Department of Periodontology, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen-Str. 50, 58455, Witten, Germany.
Clin Oral Investig. 2024 Sep 20;28(10):536. doi: 10.1007/s00784-024-05942-6.
To investigate the efficacy of ribose-crosslinked collagen (RCLC) matrices functionalized by crosslinked hyaluronic acid (xHya) for reconstructive treatment of class I and III (b-c) peri-implantitis lesions in a transmucosal healing mode.
Thirteen patients presenting with 15 implants were included in this prospective case series. Upon flap reflection, the implants were thoroughly decontaminated employing glycine powder air polishing and adjunctive sodium hypochlorite. For defect augmentation, xHyA was administered to the bony defect walls, exposed implant surfaces, and the RCLC matrix before defect grafting. The full-thickness flap was readapted and sutured around the implant neck for transmucosal healing. Baseline and respective values at the 12 months post-op evaluation were recorded for the clinical parameters peri-implant probing depth (PPD), buccal soft tissue dehiscence (BSTD) and bleeding on probing (BoP). Furthermore, two independent investigators analyzed radiographic changes in the defect area. The mean changes for all variables were analyzed with a paired t-test.
The initial mean PPD was 7.2 ± 1.9 mm, and BoP was present in 63% of sites. After 12 months, PPD at the latest visit was 3.2 ± 0.66 mm, which amounted to a respective 3.9 ± 1.85 mm reduction, while the BoP frequency dropped to 10% at all sites. Radiographic bone fill was accomplished for 62.8% of the former defect area, accompanied by a mean MBL gain of 1.02 mm around the treated implants (all p < 0.001).
Within the limits of this case series, we conclude that the proposed treatment sequence substantially improved peri-implant defects and offered a simplified but predictive technique.
Reconstructive treatment approaches for peri-implantitis are effective but remain non-superior to open flap debridement. Further research on novel biomaterial combinations that may improve reconstructive treatment outcomes are warranted. Ribose-crosslinked collagen matrices biofunctionalized by hyaluronic acid used in this study yield improved clinical and radiographic peri-implant conditions after 12 months.
探讨经交联透明质酸（xHya）功能化的核糖交联胶原（RCLC）基质在黏膜下愈合模式下对 I 类和 III 类（b-c）种植体周围炎病变的重建治疗效果。
本前瞻性病例系列纳入了 13 名患有 15 个种植体的患者。翻瓣后，采用甘氨酸粉末空气抛光和次氯酸钠辅助对种植体进行彻底的去污处理。为了进行缺陷扩增，在进行缺陷移植前，将 xHyA 施用于骨缺陷壁、暴露的种植体表面和 RCLC 基质。全厚瓣重新适应并围绕种植体颈部缝合，以进行黏膜下愈合。记录基线和术后 12 个月时的临床参数，包括种植体探诊深度（PPD）、颊侧软组织缺损（BSTD）和探诊出血（BoP）。此外，两名独立的研究者分析了缺陷区域的放射学变化。使用配对 t 检验分析所有变量的平均变化。
初始时平均 PPD 为 7.2 ± 1.9mm，63%的位点存在 BoP。术后 12 个月，末次就诊时的 PPD 为 3.2 ± 0.66mm，相应减少了 3.9 ± 1.85mm，而所有位点的 BoP 频率均下降至 10%。以前的缺陷区域有 62.8%实现了放射学骨填充，同时处理种植体周围的平均 MBL 增加了 1.02mm（所有 p < 0.001）。
在本病例系列的范围内，我们得出结论，所提出的治疗方案显著改善了种植体周围的缺陷，并提供了一种简化但具有预测性的技术。
种植体周围炎的重建治疗方法是有效的，但仍不如开放式翻瓣清创术优越。需要进一步研究新型生物材料组合，以改善重建治疗效果。本研究中使用的经透明质酸生物功能化的核糖交联胶原基质在 12 个月后可改善种植体周围的临床和放射学状况。
