薄牙龈表型和角化黏膜宽度不足（<2mm）作为种植体周围炎和种植体周围黏膜炎的风险指标的作用。
Role of thin gingival phenotype and inadequate keratinized mucosa width (<2 mm) as risk indicators for peri-implantitis and peri-implant mucositis.
机构信息
Department of Periodontics, University of Washington School of Dentistry, Seattle, WA, USA.
Division of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA, USA.
出版信息
J Periodontol. 2021 Dec;92(12):1687-1696. doi: 10.1002/JPER.20-0792. Epub 2021 May 2.
BACKGROUND
There is growing evidence on the impact of thin gingival phenotype (TnP) and inadequate keratinized mucosa width (KMW <2 mm) around dental implants on peri-implant health. This study investigated the role of TnP and inadequate KMW (<2 mm) as risk indicators for peri-implantitis and mucositis and on dental patient-reported outcomes.
METHODS
Sixty-three patients with 193 implants (mean follow-up of 6.9 ± 3.7 years) were given a clinical and radiographic examination and a questionnaire to assess patient awareness of food impaction and pain/discomfort. Chi-squared tests and regression analysis for clustered data were used to compare outcomes.
RESULTS
Implants with TnP had a statistically higher prevalence of peri-implantitis (27.1% versus 11.3%; PR, 3.32; 95% confidence interval (CI), 1.64-6.72; P = 0.001) peri-implant mucositis (42.7% versus 33%; PR, 1.8; 95% CI, 1.12-2.9; P = 0.016) and pain/discomfort during oral hygiene (25% versus 5%; PR, 3.7; 95% CI, 1.06-12.96; P = 0.044) than thick phenotype. Implants with inadequate KMW had a statistically higher prevalence of peri-implantitis (24.1% versus 17%; PR, 1.87; 95% CI, 1.07-3.25; P = 0.027) and peri-implant mucositis (46.6% versus 34.1%; PR, 1.53; 95% CI, 1-2.33; P = 0.05) and pain/discomfort during oral hygiene (28% versus 10%; PR, 2.37; 95% CI, 1.1-5.1; P = 0.027) than the adequate KMW. TnP was strongly associated with inadequate KMW (PR = 3.18; 95% CI, 1.69-6.04; P <0.001).
CONCLUSION
TnP and inadequate KMW (<2 mm) may be significant risk indicators for peri-implant disease and pain/discomfort during brushing.
背景
越来越多的证据表明，薄牙龈表型（TnP）和种植体周围角化黏膜宽度不足（KMW<2mm）会影响种植体周围健康。本研究探讨了 TnP 和不足的 KMW<2mm 作为种植体周围炎和黏膜炎的风险指标，以及对患者口腔报告结局的影响。
方法
对 63 名患者的 193 个种植体（平均随访 6.9±3.7 年）进行临床和影像学检查，并进行问卷调查，以评估患者对食物嵌塞和疼痛/不适的认知。采用卡方检验和聚类数据回归分析比较结果。
结果
具有 TnP 的种植体发生种植体周围炎的患病率更高（27.1% vs. 11.3%；PR=3.32；95%CI：1.64-6.72；P=0.001），种植体周围黏膜炎（42.7% vs. 33%；PR=1.8；95%CI：1.12-2.9；P=0.016）和口腔卫生时的疼痛/不适（25% vs. 5%；PR=3.7；95%CI：1.06-12.96；P=0.044）的患病率高于厚型表型。KMW 不足的种植体发生种植体周围炎的患病率更高（24.1% vs. 17%；PR=1.87；95%CI：1.07-3.25；P=0.027），种植体周围黏膜炎（46.6% vs. 34.1%；PR=1.53；95%CI：1-2.33；P=0.05）和口腔卫生时的疼痛/不适（28% vs. 10%；PR=2.37；95%CI：1.1-5.1；P=0.027）的患病率高于 KMW 充足的种植体。TnP 与 KMW 不足呈强相关性（PR=3.18；95%CI：1.69-6.04；P<0.001）。
结论
TnP 和不足的 KMW<2mm 可能是种植体周围疾病和刷牙时疼痛/不适的重要风险指标。
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