基于菌斑控制的种植体周围炎引导骨再生治疗随访7年1例

doi:10.7518/hxkq.2024.2024131

华西口腔医学杂志 ›› 2025, Vol. 43 ›› Issue (1): 133-139.doi: 10.7518/hxkq.2024.2024131

基于菌斑控制的种植体周围炎引导骨再生治疗随访7年1例

苏文祺¹(), 张丹丹¹, 程艳¹, 崔雯洁¹, 雷浪², 李厚轩¹()

^1.南京大学医学院附属口腔医院南京市口腔医院牙周病科南京大学口腔医学研究所，南京 210008
^2.南京大学医学院附属口腔医院南京市口腔医院正畸科南京大学口腔医学研究所，南京 210008

收稿日期:2024-04-08 修回日期:2024-05-16 出版日期:2025-02-01 发布日期:2025-01-22
通讯作者: 李厚轩 E-mail:wenqi_nju@163.com;lihouxuan3435_0@163.com;5_0@163.com
作者简介:苏文祺，主治医师，博士，E-mail：wenqi_nju@163.com
基金资助:
国家自然科学基金面上项目(82371007);江苏省研究生科研与实践创新计划项目(KYCX23_0196)

Guided bone regeneration therapy based on plaque control of peri-implantitis with follow-up at 7 years

Su Wenqi¹(), Zhang Dandan¹, Cheng Yan¹, Cui Wenjie¹, Lei Lang², Li Houxuan¹()

^1.Dept. of Periodontics, Nanjing Stomatological Hospital, Affiliated Hosptital of Medical School, Research Institute of Stomatology, Nanjing University, Nanjing 210008, China
^2.Dept. of Orthodontics, Nanjing Stomatological Hospital, Affiliated Hosptital of Medical School, Research Institute of Stomatology, Nanjing University, Nanjing 210008, China

Received:2024-04-08 Revised:2024-05-16 Online:2025-02-01 Published:2025-01-22
Contact: Li Houxuan E-mail:wenqi_nju@163.com;lihouxuan3435_0@163.com;5_0@163.com
Supported by:
National Natural Science Foundation of China(82371007);Postgraduate Research & Practice Innovation Program of Jiangsu Province(KYCX23_0196)

摘要/Abstract

摘要：

种植体周围炎是发生在种植体周围组织中与牙菌斑相关的病理状况，其特征是种植体周围黏膜组织发生炎症性改变，随后支持骨组织逐渐丧失。本文报道1例基于菌斑控制的种植体周围炎引导骨再生治疗病例。患者35牙种植术后4年因“左下后牙肿胀不适2年余”就诊。X线根尖片显示35牙种植体远中骨密度降低，临床诊断为35牙种植体周围炎。35牙种植体经引导骨再生治疗，并进行定期牙周维护，术后3.5、11、18个月和7年复查显示牙槽骨高度及骨密度稳定，牙周探诊深度变浅，但牙龈轻度退缩。本病例7年的随访结果提示，种植体周围炎经过完善的牙周治疗后，临床牙周指标可以获得明显改善，牙槽骨得到良好的修复再生。

关键词: 菌斑控制, 种植体周围炎, 手术治疗, 引导骨再生, 疗效

Abstract:

Peri-implantitis is a pathologic condition associated with dental plaque that occurs in the implant tissue and is characterized by inflammation of the mucous membrane surrounding the implant, followed by the progressive loss of supporting bone. In this study, a case of guided bone regeneration therapy based on plaque control of peri-implant inflammation was reported. Four years after surgery for the left second premolar implant, the patient presented with “left lower posterior tooth swelling and discomfort for more than 2 years”. The X-ray periapical film showed a decrease in distal bone mineral density of implant, and the clinical diagnosis was peri-implantitis of the left second premolar. Implants underwent guided bone regeneration and regular periodontal maintenance treatment. Re-examination at 3.5 months, 11 months, 18 months, and 7 years showed that the alveolar bone height and bone mineral density were stable, and the periodontal depth became shallow. However, the gingival recession was mild. In the present case, follow-up at 7 years demonstrated that the clinical periodontal indexes could be remarkably improved after complete periodontal treatment for peri-implantitis, and the alveolar bone could be well restored and regenerated.

Key words: plaque control, peri-implantitis, operative treatment, guided bone regeneration, clinical efficacy

中图分类号:

R781.4

苏文祺, 张丹丹, 程艳, 崔雯洁, 雷浪, 李厚轩. 基于菌斑控制的种植体周围炎引导骨再生治疗随访7年1例[J]. 华西口腔医学杂志, 2025, 43(1): 133-139.

Su Wenqi, Zhang Dandan, Cheng Yan, Cui Wenjie, Lei Lang, Li Houxuan. Guided bone regeneration therapy based on plaque control of peri-implantitis with follow-up at 7 years[J]. West China Journal of Stomatology, 2025, 43(1): 133-139.

图/表 5

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参考文献 27

1	Berglundh T, Armitage G, Araujo MG, et al. Peri-implant diseases and conditions: consensus report of workgroup 4 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions[J]. J Clin Periodontol, 2018, 45(): S286-S291.
2	Roccuzzo A, Imber JC, Salvi GE, et al. Peri-implantitis as the consequence of errors in implant therapy[J]. Periodontol 2000, 2023, 92(1): 350-361.
3	Mohammad NS, Nazli R, Zafar H, et al. Effects of lipid based Multiple Micronutrients Supplement on the birth outcome of underweight pre-eclamptic women: a randomized clinical trial[J]. Pak J Med Sci, 2022, 38(1): 219-226.
4	Schwarz F, Jepsen S, Obreja K, et al. Surgical therapy of peri-implantitis[J]. Periodontol 2000, 2022, 88(1): 145-181.
5	Jepsen S, Schwarz F, Cordaro L, et al. Regeneration of alveolar ridge defects. Consensus report of group 4 of the 15th European Workshop on Periodontology on Bone Regeneration[J]. J Clin Periodontol, 2019, 46(): 277-286.
6	孟焕新. 2018年牙周病和植体周病国际新分类简介[J]. 中华口腔医学杂志, 2019, 54(2): 73-78.
	Meng HX. 2018 world new classification of periodontal and peri-implant diseases and conditions[J]. Chin J Stomatol, 2019, 54(2): 73-78.
7	Renvert S, Persson GR, Pirih FQ, et al. Peri-implant health, peri-implant mucositis, and peri-implantitis: case definitions and diagnostic considerations[J]. J Periodontol, 2018, 89(): S304-S312.
8	Herrera D, Berglundh T, Schwarz F, et al. Prevention and treatment of peri-implant diseases—The EFP S3 level clinical practice guideline[J]. J Clin Periodontol, 2023, 50(): 4-76.
9	郭淑娟, 刘倩, 丁一. 牙周病和植体周病国际新分类简介[J]. 国际口腔医学杂志, 2019, 46(2): 125-134.
	Guo SJ, Liu Q, Ding Y. A brief introduction of the new classification scheme for periodontal and peri-implant diseases and conditions[J]. Int J Stomatol, 2019, 46(2): 125-134.
10	Charyeva O, Altynbekov K, Zhartybaev R, et al. Long-term dental implant success and survival: a clinical stu-dy after an observation period up to 6 years[J]. Swed Dent J, 2012, 36(1): 1-6.
11	Heitz-Mayfield LJ. Peri-implant diseases: diagnosis and risk indicators[J]. J Clin Periodontol, 2008, 35(8 ): 292-304.
12	Sasada Y, Cochran DL. Implant-abutment connections: a review of biologic consequences and peri-implantitis implications[J]. Int J Oral Maxillofac Implants, 2017, 32(6): 1296-1307.
13	Sanz M, Chapple IL, group Working 4 of the Ⅷ European Workshop on Periodontology. Clinical research on pe-ri-implant diseases: consensus report of Working Group 4[J]. J Clin Periodontol, 2012, 39(): 202-206.
14	Carcuac O, Abrahamsson I, Albouy JP, et al. Experimental periodontitis and peri-implantitis in dogs[J]. Clin O-ral Implants Res, 2013, 24(4): 363-371.
15	Ramanauskaite A, Fretwurst T, Schwarz F. Efficacy of alternative or adjunctive measures to conventional non-surgical and surgical treatment of peri-implant mucositis and peri-implantitis: a systematic review and meta-analysis[J]. Int J Implant Dent, 2021, 7(1): 112.
16	Sheikh Z, Hamdan N, Ikeda Y, et al. Natural graft tissues and synthetic biomaterials for periodontal and alveolar bone reconstructive applications: a review[J]. Biomater Res, 2017, 21: 9.
17	Monje A, Amerio E, Cha JK, et al. Strategies for implant surface decontamination in peri-implantitis therapy[J]. Int J Oral Implantol (Berl), 2022, 15(3): 213-248.
18	Hallström H, Persson GR, Lindgren S, et al. Open flap debridement of peri-implantitis with or without adjunctive systemic antibiotics: a randomized clinical trial[J]. J Clin Periodontol, 2017, 44(12): 1285-1293.
19	Mehdiyev I, Gülsen U, Sentürk MF, et al. Radiographic evaluation of low-level laser therapy-enhanced maxilla-ry sinus augmentation with simultaneous dental implant placement[J]. Ann Maxillofac Surg, 2019, 9(1): 48-52.
20	Lin GH, Suárez López Del Amo F, Wang HL. Laser therapy for treatment of peri-implant mucositis and peri-implantitis: an American Academy of Periodontology best evidence review[J]. J Periodontol, 2018, 89(7): 766-782.
21	Schwarz F, Sahm N, Schwarz K, et al. Impact of defect configuration on the clinical outcome following surgical regenerative therapy of peri-implantitis[J]. J Clin Periodontol, 2010, 37(5): 449-455.
22	Schwarz F, Herten M, Sager M, et al. Comparison of na-turally occurring and ligature-induced peri-implantitis bone defects in humans and dogs[J]. Clin Oral Implants Res, 2007, 18(2): 161-170.
23	Jose EP, Paul P, Reche A. Soft tissue management a-round the dental implant: a comprehensive review[J]. Cureus, 2023, 15(10): e48042.
24	Chackartchi T, Romanos GE, Sculean A. Soft tissue-related complications and management around dental implants[J]. Periodontol 2000, 2019, 81(1): 124-138.
25	Wennström JL. Mucogingival considerations in ortho-dontic treatment[J]. Semin Orthod, 1996, 2(1): 46-54.
26	Nozawa T, Enomoto H, Tsurumaki S, et al. Biologic height-width ratio of the buccal supra-implant mucosa[J]. Eur J Esthet Dent, 2006, 1(3): 208-214.
27	Wang Q, Tang Z, Han J, et al. The width of keratinized mucosa around dental implants and its influencing factors[J]. Clin Implant Dent Relat Res, 2020, 22(3): 359-365.

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基于菌斑控制的种植体周围炎引导骨再生治疗随访7年1例

Guided bone regeneration therapy based on plaque control of peri-implantitis with follow-up at 7 years

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