牙周炎患者龈下菌斑控制水平对种植体周骨吸收的影响研究

Effect of subgingival plaque control level on the bone resorption around implant in patients with periodontitis

目的:探讨牙周炎患者龈下菌斑控制水平对种植体周骨吸收的影响。方法:选取2019年3月至2020年2月在我院就诊的50例牙周炎牙列缺损患者作为观察组,同时选取50例同期检查的牙周健康且牙列缺损>90 d行种植术患者为对照组,均给予种植体修复,对照组治疗前未行牙周基础治疗,未应用盐酸米诺环素软膏。比较两组患者治疗前后mPLI指数、mSBI指数、种植体周骨吸收情况。结果:术前观察组患者mPLI指数较对照组患者显著提高(P<0.05),术后3个月两组患者mPLI指数评分无显著性差异(P>0.05);术前两组患者mSBI指数评分无显著性差异(P>0.05),术后3个月两组患者mSBI指数评分均显著下降,且对照组患者mSBI指数评分下降更显著(P<0.05);术前两组患者近中、远中边缘骨吸收量无显著性差异(P>0.05),术后3个月观察组近中边缘骨吸收量下降更显著,对照组远中边缘骨吸收量下降更显著(P<0.05)。结论:牙周炎患者龈下菌斑增多,对种植体边缘骨吸收量造成影响,牙周基础治疗及局部抗菌药物对菌斑进行控制后有利于提高种植体边缘骨的稳定性,提高种植体修复的成功率,值得推广。

Objective: To investigate the effect of the control level of subgingival plaque in patients with periodontitis on bone resorption around implants. Method:50 patients with periodontitis and dentition defect who were treated in our hospital from March 2019 to February 2020 were selected as the research group. At the same time, 50 patients with periodontal health but dentition defect more than 90 d undergoing implantation were selected as the control group. All were given implant restoration. The mPLI index, mSBI index, and bone resorption around implants were compared between the two groups before and after treatment. Results:The mPLI index of the study group was significantly higher than that of the control group before surgery(P<0.05). There was no significant difference in the mPLI index score of the two groups 3 months after surgery(P>0.05). Before surgery there was no significant difference in the mSBI index scores(P>0.05). The mSBI index scores of the two groups decreased significantly after 3 months, and the mSBI index scores of the control group decreased more significantly(P<0.05). Before surgery there was no significant difference between the mesial and distal marginal bone resorption(P>0.05). The decrease of mesial marginal bone resorption in the study group was more significant after 3 months, and the bone resorption in the distal edge of the control group decreased more significantly(P<0.05). Conclusion:The subgingival plaque in patients with periodontitis significantly increased, which affects the bone resorption at the edge of the implant. After the basic periodontal therapy and plaque control by local antibacterial drugs, it is beneficial to improve the stability of the marginal bone of the implant and improve the success rate of implant restoration. It is worthy of promotion.