Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark.
J Clin Periodontol. 2022 Dec;49(12):1346-1356. doi: 10.1111/jcpe.13716. Epub 2022 Aug 25.
To present the 20-year clinical outcomes of tissue-level implants in partially edentulous patients previously treated for periodontitis and in periodontally healthy patients (PHP).
The original population consisted of 149 partially edentulous patients consecutively enrolled in a private specialist practice and divided into three groups: PHP, moderately periodontally compromised patients (mPCP) and severely PCP (sPCP). After successful completion of periodontal/implant therapy, patients were enrolled in an individualized supportive periodontal care (SPC) programme.
Eighty-four patients rehabilitated with 172 implants reached the 20-year examination. During the observation time, 12 implants were removed (i.e., 11 due to biological complications and 1 due to implant fracture), leading to an overall implant survival rate of 93% (i.e., 94.9% for PHP, 91.8% for mPCP and 93.1% for sPCP [p = .29]). At 20 years, PCP compliant with SPC did not present with significantly higher odds of implant loss compared with PHP compliant with SPC (p > .05). Conversely, PCP not compliant with SPC experienced implant loss with odds ratio of 14.59 (1.30-164.29, p = .03).
Tissue-level implants, placed after comprehensive periodontal therapy and SPC, yield favourable long-term results. However, patients with a history of periodontitis and non-compliant with SPC are at higher risk of biological complications and implant loss.
介绍组织水平种植体在牙周炎和牙周健康患者(PHP)中部分缺牙患者的 20 年临床效果。
原始人群由 149 名连续在私人专科诊所就诊的部分缺牙患者组成,并分为三组:PHP、中度牙周受损患者(mPCP)和重度牙周受损患者(sPCP)。在成功完成牙周/种植体治疗后,患者被纳入个体化支持性牙周治疗(SPC)计划。
84 名患者用 172 个种植体进行修复,达到 20 年检查。在观察期间,有 12 个种植体被取出(即 11 个因生物学并发症,1 个因种植体骨折),总体种植体存活率为 93%(即 PHP 为 94.9%,mPCP 为 91.8%,sPCP 为 93.1%[p=0.29])。20 年后,接受 SPC 的 PCP 患者与接受 SPC 的 PHP 患者相比,其种植体丧失的可能性没有显著增加(p>0.05)。相反,不遵守 SPC 的 PCP 患者发生种植体丧失的风险比为 14.59(1.30-164.29,p=0.03)。
经过全面牙周治疗和 SPC 后,使用组织水平种植体可获得良好的长期效果。然而,有牙周病史且不遵守 SPC 的患者发生生物学并发症和种植体丧失的风险更高。