种植体周炎探诊深度与影像学骨水平的相关性分析

Analysis of the correlation between peri-implant probing depth and radiographic bone level

目的探讨种植体周炎患者种植体周探诊深度(PPD)与影像学骨水平(rBL)的相关性。方法纳入2019年1月至2022年12月于北京大学口腔医学院·口腔医院牙周科就诊的种植体周炎患者24例,涉及患病种植体30枚,另从2007年1月至2023年6月在北京大学口腔医学院·口腔医院牙周科有电子检查记录的种植体中使用SPSS26.0软件进行简单随机抽样选取30枚健康种植体作为对照。在保留种植修复体的前提下,使用Williams牙周探针以轻力(约0.2 N)测量PPD(种植体袋底到黏膜边缘的距离),记录各种植体颊侧、舌侧、近中及远中共4个位点的PPD。应用根尖片测量健康种植体近远中影像学骨水平(rBL,种植体颈部参考点与骨缺损最根方位点之间的距离),应用根尖片和锥形束CT分别测量种植体周炎种植体近远中及颊舌侧rBL及骨缺损宽度(DW),并记录骨缺损类型。应用χ2检验、Spearman检验和Logistic回归分析PPD与rBL的相关性及临床探诊诊断与影像学诊断的一致性。结果30枚健康种植体的近中、远中共60个位点和30枚种植体周炎种植体近中、远中、颊侧、舌侧共120个位点,共计180个位点的PPD与rBL显著正相关(r=0.64,P<0.001)。χ2检验显示种植体周炎种植体中,rBL≥1 mm与PD≥6 mm显著相关[优势比(OR)=8.15,P<0.001]。多因素Logistic回归分析显示,在校正种植体颌位和检查位置后,rBL与PPD仍然存在统计学关联,以rBL<1 mm为参照,rBL≥1 mm且<2 mm组、rBL≥2 mm且<3 mm组及rBL≥3 mm组与PPD间的OR值分别为6.23(P=0.014)、2.77(P=0.183)和10.87(P=0.001)。结论种植体周炎种植体的PPD与rBL呈显著正相关,在保留修复体的前提下,PPD可作为辅助判断种植体周骨水平的临床检查指标。

Objective To evaluate the correlation between peri-implant probing depth(PPD)and radiographic bone level(rBL)in implants with peri-implantitis.Methods From January 2019 to December 2022,24 patients with 30 implants who suffered from peri-implantitis at the Department of Periodontology,Peking University School and Hospital of Stomatology were included in the present research.SPSS 26.0 software was used to simple random sampling select 30 healthy implants from which with electronic examination records in Department of Periodontology,Peking University School and Hospital of Stomatology from January 2007 to June 2023 as the control group.On the premise of retaining the implant prosthesis,PPD(distance between pocket bottom and peri-implant soft tissue margin)was examined using a Williams periodontal probe with a light force(about 0.2 N),and a total of 4 sites were recorded for each implant.Periapical radiography and cone beam CT were applied to measure the rBL(distance between the reference point at the neck of the implant and the apical point of the bone defect)and the width of the bone defect(DW),and the type of the bone defect was recorded.The correlation and consistency between the diagnosis of PPD and rBL were analyzed.Results PPD was significantly correlated with rBL in a total of 60 implants in 180 sites(r=0.64,P<0.001).The chi-square test showed an 8.15-fold increase in the detection rate of PD≥6 mm at sites with rBL≥1 mm(P<0.001).Multivariate logistic regression analysis showed that rBL was still statistically associated with PPD after adjustment for jaw position and examination position of implants.Take rBL<1 mm as reference,the odds ratios(OR)of 1 mm≤rBL<2 mm,2 mm≤rBL<3 mm and rBL≥3 mm group with PPD were 6.23(P=0.014),2.77(P=0.183)and 10.87(P=0.001),respectively.Conclusions There is a positive correlation between PPD and rBL in implants with peri-implantitis.PPD can be used as a clinical examination index to assist in estimating the level of peri-implant bone under the premise of retaining the prosthesis.