种植体周围炎重复非手术治疗的短期疗效观察

Short-term efficacy observation of repeated non-surgical therapy for peri-implantitis

目的观察轻、中、重度种植体周围炎的重复非手术治疗效果。方法选择种植修复完成2年以上的种植体周围炎病例29例、植体31颗,按病情严重程度分为轻、中、重度三组,每组分别有种植体周围炎植体12、10、9颗,进行种植体周袋内超声清创+甘氨酸喷砂+盐酸米诺环素凝胶袋内注射+复方氯己定含漱联合治疗,共治疗两次。分别记录三组治疗前(T0)、治疗第1次后1个月(T1)、重复治疗第2次后1个月(T2)3个时间点的种植体周探诊深度(PD)、探诊出血(BOP)位点阳性率、探诊溢脓位点阳性率,比较各个时间点的临床参数变化。结果经过两次治疗,轻、中、重度组PD均值减少,轻度组T0 vs.T1,P>0.05,T0 vs.T2,P<0.05;中重度组T0 vs.T1,P<0.05,T0 vs.T2,P<0.01。三组在治疗两次后种植体周探诊出血率均不断降低,轻、中度组T0 vs.T1,P<0.05,T0 vs.T2,P<0.01,重度组治疗前后三个时间点没统计学差异。溢脓位点阳性率随炎症程度加重而升高,轻度组没有溢脓位点,中度和重度组治疗后溢脓位点阳性率不断下降(T0 vs.T1,P<0.05, T0 vs.T2,P<0.01)。经治疗,中、重度组T1、T2时仍有种植体周探诊深袋、探诊出血点和溢脓点。结论非手术方法治疗轻、中、重度种植体周围炎能显著改善其种植体周软组织炎症,重复进行非手术治疗是有必要的。轻度种植体周围炎经两次非手术治疗,能基本控制软组织炎症;中重度种植体周围炎经两次非手术治疗,不能完全控制软组织炎症。

Objective To observe the repeated non-surgical therapeutic effects on mild,moderate and severe peri-implantitis.Methods 29 patients with 31 peri-implantitis implants that were repaired for over 2 years were chosen.According to the severity,there were 12 peri-implantitis implants in mild group,10 in moderate group and 9 in severe group.The 31 peri-implantitis implants were treated twice with non-surgical combination scheme,ultrasonic mechanical debridement + air-polishing with amino acid glycine powder + minocycline ointment injection + chlorhexidine rinse.One month later,the treatment was repeated again.The PD,BOP positive site numbers,suppuration positive site numbers at the three time points were recorded respectively(the time before therapy denoted as T0,1 month after 1st therapy as T1,1 month after 2st therapy as T2).The changes of clinical parameters were compared at different time points.Results After two treatments,in mild peri-implantitis group,although the mean PD had no statistical difference(P>0.05) between T0 and T1,the difference between T0 and T2 became more obvious(P<0.05),and BOP positive site numbers decreased(T0 vs.T1,P<0.05;T0 vs.T2,P<0.01),at T0 none suppuration site was detected.In moderate group,PD,BOP positive site numbers,suppuration positive site numbers decreased continuously through repeated non-surgical therapy(T0 vs.T1,P<0.05;T0 vs.T2,P<0.01).In sever group,there were obvious differences in PD,suppuration positive site numbers(T0 vs.T1,P<0.05;T0 vs.T2,P<0.01),while there were no statistical differences in BOP among the three time points.At the time of T2,there were still deep PD sites,BOP sites,suppuration sites in both moderate and sever groups.Conclusions The non-surgical therapy can improve the clinical parameters but cannot cure the peri-implantitis thoroughly.Repeated therapy procedure is needed.Mild peri-implantitis can be basically controlled after two repeated non-surgical therapies while moderate and severe peri-implantitis cannot be controlled thoroughly.