants were analyzed. The prevalences of pre-periimplantitis and of peri-implantitis were, respectively, 31.3% and 56.6% at patient-level, while 31.7% and 27.9% at implant level. The following factors were identified as risk indicators for peri-implantitis: smoking (OR = 3.59; 95% CI: 1.52-8.45), moderate/severe periodontitis (OR = 2.77; 95% CI: 1.20-6.36), <16 remaining teeth (OR = 2.23; 95% CI: 1.05-4.73), plaque (OR = 3.49; 95% CI: 1.13-10.75), implant malposition (too vestibular: OR = 2.85; 95% CI: 1.17-6.93), implant brand (Nobel vs. Straumann: OR = 4.41;95% CI: 1.76-11.09), restoration type (bridge vs. single crown: OR = 2.47; 95% CI: 1.19-5.12), and trauma as reason of tooth loss (vs. caries: OR = 6.51; 95% CI: 1.45-29.26). Conversely, the following factors were identified as protective indicators: interproximal flossing/brushing (OR = 0.27; 95% CI: 0.11-0.68), proton pump inhibitors (OR = 0.08; 95% CI: 0.01-0.90), and anticoagulants (OR = 0.08; 95% CI: 0.01-0.56).

CONCLUSIONS

Peri-implant diseases are highly prevalent among patients with dental implants in this university-based population. Several factors were identified as risk- and protective- indicators of peri-implantitis.

摘要

目的

评估种植体周围疾病的流行情况,并确定种植体周围炎的风险/保护指标。

材料和方法

从一所大学诊所数据库中随机选择 240 名患者邀请参加。接受邀请的患者,一旦收集了他们的医疗和牙科病史数据,就会进行临床和影像学检查,以评估种植体周围健康和疾病的流行情况。种植体周围炎被定义为探诊出血/探诊溢脓(BoP/SoP)伴影像学骨水平(BL)≧2mm。还确定了一种介于种植体周围黏膜炎和种植体周围炎之间的中间种植体周围健康类别,其定义为 BoP/SoP 伴 1mm≦BL<2mm。进行了多水平多变量逻辑回归分析,以确定与种植体周围炎呈正相关(风险)或负相关(保护)的因素。

结果

分析了 99 名患者共 458 颗种植牙。在患者水平,种植体周围炎前和种植体周围炎的患病率分别为 31.3%和 56.6%,而在种植体水平分别为 31.7%和 27.9%。以下因素被确定为种植体周围炎的风险指标:吸烟(OR=3.59;95%CI:1.52-8.45)、中重度牙周炎(OR=2.77;95%CI:1.20-6.36)、剩余牙齿数<16 颗(OR=2.23;95%CI:1.05-4.73)、菌斑(OR=3.49;95%CI:1.13-10.75)、种植体位置不当(过度向颊侧:OR=2.85;95%CI:1.17-6.93)、种植体品牌(Nobel 与 Straumann:OR=4.41;95%CI:1.76-11.09)、修复类型(桥体与单冠:OR=2.47;95%CI:1.19-5.12)和因外伤导致牙齿缺失(与龋齿:OR=6.51;95%CI:1.45-29.26)。相反,以下因素被确定为保护指标:邻间牙线/牙刷(OR=0.27;95%CI:0.11-0.68)、质子泵抑制剂(OR=0.08;95%CI:0.01-0.90)和抗凝剂(OR=0.08;95%CI:0.01-0.56)。

结论

在这所基于大学的人群中,种植体周围疾病在种植体患者中非常普遍。确定了一些因素作为种植体周围炎的风险和保护指标。

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