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改良与对照方案治疗种植体周围炎相关骨缺损的疗效比较:一项回顾性分析。

Effectiveness of modified and control protocols for the surgical therapy of combined peri-implantitis-related defects. A retrospective analysis.

机构信息

Department of Oral Surgery and Implantology, Goethe University, Carolinum, Frankfurt, Germany.

Department of Orthodontics, Universitätsklinikum Düsseldorf, Düsseldorf, Germany.

出版信息

Clin Oral Implants Res. 2023 May;34(5):512-520. doi: 10.1111/clr.14057. Epub 2023 Mar 10.

Abstract

OBJECTIVES

To compare the clinical effectiveness of control and two modified protocols for surgical therapy of combined peri-implantitis-related defects.

MATERIALS AND METHODS

A total of n = 36 patients (n = 40 implants) diagnosed with combined supra- and intrabony defects were identified for this retrospective analysis. All protocols considered access flap surgery, granulation tissue removal and implant surface decontamination using a titanium brush. The control combined protocol included implantoplasty at supracrestal/ buccal- and reconstructive therapy at intrabony components using a particulate natural bone mineral + a native collagen membrane (CM) (n = 11 patients, n = 11 implants, CP). The modified protocols included the augmentation at both supra- and intrabony defect components using either a collagen-stabilized natural bone mineral (BOC) (n = 15 patients, n = 15 implants, MP1), or BOC mixed with autogenous bone chips + CM (n = 10 patients, n = 14 implants, MP2). Linear mixed effects analyses were used to assess the changes in clinical parameters (i.e., bleeding on probing - BOP, probing pocket depth - PD, and mucosal recession - MR) over time (i.e., 6 and 12 months) and the impact of the treatment groups (CP, MP1, MP2).

RESULTS

At 12 months, median BOP and PD reductions amounted to -58.33% and - 1.16 mm in the MP1, to -62.50% and -1.95 mm in the MP2, and to -66.67% and -0.83 mm in the CP groups, respectively. The associated MR changes ranged between 0.00 and 0.08 mm. The survival rates were 100% in all groups.

CONCLUSIONS

All treatment protocols were associated with short-term improvements in the clinical parameters investigated.

摘要

目的

比较控制组和两种改良方案治疗种植体周围炎相关联合缺损的临床效果。

材料和方法

本回顾性分析共纳入 n = 36 名(n = 40 个种植体)患有联合骨上和骨内缺损的患者。所有方案均考虑采用翻瓣术、去除肉芽组织和使用钛刷清洁种植体表面。对照组联合方案包括在骨上/颊侧进行种植体成形术,并在骨内部分采用颗粒状天然骨矿物质+天然胶原膜(CM)进行重建治疗(n = 11 名患者,n = 11 个种植体,CP)。改良方案包括在骨上和骨内缺损部位均进行增强,分别使用胶原稳定的天然骨矿物质(BOC)(n = 15 名患者,n = 15 个种植体,MP1)或 BOC 混合自体骨屑+CM(n = 10 名患者,n = 14 个种植体,MP2)。线性混合效应分析用于评估随时间(即 6 个月和 12 个月)的临床参数(即探诊出血、探诊深度和黏膜退缩)的变化,并评估治疗组(CP、MP1、MP2)的影响。

结果

在 12 个月时,MP1 组的 BOP 和 PD 中位数分别减少了-58.33%和-1.16mm,MP2 组分别减少了-62.50%和-1.95mm,CP 组分别减少了-66.67%和-0.83mm。相关的 MR 变化范围在 0.00 至 0.08mm 之间。所有组的生存率均为 100%。

结论

所有治疗方案均与所研究的临床参数的短期改善相关。

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