目的:本研究的目的是比较喷砂和酸蚀(SLA)种植体治疗牙周炎患者和牙周健康患者(PHP)的长期结果。
方法:有一百四十九名部分缺牙患者连续参加私人专科诊所,并根据其牙周状况分为三组:PHP,中度牙周受损患者(PCP)和重度PCP。放置植入物以支撑固定的假体,成功完成初始牙周治疗后。在主动牙周治疗(APT)结束时,患者被要求遵循个体化的牙周支持性治疗(SPT)计划.根据累积拦截支持疗法(CIST)进行种植体周围生物并发症的诊断和治疗。十年后,临床和影像学测量由两名校准操作员记录,对最初的患者分类视而不见,123名患者,因为26人失去了跟进。登记了10年期间根据治疗模式C和D(抗生素和/或手术)治疗的部位数量。
结果:六个植入物因生物并发症被移除。PHP的植入物存活率为100%,中度PCP为96.9%,重度PCP为97.1%。在PHP中,18.8%的病例进行了抗生素和/或手术治疗,52.2%的中度PCP和66.7%的重度PCP,PHP和两个PCP组之间的差异具有统计学意义。十年后,植入物的百分比,至少有一个部位的PD≥6mm,是,分别,对于PHP,0%中度PCP为9.4%,重度PCP为10.8%,PHP和两个PCP组之间的差异具有统计学意义。
结论:这项研究表明,SLA植入物,置于严格的牙周控制之下,提供可预测的长期结果。然而,有牙周炎病史的患者,没有完全遵守SPT的人,有统计学意义的更多需要额外手术和/或抗生素治疗的部位.因此,患者应该被告知,从一开始,SPT在提高植入治疗的长期结果中的价值,特别是那些受牙周炎影响的人。
OBJECTIVE: The aim of this study was to compare the long-term outcomes of sandblasted and acid-etched (SLA) implants in patients previously treated for periodontitis and in periodontally healthy patients (PHP).
METHODS: One hundred and forty-nine partially edentulous patients were consecutively enrolled in private specialist practice and divided into three groups according to their periodontal condition: PHP, moderately periodontally compromised patients (PCP) and severely PCP. Implants were placed to support fixed prostheses, after successful completion of initial periodontal therapy. At the end of active periodontal treatment (APT), patients were asked to follow an individualized supportive periodontal therapy (SPT) program. Diagnosis and treatment of peri-implant biological complications were performed according to cumulative interceptive supportive therapy (CIST). At 10 years, clinical and radiographic measures were recorded by two calibrated operators, blind to the initial patient classification, on 123 patients, as 26 were lost to follow up. The number of sites treated according to therapy modalities C and D (antibiotics and/or surgery) during the 10 years was registered.
RESULTS: Six implants were removed for biological complications. The implant survival rate was 100% for PHP, 96.9% for moderate PCP and 97.1% for severe PCP. Antibiotic and/or surgical therapy was performed in 18.8% of cases in PHP, in 52.2% of cases in moderate PCP and in 66.7% cases in severe PCP, with a statistically significant differences between PHP and both PCP groups. At 10 years, the percentage of implants, with at least one site that presented a PD ≥ 6 mm, was, respectively, 0% for PHP, 9.4% for moderate PCP and 10.8% for severe PCP, with a statistically significant difference between PHP and both PCP groups.
CONCLUSIONS: This study shows that SLA implants, placed under a strict periodontal control, offer predictable long-term results. Nevertheless, patients with a history of periodontitis, who did not fully adhere to the SPT, presented a statistically significant higher number of sites that required additional surgical and/or antibiotic treatment. Therefore, patients should be informed, from the beginning, of the value of the SPT in enhancing long-term outcomes of implant therapy, particularly those affected by periodontitis.