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使用矿化脱水同种异体移植物和可吸收膜对种植体周围炎进行重建治疗的10年随访:一项回顾性病例系列研究

A 10-Year Follow-Up of Reconstructive Treatment of Peri-Implantitis Using Mineralized Dehydrated Allograft and Resorbable Membrane: A Retrospective Case Series.

作者信息

La Monaca Gerardo, Pranno Nicola, Annibali Susanna, Polimeni Antonella, Cristalli Maria Paola

机构信息

Department of Oral and Maxillo-Facial Sciences, Sapienza, University of Rome, Rome, Italy.

出版信息

Clin Oral Implants Res. 2025 Mar;36(3):325-338. doi: 10.1111/clr.14385. Epub 2024 Nov 29.

Abstract

OBJECTIVES

To evaluate the 10-year clinical and radiographic outcomes of peri-implantitis intrabony defects treated with mineralized dehydrated bone allograft (MDBA) and resorbable membrane in patients undergoing a regular supportive peri-implant/periodontal therapy (STP).

MATERIALS AND METHODS

The original study participants were 34 (34 defects). After mechanical debridement and chemical decontamination of implant surfaces, intrabony defects were filled with MDBA and covered by a resorbable membrane. Patients were enrolled in a maintenance program with a recall interval of 6 months. The primary outcome was the absence of additional marginal peri-implant bone loss ≥ 1.0 mm after surgery. The composite outcome was no additional marginal peri-implant bone loss ≥ 1.0 mm and the absence of probing depth (PD) ≥ 5 mm, bleeding on probing and suppuration.

RESULTS

Of the original 34 implants, 20 completed the 10-year follow-up, and three failed. Related to the primary outcome, the mean peri-implant marginal bone level changed from 4.78 mm (SD 1.84) at baseline to 3.10 mm (SD 1.73) after surgery and 3.71 mm (SD 1.78) at the follow-up end point. According to the composite outcome for disease resolution, 19 of the 34 original implants were successfully treated at the 10-year follow-up with a statistically significant difference between 1 (31/34 implants) and 5 years (20/34 implants) (p = 0.003) and 1 and 10 years (p = 0.001) but not between 5 and 10 years (p = 1.000).

CONCLUSIONS

Ten years after the reconstructive treatment, followed by regular SPT, the cumulative successful treatment rate, according to the primary and the composite outcomes, was 58% (20/34 implants) and 53% (19/34) implants, respectively.

摘要

目的

评估在接受常规种植体周围/牙周支持治疗(STP)的患者中,使用矿化脱水同种异体骨(MDBA)和可吸收膜治疗种植体周围炎骨内缺损的10年临床和影像学结果。

材料与方法

最初的研究参与者为34例(34处缺损)。在对种植体表面进行机械清创和化学去污后,骨内缺损用MDBA填充并用可吸收膜覆盖。患者参加了召回间隔为6个月的维护计划。主要结局是术后无额外的种植体周围边缘骨丢失≥1.0 mm。综合结局是无额外的种植体周围边缘骨丢失≥1.0 mm,且无探诊深度(PD)≥5 mm、探诊出血和化脓。

结果

在最初的34颗种植体中,20颗完成了10年随访,3颗失败。关于主要结局,种植体周围边缘骨平均水平从基线时的4.78 mm(标准差1.84)变为术后的3.10 mm(标准差1.73)以及随访终点时的3.71 mm(标准差1.78)。根据疾病缓解的综合结局,34颗原始种植体中的19颗在10年随访时成功治疗,1年(31/34颗种植体)和5年(20/34颗种植体)之间有统计学显著差异(p = 0.003),1年和10年之间有统计学显著差异(p = 0.001),但5年和10年之间无统计学显著差异(p = 1.000)。

结论

重建治疗后10年,在进行常规SPT的情况下,根据主要结局和综合结局,累积成功治疗率分别为58%(20/34颗种植体)和53%(19/34颗种植体)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fb6/11891028/046e88209684/CLR-36-325-g004.jpg

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