Faculty of Medicine and Health Sciences, School of Dental Medicine, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium.
Center for Periodontology and Implantology Leuven, Heverlee, Belgium.
Clin Implant Dent Relat Res. 2021 Jun;23(3):298-308. doi: 10.1111/cid.13000. Epub 2021 Jun 2.
To evaluate the effect of early bone loss (EBL), on long-term bone stability and future peri-implantitis development.
Patients referred for implant placement between 2005 and 2009 were consecutively treated and followed for 10 years. After 10 years, patients were invited for a scientific diagnostic visit to evaluate implant survival and bone loss. Bone level changes were compared with baseline. Non-parametric testing was performed in cross-tabs (Pearson Chi-square and Fishers's exact test). Kaplan-Meier-estimated survival curves were plotted for different thresholds for EBL at different timepoints. Generalized linear mixed models with binomial distribution and logit link for peri-implantitis were fitted. An adjusted logistic mixed model was made to evaluate peri-implantitis, in relation with smoking status, history of periodontitis, and EBL > 0.5 mm.
Four hundred and seven patients (mean age of 64.86 years [range 28-92, SD 10.11]), with 1482 implants, responded to the 10-year recall invitation. After an average follow-up time of 10.66 years (range 10-14, SD 0.87), implant survival was 94.74%. Mean crestal bone loss after 10 years was 0.81 mm (SD 1.58, range 0.00-17.00). One hundred and seventy five implants in 76 patients had peri-implantitis (11.8% on implant level, 18.7% on patient level). EBL of 0.5, 1, and 2 mm were significant predictors for peri-implantitis and implant loss after 10 years. Implants with EBL ≥0.5 mm during the first year of function showed a 5.43 times higher odds for future peri-implantitis development. Probability in developing peri-implantitis was 52.06% when smoking, Periodontal history and EBL of >0.5 mm was combined.
The present study suggests that EBL is a predictor for long-term peri-implant pathology, with a significant higher risk for peri-implantitis when early bone loss exceeds the thresholds of 0.5 and 1 mm, especially when additional risk factors such as smoking or susceptibility for periodontal disease prior to implant treatment are present. Clinical trial registration number B670201524796.
评估早期骨丢失（EBL）对长期骨稳定性和未来种植体周围炎发展的影响。
2005 年至 2009 年间连续就诊并接受治疗的患者被连续随访 10 年。10 年后，邀请患者进行科学的诊断访问，以评估种植体的存活率和骨量损失。将骨量变化与基线进行比较。使用交叉表（Pearson Chi-square 和 Fishers 确切检验）进行非参数检验。为不同时间点的 EBL 绘制不同阈值的 Kaplan-Meier 估计生存曲线。使用二项分布和对数链接的广义线性混合模型拟合种植体周围炎。制作调整后的逻辑混合模型，以评估与吸烟状况、牙周炎病史和 EBL>0.5mm 相关的种植体周围炎。
407 名患者（平均年龄 64.86 岁[范围 28-92，标准差 10.11]），共 1482 枚种植体，对 10 年召回邀请做出了回应。在平均随访 10.66 年后（范围 10-14，标准差 0.87），种植体存活率为 94.74%。10 年后的平均牙槽嵴骨量损失为 0.81mm（标准差 1.58，范围 0.00-17.00）。76 名患者中有 175 枚种植体发生种植体周围炎（种植体水平 11.8%，患者水平 18.7%）。EBL 为 0.5、1 和 2mm 是种植体周围炎和 10 年后种植体丢失的显著预测因子。在功能的第一年 EBL≥0.5mm 的种植体发生未来种植体周围炎发展的可能性高 5.43 倍。当吸烟、牙周病史和 EBL>0.5mm 合并时，发生种植体周围炎的概率为 52.06%。
本研究表明，EBL 是长期种植体病理学的预测因子，当早期骨丢失超过 0.5 和 1mm 的阈值时，种植体周围炎的风险显著增加，尤其是当存在其他危险因素时，如吸烟或在种植治疗前对牙周病的易感性。临床试验注册号 B670201524796。
