Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, 82 Gumi‑ro 173beon‑gil, Bundang‑gu, 13620, Seongnam, Korea.
Department of Dentistry and Dental Research Institute, School of Dentistry, Seoul National University, 101, Daehak-ro Jongno-gu, Seoul, 03080, Korea.
BMC Oral Health. 2023 May 22;23(1):308. doi: 10.1186/s12903-023-02981-5.
Few trials have compared the results of surgical treatment for peri-implantitis based on severity of peri-implantitis and surgical method. This study investigated the survival rate of implants based on type of surgical method used and initial severity of peri-implantitis. Classification of severity was determined based on bone loss rate relative to fixture length.
Medical records of patients who underwent peri-implantitis surgery from July 2003 to April 2021 were identified. Classification of peri-implantitis was divided into 3 groups (stage 1: bone loss < 25% (of fixture length), stage 2: 25% < bone loss < 50%, stage 3: bone loss > 50%) and performance of resective or regenerative surgery was investigated. Kaplan-Meier survival curves and Cox hazards proportional models were used to analyze the cumulative survival rate of implants. Median survival time, predicted mean survival time, hazard ratio (HR), and 95% confidence interval (CI) were calculated.
Based on Kaplan-Meier analysis, 89 patients and 227 implants were included, and total median postoperative survival duration was 8.96 years. Cumulative survival rates for stage 1, 2, and 3 were 70.7%, 48.9%, and 21.3%, respectively. The mean survival time for implants in stage 1, 2, and 3 was 9.95 years, 7.96 years, and 5.67 years, respectively, with statistically significant difference (log-rank p-value < 0.001). HRs for stage 2 and stage 3 were 2.25 and 4.59, respectively, with stage 1 as reference. Significant difference was not found in survival time between resective and regenerative surgery groups in any peri-implantitis stage.
The initial bone loss rate relative to the fixture length significantly correlated with the outcome after peri-implantitis surgery, demonstrating a notable difference in the long-term survival rate. Difference was not found between resective surgery and regenerative surgery in implant survival time. Bone loss rate could be utilized as a reliable diagnostic tool for evaluating prognosis after surgical treatment, regardless of surgical method used.
Retrospectively registered. (KCT0008225).
很少有试验比较基于种植体周围炎严重程度和手术方法的手术治疗结果。本研究根据所使用的手术方法类型和种植体周围炎的初始严重程度，调查了种植体的存活率。严重程度的分类是基于相对于固定器长度的骨损失率确定的。
确定了 2003 年 7 月至 2021 年 4 月接受种植体周围炎手术的患者的病历。种植体周围炎的分类分为 3 组（第 1 期：骨损失<固定器长度的 25%（），第 2 期：25%<骨损失<50%，第 3 期：骨损失>50%），并调查了切除性或再生性手术的执行情况。使用 Kaplan-Meier 生存曲线和 Cox 风险比例模型分析种植体的累积存活率。计算了中位数生存时间、预测平均生存时间、风险比（HR）和 95%置信区间（CI）。
基于 Kaplan-Meier 分析，纳入 89 名患者和 227 个种植体，总术后中位随访时间为 8.96 年。第 1 期、第 2 期和第 3 期的累积存活率分别为 70.7%、48.9%和 21.3%。第 1 期、第 2 期和第 3 期种植体的平均生存时间分别为 9.95 年、7.96 年和 5.67 年，差异具有统计学意义（对数秩检验 p 值<0.001）。第 2 期和第 3 期的 HR 分别为 2.25 和 4.59，以第 1 期为参照。在任何种植体周围炎阶段，切除性手术和再生性手术组的生存时间均无显著差异。
相对于固定器长度的初始骨损失率与种植体周围炎手术后的结果显著相关，表明长期生存率有明显差异。在种植体存活率方面，切除性手术和再生性手术之间没有差异。无论使用何种手术方法，骨损失率都可以作为评估手术治疗后预后的可靠诊断工具。
回顾性注册（KCT0008225）。
