Etiology and Therapy of Periodontal and Peri-implant Diseases (ETEP) Research Group, Faculty of Dentistry, University Complutense of Madrid, Madrid, Spain.
Section of Graduate Periodontology, University Complutense, Madrid, Spain.
J Clin Periodontol. 2024 Aug;51(8):968-980. doi: 10.1111/jcpe.13993. Epub 2024 May 1.
To evaluate the effectiveness of a flapless surgical approach in the treatment of peri-implantitis and to explore the factors influencing its outcome.
The present retrospective study evaluated patients with at least one implant diagnosed with peri-implantitis and treated with a flapless surgical access, with or without systemic antimicrobials, curettage and, when needed, prostheses modification. Clinical and radiographic parameters were assessed at baseline and at 3 months and at least 12 months. The primary outcome was disease resolution (≤1 bleeding sites, probing depth [PD] ≤5 mm, no bone loss >0.5 mm). Multilevel regression analyses were used to identify predictors influencing the probability of attaining disease resolution.
One hundred and seventeen patients with 338 implants were included. Disease resolution was attained in 54.4% of the 338 implants receiving flapless surgical access. At the end of the follow-up period, 111 patients (94.9%) with 295 implants (87.3%) did not require any further treatment, with 81.4% of these implants presenting PD ≤ 5 mm. History of periodontitis and PD at baseline were identified as negative predictors, while compliance with supportive peri-implant care, a machined surface and the adjunctive use of systemic azithromycin or metronidazole were identified as positive predictive factors for disease resolution.
A flapless surgical approach led to disease resolution in 54.4% of the implants with peri-implantitis. Several risk/protective predictors for disease resolution were identified.
评估无瓣手术方法在治疗种植体周围炎中的有效性，并探讨影响其疗效的因素。
本回顾性研究评估了至少有一个种植体被诊断为种植体周围炎并接受无瓣手术方法治疗的患者，该方法可单独使用，也可联合使用系统抗菌药物、刮治术，必要时还可修改修复体。在基线时、治疗后 3 个月和至少 12 个月时评估临床和影像学参数。主要结局是疾病缓解（≤1 个出血部位、探诊深度[PD]≤5mm、无骨丧失>0.5mm）。采用多水平回归分析确定影响疾病缓解概率的预测因素。
共纳入 117 例患者的 338 个种植体。338 个接受无瓣手术方法治疗的种植体中，有 54.4%达到疾病缓解。在随访期末，111 例患者（94.9%）的 295 个种植体（87.3%）无需进一步治疗，其中 81.4%的种植体 PD≤5mm。牙周炎病史和基线时的 PD 被确定为负预测因素，而对种植体周围支持性护理的依从性、机加工表面以及联合使用系统阿奇霉素或甲硝唑被确定为疾病缓解的正预测因素。
无瓣手术方法可使 54.4%的种植体周围炎种植体达到疾病缓解。确定了一些与疾病缓解相关的风险/保护预测因素。
