Kim Yun-Jeong, Song Young Woo, Park Shin-Young, Cha Jae-Kook, Lee Hyo-Jung, Yang Seung-Min, Park Jun-Beom, Koo Ki-Tae
Department of Periodontology, Seoul National University Gwanak Dental Hospital, Seoul, Korea.
Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea.
J Periodontal Implant Sci. 2024 Dec;54(6):377-392. doi: 10.5051/jpis.2403920196.
Over the past few decades, dental implants have been successfully utilized to replace teeth lost due to periodontal disease and other conditions. However, similar to natural teeth, dental implants are vulnerable to inflammatory peri-implant diseases, which can compromise their long-term viability. This review aims to summarize the current understanding of peri-implant diseases and discuss effective strategies for their diagnosis, treatment, and long-term management. Evidence related to peri-implant diseases was categorized and reviewed in 4 sections: 1) definition, prevalence, and classification; 2) risk indicators and etiological factors; 3) diagnostic criteria; and 4) treatment protocols for peri-implant diseases. The prevalence of peri-implant mucositis and peri-implantitis is significant, affecting 43% and 22% of implant cases, respectively. Key risk factors include poor oral hygiene, a history of periodontitis, and systemic conditions such as diabetes and smoking. The outcomes of treatment are influenced by the design of the implant prosthesis and the condition of the surrounding soft tissue. Management strategies include: 1) non-surgical treatment for implants diagnosed with peri-implant mucositis; 2) comprehensive treatment, which involves both mechanical and chemical debridement and surgical access, for implants affected by peri-implantitis; and 3) removal of failed implants, followed by the restoration of pre-existing peri-implant bone defects. Managing peri-implant diseases necessitates a comprehensive approach, encompassing risk assessment, tailored treatment planning, and stringent maintenance protocols. Regular follow-ups and patient education are critical for preventing disease recurrence and ensure the long-term success of implant therapy.
在过去几十年中，牙种植体已成功用于替代因牙周病和其他病症而缺失的牙齿。然而，与天然牙相似，牙种植体易患种植体周围炎性疾病，这可能会损害其长期存活能力。本综述旨在总结目前对种植体周围疾病的认识，并讨论其诊断、治疗和长期管理的有效策略。与种植体周围疾病相关的证据分为4个部分进行分类和综述：1）定义、患病率和分类；2）风险指标和病因；3）诊断标准；4）种植体周围疾病的治疗方案。种植体周围黏膜炎和种植体周围炎的患病率很高，分别影响43%和22%的种植病例。关键风险因素包括口腔卫生差、牙周炎病史以及糖尿病和吸烟等全身状况。治疗结果受种植体修复体设计和周围软组织状况的影响。管理策略包括：1）对诊断为种植体周围黏膜炎的种植体进行非手术治疗；2）对受种植体周围炎影响的种植体进行综合治疗，包括机械清创和化学清创以及手术入路；3）取出失败的种植体，随后修复先前存在的种植体周围骨缺损。管理种植体周围疾病需要采取综合方法，包括风险评估、量身定制的治疗计划和严格的维护方案。定期随访和患者教育对于预防疾病复发和确保种植治疗的长期成功至关重要。
