种植体上部修复对慢性牙周炎合并牙列缺损患者的修复效果及对其牙周指标的影响

Effect of upper implant repair on periodontitis patients with dentition defect and its periodontal indexes

目的探讨种植体上部修复对慢性牙周炎合并牙列缺损患者的修复效果及对其牙周指标的影响。方法选取2019年1月至2021年12月北京怀柔医院收治的110例慢性牙周炎合并牙列缺损患者作为实验组,另选取同期100例牙周健康的牙列缺损患者作为对照组,所有患者均为上前牙牙列缺损。两组均进行口腔种植修复技术治疗,比较两组术后6、12个月时的牙周指数[菌斑指数(PLI)、牙龈乳头指数(PIS)、龈沟出血指数(SBI)及牙周探诊深度(PD)]、炎症因子水平[白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)]、牙槽骨吸收量及术后12个月的种植体留存、脱落和松动情况。结果术后6个月,两组PLI、SBI比较差异无统计学意义,实验组PIS高于对照组,PD深于对照组,差异有统计学意义(P<0.05);术后12个月,两组PIS、SBI及实验组PLI均高于术后6个月,PD深于术后6个月,对照组PLI低于术后6个月,但实验组PLI、SBI、PIS均高于对照组,PD深于对照组,差异有统计学意义(P<0.05)。术后6、12个月,实验组IL-6、IL-1β、TNF-α水平均高于对照组,差异有统计学意义(P<0.05);术后12个月,两组IL-6、IL-1β、TNF-α水平均高于术后6个月,差异有统计学意义(P<0.05)。术后6、12个月,实验组牙槽骨吸收量高于对照组,差异有统计学意义(P<0.05);术后12个月,两组牙槽骨吸收量均高于术后6个月,差异有统计学意义(P<0.05)。术后12个月,实验组种植体留存率高于对照组,差异有统计学意义(P<0.05);两组种植体脱落率和松动率比较差异无统计学意义。结论慢性牙周炎患者进行牙种植修复短期疗效显著,而长期疗效并不理想,存在发生种植体周围炎症的风险。

Objective To explore the effect of upper implant repair on periodontitis patients with dentition defect and its periodontal indexes.Methods 110 patients with chronic periodontitis and dentition defect admitted to Beijing Huairou Hospital from January 2019 to December 2021 were selected as the experimental group,and 100 patients with healthy dentition defect were selected as the control group,all patients were upper an-terior dentition defect.Both groups were treated with oral implant restoration technology.The periodontal index(plaque index[PLI],papillary index[PIS],sulcus bleeding index[SBI]and probing depth[PD]),inflammatory factor levels(interleukin-1β[IL-1β],interleukin-6[IL-6]and tumor necro-sis factor-α[TNF-α])at 6 and 12 months after operation,alveolar bone absorption and implant retention,shedding and loosening at 12 months after operation were compared between the two groups.Results At 6 months after operation,there was no significant difference in PLI and SBI between the two groups,the PIS in the experimental group were higher than that in the control group,PD was deeper than that in the control group,and the difference was statistically significant(P<0.05);at 12 months after operation,PIS,SBI in the two groups and PLI in the experimental group were higher than those at 6 months after operation,PD was deeper than that at 6 months after operation,and PLI in the control group was lower than that at 6 months after operation,but PLI,SBI and PIS in the experimental group were higher than those in the control group,PD was deeper than that in the control group,and the differences were statistically significant(P<0.05).At 6 and 12 months after operation,the levels of IL-6,IL-1βand TNF-αin the experimental group were higher than those in the control group,and the differences were statistically significant(P<0.05);at 12 months after operation,the levels of IL-6,IL-1βand TNF-αin the two groups were higher than those at 6 months after operation,and the differences were statisti-cally significant(P<0.05).At 6 and 12 months after operation,the alveolar bone absorption in the experimental group was higher than that in the control group,and the difference was statistically significant(P<0.05);at 12 months after operation,the alveolar bone absorption of the two groups was higher than that at 6 months after operation,and the differences were statistically significant(P<0.05).At 12 months after operation,the implant retention rate in the experimental group was higher than that in the control group,and the difference was statistically significant(P<0.05);there was no significant difference in implant loss rate and loosening rate between the two groups.Conclusion Dental implant restoration in patients with chronic periodontitis can have the significant short-term effect,but the long-term effect is not ideal,and there is the risk of peri-implantitis.