慢性牙周炎患者植体周龈沟液pH值及临床指标随负载时间的变化

Changes of the pH value and clinical indexes of peri-implant crevicular fluid with loading time in patients with chronic periodontitis

目的 研究慢性牙周炎患者植体周龈沟液pH值和临床指标随负载时间的变化,旨在为植体周状态的早期诊断提供更加简单、快捷的临床指标,并为植体周病的一级预防提供临床参考。方法 选取2014年10月至2021年10月接受种植修复的77例(共401个位点)重度慢性牙周炎患者为研究对象,根据口内种植体负载时间将其分为六组。比较六组植体周龈沟液pH值、植体周探诊深度(PPD)、改良菌斑指数(mPLI)、改良龈沟出血指数(mBI)及植体周状态,并分析植体周黏膜炎发生率与种植体负载时间的相关性。结果 植体周龈沟液pH值在种植体负载1年内无明显变化,种植体负载3、7年的植体周pH值呈碱性化趋势,趋近于7.0。PPD范围在(3.00±1.28)mm至(4.46±1.51)mm,PPD与植体周炎症程度呈正相关趋势。随着种植体负载时间的延长,mPLI呈上升趋势,由负载1个月的(0.00±0.00)增至负载7年的(0.85±0.34)(P<0.0001)。mBI在种植体负载初期即6个月内及负载3~5年范围内有两次上升趋势。Pearson相关性分析结果显示,植体周黏膜炎发生率与种植体负载时间呈明显正相关(r=0.865,P<0.05)。结论 慢性牙周炎患者植体周复查时可通过植体用龈沟液pH值、PPD、mPLI和mBI诊断植体周状态;种植体负载3、5、7年是植体周黏膜炎发生率的上升期,积极控制菌斑、定期进行维护治疗可减少植体周病的发生。

Objective To study the changes of the pH value and clinical indexes of peri-implant crevicular fluid with loading time in patients with chronic periodontitis,so as to provide simpler and faster clinical indexes for the early diagnosis of peri-implant state,and provide a clinical reference for the primary prevention of peri-implant disease.Methods Seventy-seven patients(401 sites)with severe chronic periodontitis who received implant repair from October 2014 to October 2021 were selected as the research objects.The patients were divided into six groups according to the loading time of intraoral implants.The pH of peri-implant crevicular fluid,peri-implant probing depth(PPD),modification plaque index(mPLI),modification sulcus bleeding index(mBI)and peri-implant state were compared among the six groups,and the correlation between the incidence of peri-implant mucositis and the loading time of implant was analyzed.Results The pH value of peri-implant crevicular fluid did not change significantly within 1 year of implant loading,and the peri-implant pH value after 3 and 7 years of implant loading showed an alkaline trend,approaching 7.0.PPD ranged from(3.00±1.28)mm to(4.46±1.51)mm,and showed a positive correlation with the degree of peri-implant inflammation.The mPLI showed an upward trend with the extension of implant loading time,and mPLI in loading one month was(0.00±0.00),which was significantly higher than(0.85±0.34)in loading 7 years(P<0.0001).The mBI showed two upward trends in the initial stage in loading 6 months and in the loading 3 to 5 years.Pearson correlation analysis results showed that the incidence of peri-implant mucositis was significantly positively correlated with implant loading time(r=0.865,P<0.05).Conclusion The peri-implant state of patients with chronic periodontitis can be diagnosed by the pH value of peri-implant crevicular fluid,PPD,mPLI and mBI during periplantal review.The incidence of peri-implant mucositis increases after 3,5,and 7 years of implant loading.Active control of plaque and regular maintenance treatment can reduce the incidence of peri-implant disease.