翻瓣刮治联合引导骨再生术治疗种植体周围感染影响因素分析

Therapeutic effect of flap valvuloplasty combined with guided bone regeneration for the treatment of peri-implant infection

目的探讨翻瓣刮治联合引导骨再生术治疗牙种植体周围感染患者临床效果,为患者临床治疗方案选择提供参考。方法选取2014年7月至2017年8月60例于医院行种植体修复并发生牙种植体感染患者的临床资料。按照随机数字表法将此次研究对象分组为对照组与治疗组,每组30例。并对牙龈上菌斑、软垢进行细菌培养、鉴定。结果 60个种植体共培养分离出112株病原菌,其中产黑色素普雷沃菌39株,占34.82%;其次为口腔链球菌25株,占22.32%;牙龈卟啉单胞菌18株,占16.07%;核梭杆菌13株,占11.61%;血链球菌9株,占8.04%;韦荣球菌5株,占4.46%;共生放线杆菌3株,占2.68%。两组患者治疗后1个月、6个月、12个月时菌斑指数、牙周袋探诊指数及龈沟出血指数均低于治疗前,差异有统计学意义(P<0.05)。治疗治疗后1个月、6个月时种植体边缘骨高度-2.21 mm、-2.05 mm优于对照组-3.51 mm、-3.34 mm(t=3.01、2.96,P<0.05)。结论临床应用翻瓣刮治联合引导骨再生术治疗牙种植体周围感染患者具有显著疗效,且可促进患者骨与种植体间的结合,从而取得更为显著的治疗效果。

Objective To discuss the clinical effect of flap valvuloplasty combined with guided bone regeneration in the treatment of patients with peri-implant infection.Methods The clinical data of 60 patients with peri-implant infection who underwent implant restoration in our hospital from July 2014 to August 2017 were retrospectively analyzed.The subjects were randomly divided into control group(n=30)and treatment group(n=30).The plaque and soft scale samples on the gums were collected and cultured for bacteria identification.Results A total of 112 strains of bacteria were isolated,including 39 strains of Presporium melanin(34.82%),25 strains of oral streptococci,(22.32%),18 strains of Porphyromonas gingivalis(16.07.%),13 strains of Fusobacterium nucleatum(11.61%),9 strains of Streptococcus sanguis(8.04%),5 strains of Weirongococcus(4.46%)and 3 strains of Actinomyces compositae(2.68%).The plaque index,periodontal pocket probing index and sulcus bleeding index were significantly lower in the two groups at 1 month,6 months and 12 months after treatment(P<0.05).At one month and 6 months of treatment,the heights of the implant marginal bone of patients in treatment group were significantly better than that of controls(-2.21 vs-3.51 mm;-2.05 vs-3.34 mm)(t=3.01,2.96,P<0.05).Conclusions The therapeutic effect of flap valvuloplasty combined with guided bone regeneration for the treatment of patients with infection around the dental implant is obvious,which can promote the combination of bone and implant to achieve a more significant therapeutic effect.