Bianconi Stefano, Romanos Georgios, Testori Tiziano, Del Fabbro Massimo
Department of Oral Surgery and Dentistry, General Hospital, 39100 Bolzano, Italy.
Department of Periodontics and Endodontics, Stony Brook University, Stony Brook, NY 11794, USA.
J Clin Med. 2024 Jan 25;13(3):713. doi: 10.3390/jcm13030713.
Implant replacement is among the treatment options for severe peri-implantitis. The aim of this single-cohort study was to evaluate the feasibility of replacing compromised implants affected by advanced peri-implantitis with new implants with a porous trabecular metal (TM) structure. Patients with one or more implants in the posterior region showing a defect depth >50% of implant length, measured from the residual crest, were consecutively included. Two months after implant removal, patients received a TM implant combined with a xenograft and a resorbable membrane. The implant stability quotient (ISQ) was measured at placement and re-assessed five months later (at uncovering), then after 6, 12, and 24 months of function. Marginal bone loss was radiographically evaluated. Twenty consecutive cases were included. One patient dropped out due to COVID-19 infection, and nineteen cases were evaluated up to 24 months. At placement, the mean ISQ was 53.08 ± 13.65 (standard deviation), which increased significantly to 69.74 ± 9.01 after five months of healing ( < 0.001) and to 78.00 ± 7.29 after six months of loading ( < 0.001). Thereafter, the ISQ remained stable for up to 24 months (80.55 ± 4.73). All implants successfully osseointegrated and were restored as planned. After two years, the average marginal bone level change was -0.41 ± 0.38 mm (95% confidence interval -0.60, -0.21), which was limited yet significantly different from the baseline ( < 0.05). The treatment of advanced peri-implant defects using TM implants inserted two months after explantation in combination with guided bone regeneration may achieve successful outcomes up to two years follow-up, even in the presence of low primary stability.
种植体置换是重度种植体周围炎的治疗选择之一。这项单队列研究的目的是评估用具有多孔小梁金属（TM）结构的新种植体替换受晚期种植体周围炎影响的受损种植体的可行性。连续纳入后牙区有一个或多个种植体、从剩余牙槽嵴测量缺陷深度大于种植体长50%的患者。种植体拔除两个月后，患者接受TM种植体联合异种骨移植和可吸收膜治疗。在种植体植入时测量种植体稳定性商数（ISQ），并在五个月后（暴露时）重新评估，然后在功能6个月、12个月和24个月后再次评估。通过影像学评估边缘骨丢失情况。连续纳入20例病例。1例患者因COVID-19感染退出，19例病例随访至24个月。植入时，平均ISQ为53.08±13.65（标准差），愈合五个月后显著增加至69.74±9.01（P<0.001），加载六个月后增加至78.00±7.29（P<0.001）。此后，ISQ在长达24个月内保持稳定（80.55±4.73）。所有种植体均成功实现骨结合并按计划进行修复。两年后，平均边缘骨水平变化为-0.41±0.38mm（95%置信区间-0.60，-0.21），虽有限但与基线相比有显著差异（P<0.05）。在外植两个月后插入TM种植体并结合引导骨再生治疗晚期种植体周围缺损，即使在初始稳定性较低的情况下，在长达两年的随访中也可能取得成功结果。
