Monje Alberto, Schwarz Frank
Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain.
Department of Periodontology, School of Dental Medicine, University of Michigan, Ann Arbor, Michigan, USA.
Clin Adv Periodontics. 2022 Mar;12(1):57-63. doi: 10.1002/cap.10186. Epub 2021 Nov 12.
The purpose of this technical note is to present the principles for combined therapy as well as to illustrate the step-by-step approach of this procedure to efficiently manage peri-implantitis.
Peri-implantitis is the primary threat that compromises the longevity of dental implants. This entity is regarded as a biofilm-mediated inflammatory condition. As such, the arrestment of disease is conditioned by the elimination of the etiological factor and the clinical resolution of inflammation by eliminating pathogenic pockets. It was suggested that the therapy of peri-implantitis relies upon defect configuration. In this sense, defect configuration is, in part, conditioned by the dimensions of the alveolar bone and implant position. In the clinical basis, it is frequent to identify combined defects exhibiting area(s) where reconstructive therapy is inefficient due to uncontained defect morphology. These situations represent clinical indications for combined therapy.
This therapeutic modality is based on the combination of reconstructive therapy in the infraosseous defect component and surface modification for the area of the implant within the supracrestal component or outside the reparative potential.
本技术说明的目的是介绍联合治疗的原则，并阐述该程序的逐步方法，以有效管理种植体周围炎。
种植体周围炎是影响牙种植体长期使用的主要威胁。这种情况被视为生物膜介导的炎症状态。因此，疾病的控制取决于病因的消除以及通过消除致病袋实现炎症的临床消退。有人提出，种植体周围炎的治疗依赖于缺损形态。从这个意义上说，缺损形态部分取决于牙槽骨的尺寸和种植体位置。在临床实践中，经常会发现联合缺损，其中由于缺损形态无法控制，重建治疗在某些区域效率低下。这些情况代表了联合治疗的临床指征。
这种治疗方式基于骨下缺损部分的重建治疗与种植体在龈上部分或修复潜能之外区域的表面改性相结合。
