种植修复大于1年,碟形骨吸收至种植体平台下3 mm时,应选择翻瓣植骨
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摘要
在口腔种植临床工作中,各种原因导致的种植体周围骨吸收是一种常见的临床问题。然而,在对于碟形骨吸收的处理上,还缺乏统一的认识和标准。本文结合历史文献以及最新的共识性论述,提出当种植体修复时间超过1年,碟形骨吸收至种植体平台下3 mm时,患者处于一种较危险,并极有可能满足种植体周围炎的病理性状态当中。本文总结认为,处于这一病理状态下的患者需要进行翻瓣植骨的治疗。
Peri-implant bone resorption resulting from various causes is a common clinical problem in the clinical work of oral implantology. Whereas,there is a lack of a unified understanding and standard regarding saucer-like bone resorption. To make a comprehensive understanding of this situation,this article reviewed recent literatures and consensus reports,demonstrating that under the pre-described situation( the repair time surpasses one year and"saucer-like"marginal bone loss amounts to 3 mm below the implant shoulder,patients might be in a dangerous pathological condition close to peri-implantitis. To achieve stable long-term outcomes,an open flap debridement and regenerative treatment are required.
Peri-implant bone resorption resulting from various causes is a common clinical problem in the clinical work of oral implantology. Whereas,there is a lack of a unified understanding and standard regarding saucer-like bone resorption. To make a comprehensive understanding of this situation,this article reviewed recent literatures and consensus reports,demonstrating that under the pre-described situation( the repair time surpasses one year and"saucer-like"marginal bone loss amounts to 3 mm below the implant shoulder,patients might be in a dangerous pathological condition close to peri-implantitis. To achieve stable long-term outcomes,an open flap debridement and regenerative treatment are required.
引文
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[2]Albrektsson T,Zarb G,Worthington P,et al.The long-term efficacy of currently used dental implants:a review and proposed criteria of success[J].Int J Oral Maxillofac Implants,1986,1(1):11-25.
[3]Trullenque-Eriksson A,Guisado-Moya B.Retrospective long-term evaluation of dental implants in totally and partially edentulous patients.Part I:survival and marginal bone loss[J].Implant Dent,2014,23(6):732-737.
[4]Dierens M,Vandeweghe S,Kisch J,et al.Long-term follow-up of turned single implants placed in periodontally healthy patients after16 to 22 years:microbiologic outcome[J].J Periodontol,2013,84(7):880-894.
[5]Renvert S,Persson GR,Pirih FQ,et al.Peri-implant health,peri-implant mucositis,and peri-implantitis:Case definitions and diagnostic considerations[J].J Clin Periodontol,2018,45(Suppl20):S278-S285.
[6]Lindhe J,Meyle J.Peri-implant diseases:Consensus Report of the Sixth European Workshop on Periodontology[J].J Clin Periodontol,2008,35(8 Suppl):282-285.
[7]Koldsland OC,Scheie AA,Aass AM.Prevalence of peri-implantitis related to severity of the disease with different degrees of bone loss[J].J Periodontol,2010,81(2):231-238.
[8]De Bruyn H,Vandeweghe S,Ruyffelaert C,et al.Radiographic evaluation of modern oral implants with emphasis on crestal bone level and relevance to peri-implant health[J].Periodontol 2000,2013,62(1):256-270.
[9]Schwarz F,Derks J,Monje A,et al.Peri-implantitis[J].J Clin Periodontol,2018,45(Suppl 20):S246-S266.
[10]Figuero E,Graziani F,Sanz I,et al.Management of peri-implant mucositis and peri-implantitis[J].Periodontol 2000,2014,66(1):255-273.
[11]Renvert S,Lessem J,Dahlén G,et al.Topical minocycline microspheres versus topical chlorhexidine gel as an adjunct to mechanical debridement of incipient peri-implant infections:a randomized clinical trial[J].J Clin Periodontol,2006,33(5):362-369.
[12]Renvert S,Lessem J,Dahlén G,et al.Mechanical and repeated antimicrobial therapy using a local drug delivery system in the treatment of peri-implantitis:a randomized clinical trial[J].J Periodontol,2008,79(5):836-844.
[13]Bassetti M,Schr D,Wicki B,et al.Anti-infective therapy of peri-implantitis with adjunctive local drug delivery or photodynamic therapy:12-month outcomes of a randomized controlled clinical trial[J].Clin Oral Implants Res,2014,25(3):279-287.
[14]Heitz-Mayfield LJ,Mombelli A.The therapy of peri-implantitis:a systematic review[J].Int J Oral Maxillofac Implants,2014,29(Suppl):325-345.
[15]Schwarz F,Sahm N,Schwarz K,et al.Impact of defect configuration onthe clinical outcome following surgical regenerative therapy of peri-implantitis[J].J Clin Periodontol,2010,37(5):449-455.
[16]Mercado F,Hamlet S,Ivanovski S.Regenerative surgical therapy for peri-implantitis using deproteinized bovine bone mineral with10%collagen,enamel matrix derivative and Doxycycline-A prospective 3-year cohort study[J].Clin Oral Implants Res,2018,29(6):583-591.
[2]Albrektsson T,Zarb G,Worthington P,et al.The long-term efficacy of currently used dental implants:a review and proposed criteria of success[J].Int J Oral Maxillofac Implants,1986,1(1):11-25.
[3]Trullenque-Eriksson A,Guisado-Moya B.Retrospective long-term evaluation of dental implants in totally and partially edentulous patients.Part I:survival and marginal bone loss[J].Implant Dent,2014,23(6):732-737.
[4]Dierens M,Vandeweghe S,Kisch J,et al.Long-term follow-up of turned single implants placed in periodontally healthy patients after16 to 22 years:microbiologic outcome[J].J Periodontol,2013,84(7):880-894.
[5]Renvert S,Persson GR,Pirih FQ,et al.Peri-implant health,peri-implant mucositis,and peri-implantitis:Case definitions and diagnostic considerations[J].J Clin Periodontol,2018,45(Suppl20):S278-S285.
[6]Lindhe J,Meyle J.Peri-implant diseases:Consensus Report of the Sixth European Workshop on Periodontology[J].J Clin Periodontol,2008,35(8 Suppl):282-285.
[7]Koldsland OC,Scheie AA,Aass AM.Prevalence of peri-implantitis related to severity of the disease with different degrees of bone loss[J].J Periodontol,2010,81(2):231-238.
[8]De Bruyn H,Vandeweghe S,Ruyffelaert C,et al.Radiographic evaluation of modern oral implants with emphasis on crestal bone level and relevance to peri-implant health[J].Periodontol 2000,2013,62(1):256-270.
[9]Schwarz F,Derks J,Monje A,et al.Peri-implantitis[J].J Clin Periodontol,2018,45(Suppl 20):S246-S266.
[10]Figuero E,Graziani F,Sanz I,et al.Management of peri-implant mucositis and peri-implantitis[J].Periodontol 2000,2014,66(1):255-273.
[11]Renvert S,Lessem J,Dahlén G,et al.Topical minocycline microspheres versus topical chlorhexidine gel as an adjunct to mechanical debridement of incipient peri-implant infections:a randomized clinical trial[J].J Clin Periodontol,2006,33(5):362-369.
[12]Renvert S,Lessem J,Dahlén G,et al.Mechanical and repeated antimicrobial therapy using a local drug delivery system in the treatment of peri-implantitis:a randomized clinical trial[J].J Periodontol,2008,79(5):836-844.
[13]Bassetti M,Schr D,Wicki B,et al.Anti-infective therapy of peri-implantitis with adjunctive local drug delivery or photodynamic therapy:12-month outcomes of a randomized controlled clinical trial[J].Clin Oral Implants Res,2014,25(3):279-287.
[14]Heitz-Mayfield LJ,Mombelli A.The therapy of peri-implantitis:a systematic review[J].Int J Oral Maxillofac Implants,2014,29(Suppl):325-345.
[15]Schwarz F,Sahm N,Schwarz K,et al.Impact of defect configuration onthe clinical outcome following surgical regenerative therapy of peri-implantitis[J].J Clin Periodontol,2010,37(5):449-455.
[16]Mercado F,Hamlet S,Ivanovski S.Regenerative surgical therapy for peri-implantitis using deproteinized bovine bone mineral with10%collagen,enamel matrix derivative and Doxycycline-A prospective 3-year cohort study[J].Clin Oral Implants Res,2018,29(6):583-591.