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牙周炎病史对种植牙临床效果的影响:一项为期 20 年的前瞻性研究。

Clinical outcomes of dental implants in patients with and without history of periodontitis: A 20-year prospective study.

机构信息

Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.

Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark.

出版信息

J Clin Periodontol. 2022 Dec;49(12):1346-1356. doi: 10.1111/jcpe.13716. Epub 2022 Aug 25.

Abstract

AIM

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).

MATERIAL AND METHODS

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.

RESULTS

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).

CONCLUSIONS

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.

摘要

目的

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。

材料和方法

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。

结果

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)。

结论

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bde6/9804375/6bb5bc7b0809/JCPE-49-1346-g001.jpg

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