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回顾性评估使用种植体疾病风险评估 (IDRA) 工具的患者发生种植体周围疾病的风险:一项队列研究。

Retrospective assessment of patients' risk for peri-implant diseases using the implant disease risk assessment (IDRA) tool: A cohort study.

机构信息

Department of Dentistry, Federal University of Rio Grande do Norte, Natal, RN, Brazil.

Department of Periodontology, University of Florida College of Dentistry, Gainesville, Florida, USA.

出版信息

Clin Implant Dent Relat Res. 2024 Oct;26(5):1056-1066. doi: 10.1111/cid.13371. Epub 2024 Aug 7.

Abstract

INTRODUCTION

The implant disease risk assessment (IDRA) tool was designed to assess an individual's risk of developing peri-implant diseases by evaluating and integrating multiple risk factors. This study aimed to evaluate the IDRA tool to determine the risk of developing peri-implant disease in patients rehabilitated with dental implants.

METHODS

A retrospective observational cross-sectional study was conducted, collecting data from 92 patients with 92 selected dental implants. Data included the history of periodontitis, sites with bleeding on probing (BoP), teeth and/or implants with probing depths (PDs) ≥ 5 mm, alveolar bone loss relative to the patient's age, susceptibility to periodontitis, the frequency of supportive periodontal therapy (SPT), the distance from the restorative margin (RM) of the implant-supported prosthesis to the marginal bone crest (MBC), and factors related to the prosthesis itself. Additionally, the validated instrument periodontal risk assessment (PRA) was employed for comparison. Statistical analyses utilized Chi-square, Mann-Whitney, and ROC curve.

RESULTS

Outcomes indicated that 62 implants (67.4%) were classified as high-risk. Among the IDRA parameters, history of periodontitis was the primary factor contributing to an increased risk (p < 0.001). IDRA revealed high sensitivity (100%) and low specificity (63%) (AUC = 0.685; 95% CI: 0.554-0.816; p = 0.047), and there was a low agreement between the IDRA and PRA tools (Kappa = 0.123; p = 0.014). The peri-implant disease developed in 16 implants with 5.44 (±2.50) years of follow-up, however, no significant association was observed between the high- and low-medium risk groups and the occurrence of peri-implant diseases.

CONCLUSION

Most of the evaluated implants presented high IDRA risk. The IDRA tool exhibited high sensitivity and low specificity; no significant association was observed between the risk profile and the development of peri-implant diseases.

摘要

引言

植入物疾病风险评估(IDRA)工具旨在通过评估和整合多个风险因素来评估个体发生牙周病的风险。本研究旨在评估 IDRA 工具,以确定接受牙种植体修复的患者发生种植体周围疾病的风险。

方法

本研究为回顾性观察性横断面研究,收集了 92 名患者的 92 颗种植体的数据。数据包括牙周炎病史、探诊出血(BoP)部位、探诊深度(PD)≥5mm 的牙齿和/或种植体、相对于患者年龄的牙槽骨丧失、牙周炎易感性、支持性牙周治疗(SPT)的频率、种植体支持修复体的修复边缘(RM)到边缘骨嵴(MBC)的距离,以及与修复体本身相关的因素。此外,还使用了经过验证的牙周病风险评估(PRA)工具进行比较。统计分析采用卡方检验、Mann-Whitney 检验和 ROC 曲线。

结果

结果显示,有 62 颗种植体(67.4%)被归类为高风险。在 IDRA 参数中,牙周炎病史是导致风险增加的主要因素(p<0.001)。IDRA 具有 100%的高敏感性和 63%的低特异性(AUC=0.685;95%CI:0.554-0.816;p=0.047),且 IDRA 和 PRA 工具之间的一致性较低(Kappa=0.123;p=0.014)。在 5.44(±2.50)年的随访中,16 颗种植体发生了种植体周围疾病,但高风险和中低风险组之间没有观察到与种植体周围疾病发生的显著相关性。

结论

评估的大多数种植体具有较高的 IDRA 风险。IDRA 工具具有高敏感性和低特异性;风险状况与种植体周围疾病的发生之间没有观察到显著相关性。

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