Private Practice, Naperville, Naperville, Illinois, USA.
Department of Periodontics, University of Louisville School of Dentistry, Louisville, Kentucky, USA.
J Periodontol. 2023 Dec;94(12):1405-1413. doi: 10.1002/JPER.23-0161. Epub 2023 Jul 18.
Evidence on the etiology behind bone loss around submerged, prosthetically nonloaded implants is still limited. The long-term stability and success of implants with early crestal bone loss (ECBL), especially when placed as two-stage implants, is uncertain. Hence, the aim of this retrospective study is to analyze the potential patient-level, tooth- and implant-related factors for ECBL around osseointegrated, submerged implants, before restoration as compared with healthy implants with no bone loss.
Retrospective data were collected from patient electronic health records between 2015 and 2022. Control sites included healthy implants with no bone loss and test sites included implants with ECBL, both of which were submerged. Patient, tooth and implant level data were collected. ECBL was assessed using periapical radiographs obtained during implant placement and second-stage surgeries. Generalized estimating equation logistic regression models were used to account for multiple implants within patients.
The total number of implants included in the study was 200 from 120 patients. Lack of supportive periodontal therapy (SPT) was shown to have nearly five-times higher risk of developing ECBL and was statistically significant (p < 0.05). Guided bone regeneration (GBR) procedures before implant placement had a protective effect with an odds ratio of 0.29 (p < 0.05).
Lack of SPT was significantly associated with ECBL, while sites that received GBR procedures prior to implant placement were less likely to exhibit ECBL. Our results underscore the importance of periodontal treatment and SPT for peri-implant health, even when the implants are submerged and unrestored.
关于在植入物表面未负载、植入物已淹没的情况下骨丢失的病因学证据仍然有限。早期边缘骨丧失（ECBL）的植入物的长期稳定性和成功率，尤其是当作为两阶段植入物放置时，是不确定的。因此，本回顾性研究的目的是分析在修复前与无骨丢失的健康植入物相比，骨整合、淹没植入物周围 ECBL 的潜在患者、牙齿和植入物相关因素。
回顾性数据于 2015 年至 2022 年期间从患者电子健康记录中收集。对照组包括无骨丢失的健康植入物，实验组包括 ECBL 植入物，两者均为淹没状态。收集患者、牙齿和植入物水平的数据。使用植入物放置和二期手术期间获得的根尖片评估 ECBL。使用广义估计方程逻辑回归模型来考虑患者内的多个植入物。
本研究共纳入了 120 名患者的 200 个种植体。缺乏支持性牙周治疗（SPT）显示出近五倍的 ECBL 发病风险，且具有统计学意义（p<0.05）。植入物放置前进行引导骨再生（GBR）手术具有保护作用，优势比为 0.29（p<0.05）。
缺乏 SPT 与 ECBL 显著相关，而在植入物放置前接受 GBR 手术的部位则不太可能出现 ECBL。我们的结果强调了牙周治疗和 SPT 对植入体周围健康的重要性，即使植入物被淹没且未修复。
