Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain.
Department of Oral and Maxillofacial Surgery, Universitat Internacional de Catalunya, Barcelona, Spain.
Clin Implant Dent Relat Res. 2021 Jun;23(3):432-443. doi: 10.1111/cid.13004. Epub 2021 May 4.
The current evidence regarding the alterations experienced by the alveolar ridge (hard tissue changes) after implant removal due to peri-implantitis is limited.
To assess the hard tissue dimensional changes following implant removal due to peri-implantitis.
Clinical records were examined to identify patients with implants that had to be removed due to a hopeless prognosis secondary to peri-implantitis due to expendability of peri-implantitis implants for functional reasons. Patients with preoperative and postoperative cone-beam computed tomography (CBCT) scans were included. Patient-related, implant-related, and surgery-related factors were assessed based on the clinical records. Linear measurements were made to evaluate the influence of bone plate thickness (BPT), ridge width (RW), and ridge height (RH) at various levels upon the outcome of implant removal. A descriptive statistical analysis of the quantitative and qualitative variables was performed. Correlations of the variables with the primary outcome (dimensional changes) were tested using univariate and multivariate analyses (multinomial random intercept mixed model linear regressions).
A total of 26 patients (n = 79) met the eligibility criteria. The mean decrease in RW at 1 and 3 mm below the crest was 11.3% and 4.4%, respectively (P < 0.001). Buccal and lingual RH was significantly reduced by 2.2% and 6.3%, respectively (P < 0.001). Few patient-related, implant-related, and surgery-related factors appeared to have an impact upon the hard tissue dimensional changes. Bone regeneration simultaneous to implant removal minimized the dimensional changes of the ridge both vertically (5% lesser buccal RH reduction) and horizontally (12% lesser RW reduction) when compared with spontaneous healing. The use of a reverse-torque removal kit seemed to be critical in limiting the dimensional changes of the ridge.
Minimal hard tissue changes can be expected following implant removal due to peri-implantitis. Simultaneous bone regeneration procedures and the use of a removal kit may considerably reduce the impact upon the dimensional changes (NCT04534361).
目前，有关由于种植体周围炎导致种植体去除后牙槽嵴（硬组织变化）所经历的改变的证据有限。
评估由于种植体周围炎导致种植体去除后硬组织的三维变化。
通过检查临床记录，确定了因种植体周围炎导致种植体预后不佳而必须去除的患者，这是由于种植体周围炎导致种植体丧失功能而需要去除。纳入了术前和术后锥形束计算机断层扫描（CBCT）扫描的患者。根据临床记录评估了与患者、种植体和手术相关的因素。进行线性测量以评估骨板厚度（BPT）、牙槽嵴宽度（RW）和牙槽嵴高度（RH）在不同水平对种植体去除结果的影响。对定量和定性变量进行描述性统计分析。使用单变量和多变量分析（多项随机截距混合模型线性回归）测试变量与主要结果（尺寸变化）的相关性。
共有 26 名患者（n=79）符合入选标准。嵴顶下 1 和 3 mm 处 RW 的平均减少量分别为 11.3%和 4.4%（P<0.001）。颊侧和舌侧 RH 分别显著减少了 2.2%和 6.3%（P<0.001）。少数患者相关、种植体相关和手术相关因素似乎对硬组织尺寸变化有影响。与自发愈合相比，同时进行骨再生可最大限度地减少种植体去除后嵴的垂直（颊侧 RH 减少 5%）和水平（RW 减少 12%）尺寸变化。使用反向扭矩移除套件似乎对于限制嵴的尺寸变化至关重要。
由于种植体周围炎导致种植体去除后，预计硬组织会发生微小变化。同时进行骨再生程序和使用移除套件可以大大减少对尺寸变化的影响（NCT04534361）。
