Wörner Felix, Eger Thomas, Kasaj Adrian, Ehmke Benjamin
Oral Health Prev Dent. 2024 Dec 18;22:695-704. doi: 10.3290/j.ohpd.b5884987.
To help fill the knowledge gaps regarding the long-term effectiveness of peri-implantitis therapy, this retrospective study of soldiers with treated severe periodontitis (stage III gen. / IV) who had been undergoing adherent SPT for at least 20 years aimed to determine the frequency of peri-implantitis and patient-related risk factors for this, as well as the 10-year survival rates of dental implants under peri-implantitis therapy.
The observation period was between 1993 and 2023. All patients were referred by their military dentists for specialist dental training and underwent systematic periodontal therapy. A multi-stage peri-implantitis treatment concept was used.
In 86 (31%) of 276 patients (total treatment time 23.6 ± 2.8 years, 53.1 ± 20.4 SPT sessions), 296 implant restorations were performed to close gaps or lengthen rows of teeth. In 29 (33%) of the implant patients, peri-implantitis developed on 25% of the implants. As a result, 11% of all implants were lost within 10 years due to peri-implantitis. Peri-implantitis led to implant loss in 59% of affected patients and 45% of implants. The survival time of implants lost later was 8.4 ± 6.2 years. Peri-implantitis and implant loss rates increased statistically significantly in stage IV periodontitis as well as in heavy smokers. Patients with implant loss and peri-implantitis had received systemic antibiotics due to periodontitis recurrence statistically significantly more frequently than patients without peri-implantitis and without implants during the ≥ 20-year SPT (p 0.05).
Based on the present results, the early extraction of teeth during SPT in patients with treated generalised periodontitis stage III and stage IV plus replacement with implants is not advantageous.
为填补关于种植体周围炎治疗长期疗效的知识空白，本项对患有重度牙周炎（III期/IV期）且接受至少20年依从性维护期牙周治疗（SPT）的士兵进行的回顾性研究，旨在确定种植体周围炎的发生率及其相关患者风险因素，以及种植体周围炎治疗下牙种植体的10年生存率。
观察期为1993年至2023年。所有患者均由军队牙医转介接受专科牙科培训，并接受了系统性牙周治疗。采用了多阶段种植体周围炎治疗方案。
276例患者中的86例（31%）（总治疗时间23.6±2.8年，53.1±20.4次维护期牙周治疗疗程）进行了296次种植体修复以关闭间隙或延长牙列。在29例（33%）种植体患者中，25%的种植体发生了种植体周围炎。结果，11%的所有种植体在10年内因种植体周围炎而丢失。种植体周围炎导致59%的受影响患者和45%的种植体丢失。后期丢失的种植体的存活时间为8.4±6.2年。在IV期牙周炎患者以及重度吸烟者中，种植体周围炎和种植体丢失率在统计学上显著增加。在≥20年的维护期牙周治疗期间，发生种植体丢失和种植体周围炎的患者因牙周炎复发接受全身抗生素治疗的频率在统计学上显著高于没有种植体周围炎且没有种植体丢失的患者（p<0.05）。
基于目前的结果，在已治疗的III期和IV期广泛性牙周炎患者的维护期牙周治疗期间早期拔牙并植入种植体并无益处。
