Department of Medical Sciences and Diagnostic Integrated, S. Martino Hospital, University of Genoa, Genova, Italy.
Stomatology Department, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain.
Odontology. 2023 Jan;111(1):255-262. doi: 10.1007/s10266-022-00734-4. Epub 2022 Sep 8.
Dental implants placed in fresh extraction alveoli provide several advantages, including shorter treatment periods and improved patient comfort. After a compromised tooth extraction, the Er,Cr:YSGG laser can considerably reduce bacterial concentration. The objective of this controlled study conducted after at least 1 year of follow-up was to compare the use of immediate post-extraction implants in infected sites treated with laser (test group) versus conventional implants in edentulous sites (control group) through an analysis of pre- and post-operative radiographs. The study was based on a series of patients treated between 2014 and 2019, with a 1-year minimum follow-up, and up to over 4 years. An analysis of the clinical history of the treated patients and pre- and post-operative radiographs was performed to evaluate the implant success and to measure the marginal bone level (MBL). Overall, 149 implants were studied. There was only one failure in the test group (1%) and no failures in the control group. The test group gained 0.1 mm of the MBL compared to the baseline, while the control group lost 0.1 mm of the MBL. The difference between the two groups of only 0.2 mm was not statistically significant (P = 0.058). Immediate dental implants in infected sockets debrided and decontaminated using Er,Cr:YSGG laser do not appear to enhance the likelihood of failure; however, peri-implantitis and associated problems must be avoided by following a certain set of protocols and procedures.
在新鲜拔牙窝中植入牙种植体有几个优点,包括治疗周期更短和患者舒适度提高。在受损的拔牙后,Er,Cr:YSGG 激光可以显著降低细菌浓度。这项经过至少 1 年随访的对照研究的目的是通过分析术前和术后的射线照片,比较在激光处理的感染部位立即植入牙种植体(试验组)与在无牙部位植入常规牙种植体(对照组)的使用。该研究基于 2014 年至 2019 年期间治疗的一系列患者,随访时间至少为 1 年,最长超过 4 年。对接受治疗的患者的临床病史和术前、术后射线照片进行了分析,以评估种植体的成功,并测量边缘骨水平(MBL)。总体上,研究了 149 个种植体。试验组仅有 1 例(1%)失败,对照组无失败。与基线相比,试验组 MBL 增加了 0.1 毫米,而对照组 MBL 减少了 0.1 毫米。两组之间仅相差 0.2 毫米,无统计学意义(P=0.058)。使用 Er,Cr:YSGG 激光对受感染的牙槽窝进行清创和去污的即刻牙种植体似乎不会增加失败的可能性;然而,必须通过遵循一定的协议和程序来避免种植体周围炎和相关问题。