Oral Surgery Unit, Department of Oral and Maxillo-Facial Sciences, 'Sapienza' University of Rome, Via Caserta 6, 00161, Rome, Italy.
Private Practice, Rome, Italy.
Clin Oral Investig. 2021 Jul;25(7):4553-4561. doi: 10.1007/s00784-020-03769-5. Epub 2021 Jan 14.
The aims of this retrospective study were to report data on the prevalence of retrograde peri-implantitis (RPI) in a single-center in a 20-year observation period and to evaluate implant survival after surgical treatment.
A retrospective cohort study was conducted screening all patients who underwent implant treatment in a private practice. Patients were enrolled if they had one or more implants showing a radiolucency around the implant apex, without implant mobility. Furthermore, clinical symptoms of RPI and days from symptoms' appearance after implant placement were also collected, as well as periodontal and endodontic status of nearby teeth. All patients were treated with the same surgical approach: antibiotic therapy, mechanical curettage, chemical decontamination and xenograft application.
Out of the 1749 implants placed, only 6 implants were classified as affected by RPI, with a prevalence of 0.34%. Clinical symptoms of RPI (pain, swelling, dull percussion or fistula presence) varied among patients and were reported after a mean period of 51.83 ± 52.43 days.
RPI was successfully treated with surgical curettage and bone substitute application and all implants are still in place after a mean follow-up of 8.83 ± 5.34 years.
Bacteria from teeth with failed endodontic treatment or residual lesions might be reactivated by drilling for implant osteotomy, with subsequent colonization of the implant apex and possible failure before prosthetic loading. Therefore, it might be recommended to take a periapical x-ray at implant placement and after 6-8 weeks in order to intercept RPI before prostheses delivery.
本回顾性研究的目的是报告在单中心 20 年观察期内逆行性种植体周围炎（RPI）的患病率，并评估手术治疗后的种植体存活率。
对一家私人诊所进行了一项回顾性队列研究，筛选所有接受种植体治疗的患者。如果患者有一个或多个种植体在种植体根尖周围出现放射性透光区，且无种植体活动，则将其纳入研究。此外，还收集了 RPI 的临床症状以及从种植体放置到症状出现的天数，以及附近牙齿的牙周和牙髓状况。所有患者均采用相同的手术方法治疗：抗生素治疗、机械刮治、化学去污和异种移植物应用。
在 1749 个植入物中，只有 6 个被归类为 RPI 受累，患病率为 0.34%。RPI 的临床症状（疼痛、肿胀、钝击痛或瘘管存在）在患者之间有所不同，报告时间平均为 51.83±52.43 天。
通过手术刮治和骨替代物应用成功治疗了 RPI，所有植入物在平均 8.83±5.34 年的随访后仍在位。
来自失败的牙髓治疗或残留病变的细菌可能会在种植体骨切开术中被重新激活，随后种植体根尖定植并在修复体加载前可能发生失败。因此，建议在种植体放置时和 6-8 周后拍摄根尖片，以便在假体交付前截获 RPI。
