慢性牙周炎患者种植修复的临床观察

目的:探讨种植义齿修复慢性牙周炎患者牙列缺损的手术技巧及局部预防用药的疗效,并分析相关影响因素。方法:16例因慢性牙周炎致牙列缺损病例植入种植体89枚。5～6个月后行二期修复。根据临床检查、X线片和患者主诉评价修复效果。结果:所有病例均已完成修复,平均随访24个月。均无种植体松动脱落,患者咀嚼功能正常。结论:采取微创种植手术及派丽奥创口缓释用药措施,慢性牙周炎缺牙病例行种植义齿修复可以获得满意的早期临床疗效。     

牙周炎患者即刻种植修复的临床观察

目的 评价重度牙周炎患者拔牙后种植治疗并行即刻修复的临床效果.方法 选择在中山大学光华口腔医学院·附属口腔医院种植科就诊的需行义齿修复的重度牙周炎患者12例.术前行完善的牙周治疗,术中拔除余留牙,彻底清创,植入种植体并于手术当日完成树脂临时修复,6个月后行永久修复.术后l、6、12、24个月复诊,评价种植体和修复体存留率及软硬组织状态.结果 植入种植体84枚,上颌50枚、下颌34枚,其中32枚为即刻植入新鲜拔牙窝.3例(4枚)种植体失败,种植体两年存留率为95％,其中上颌92％( 46/50),下颌为100％ (34/34);修复成功率为100％.所有的种植失败均发生在手术后6个月内.即刻种植体植入拔牙窝和种植体植入正常牙槽骨两组在植入扭矩及牙槽骨吸收水平方面差异无统计学意义.结论 本组牙周炎患者行完善牙周治疗后全口种植即刻修复取得满意的修复效果.     

慢性牙周炎缺牙患者种植体周围组织状况的研究

目的 探讨慢性牙周炎对种植体周组织健康的影响.方法 慢性牙周炎缺牙进行种植义齿修复的患者14例为试验组,无牙周炎13例患者为对照组,在对照组和慢性牙周炎试验组各植入20枚ITI种植体,修复后6个月,检测改良菌斑指数、改良龈沟出血指数、探诊深度、边缘骨质吸收状况指标,并进行比较.结果 对照组和试验组的各项指标差异无统计学意义.结论 对可控制的慢性牙周炎缺牙患者,应用ITI种植系统可以获得可靠的疗效.     

慢性牙周炎患者种植修复的临床疗效评价

目的:探讨慢性牙周炎状态对种植修复的临床疗效影响.方法:在牙列缺损患者中,选择符合纳入标准的慢性牙周炎患者55例,牙周健康患者58例为对照组,各植入70颗Ankylos种植体.完成修复的3、6和12个月后,观察并记录改良菌斑指数、改良龈沟出血指数、探诊深度和边缘骨吸收量等指标,计算种植体的存留率.结果:修复后两组种植体存留率均为100％.其中牙周炎组与牙周健康组种植体边缘骨吸收量:3个月后分别为0.44±0.15mm和0.41±0.17mm,6个月后1.01±0.20mm和0.93±0.35mm,12个月后1.13±0.25 mm和1.10±0.24mm,差异均无统计学意义,P＞0.05.观察期内两组间mPLI、mSBI和PD值的差异也均无统计学意义,P＞0.05.结论:在经过系统牙周治疗病情稳定后,慢性牙周炎患者行种植修复后,其短期疗效与牙周健康患者无显著差异.     

牙周炎患者即刻修复的临床观察

目的：对牙周炎患者行即刻修复进行临床观察研究。方法：选择于2008年5月至2009年5月期间在中山大学光华口腔医学院附属口腔医院种植科就诊的具有牙周炎病史的牙列缺损或牙列缺失患者,共31例（男16例,女15例）。所有患者均已行完善的牙周治疗。共植入种植体107枚,均于手术当天完成树脂临时修复。术后3个月行永久修复。结果：31例107枚种植体中,下颌18例66枚种植体,上颌13例41枚种植体,修复后成功率为100%.结论：牙周炎病史患者行完善的牙周治疗后,行种植即刻修复也可获得满意的短期临床效果。     

15例慢性局限性牙周炎患者牙种植修复的临床效果评价

目的:对慢性局限性牙周炎患者牙种植修复后的临床效果进行评价。方法:选取在烟台市口腔医院修复科就诊的患有慢性牙周炎需要种植的患者共15例,所有患者种植前都经过牙周科系统的洁治、刮治,牙周炎得以控制。15例患者共计植入种植体53颗,其中即刻种植6例,植入15颗种植体,延期种植9例,植入38颗种植体。所有种植体3—6个月后完成修复,3个月、6个月、1年、以后每1年定期回访检查,进行评价,共回访2年,评价内容包括X片测量牙槽嵴顶至种植体顶的距离、牙周袋深度、临床效果等。结果:所有种植体2年后均行使功能良好,种植体存留率100%,负荷两年后牙槽骨吸收平均为1.62±0.64mm。结论:对慢性牙周炎患者进完善的牙周治疗,病情得到控制后行种植修复,2年的临床效果是肯定的,更长期的效果有待进一步研究。     

慢性牙周炎患者种植义齿修复临床疗效评价的meta分析

目的:评价慢性牙周炎(CP)患者种植义齿修复临床疗效。方法:系统检索CBM、CNKI、VIP、协作网图书馆、MEDLINE、EMBASE相关研究,筛选符合纳入标准文献,用Stata12.0进行分析,合并OR及其95%CI作为效应指标评价CP种植义齿存留率,合并SMD及其95%CI作为效应指标评价CP种植义齿修复后检测指标改良菌斑指数(mPLI)、改良出血指数(mSBI)、探诊深度(PD)、边缘骨吸收(MBI)、附着丧失(AL)、龈沟液量(PISF),发表性偏倚以漏斗图显示,Egger’s test检验漏斗图的不对称性。结果:12篇文献513个研究对象共计693枚种植体纳入分析,CP种植体存留率合并OR(95%CI)=1.305,P=0.291,CP组种植体平均存留率=94.9%,对照组种植体平均存留率=98.7%,无统计意义,mPLI、mSBI、PD、MBI、AL及PISF合并SMD(95%CI)=-2.367、1.43、0.429、0.303、0.926、6.221,各项检测指标P<0.05,有统计意义。结论:MBI和PD作为关键研究指标,结果有统计意义,认为即使在良好的牙周治疗下种植体骨水平也会因CP存在而丧失,依靠种植体周围骨支持的种植体存留率无统计意义,随时间延长,MBI及PD会加大,进而影响种植体稳定性,使种植体存留率存在统计意义。     

11例慢性牙周炎患者种植修复的临床效果评价

目的：评价11例慢性牙周炎患者行牙种植修复的临床效果,并探讨其影响因素。方法：选择因牙列缺损需行种植修复的慢性牙周炎患者11例,术前行牙周基础治疗并积极进行口腔卫生宣教,牙周炎控制后共植入32枚种植体,3个月后行永久修复,修复完成后第1、3、6和12个月复诊。复诊时检测种植体周围边缘骨吸收量、软组织健康状况及各种机械并发症。结果：所有种植体行使功能良好,完成修复第一年平均骨吸收量为1．02mm,随诊期内所有种植体周围软组织健康状况良好,未发现机械并发症。结论：慢性牙周炎患者行种植修复可获得良好的临床效果,术前规范的牙周基础治疗和口腔卫生宣教以及患者自我清洁能力的提高是治疗成功的关键。     

种植修复治疗慢性牙周炎牙列缺损的短期疗效

目的 探讨种植修复治疗慢性牙周炎所致牙列缺损患者的短期疗效.方法 选取2014年6月~2015年5月在广州市海珠区口腔医院行种植修复的轻中度慢性牙周炎患者53例作观察组,选取同期行种植修复的牙周健康者53例作对照组.分别于术后半年和1年时,检测两组患者种植牙菌斑指数(plaque index,PLI)、龈沟出血指数(sulcus bleeding index,SBI)、牙周袋探诊深度(periodontal probing depth,PD)和牙龈乳头指数(gingival papilla index,PIS),同时检测龈沟液白细胞介素-6(interleukin-6,IL-6)、白细胞介素-8(interleukin-8,IL-8)、高敏-C反应蛋白(high sensitive C-reactive protein,hs-CRP)和肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α).末次随访时,观察两组患者种植体有无松动、脱落情况,计算存留率.结果 术后1年随访时,观察组64枚种植体中5枚脱落,对照组71枚种植体中2枚脱落,两组术后1年种植体存留率比较无统计学差异(x2=1.709,P=0.191).术后半年两组SBI(t=0.936,P=0.351)、PLI(t=0.457,P=0.649)、PIS(t=1.132,P=0.217)和PD(t=0.957,P=0.341)比较无统计学差异.术后1年观察组各牙周指标大于对照组,差异有统计学意义,SBI(t=5.297,P=0.000)、PLI(t=2.341,P=0.021)、PIS(t=8.218,P=0.000)和PD(t=6.492,P=0.000).术后半年观察组IL-6(t=6.463,P=0.000)、IL-8(t=7.202,P=0.000)、hs-CRP(t=4.237,P=0.000)和TNF-α(t=6.194,P=0.000)水平明显高于对照组.术后1年观察组各炎性因子IL-6(t=12.835,P=0.000)、IL-8(t=13.207,P=0.000)、hs-CRP(t=11.319,P=0.000)和TNF-α(t=8.117,P=0.000)水平也高于对照组,差异具有统计学意义.结论 种植修复治疗慢性牙周炎所致牙列缺损能够获得较满意的短期疗效,但是其远期疗效尚待进一步验证.     

12例重度慢性牙周炎患者全颌种植义齿修复的临床观察

目的探讨对经牙周治疗的重度慢性牙周炎患者拔除剩余牙齿后同期植入种植体并采用全颌种植义齿修复的可行性。方法对12例重度慢性牙周炎患者行牙周治疗，控制病情后，拔除剩余牙齿并同期植入种植体，5～6个月后行全颌种植义齿修复。根据临床、X线检查和患者主诉评价修复效果。结果共计108枚种植体植入20个牙弓，其中37枚种植体即刻植入拔牙窝内。种植体平均承载3年，所有种植体均无松动。2枚种植体发生种植体周围炎，有进行性骨吸收，其中1枚为即刻植入拔牙窝内的种植体。除2枚有进行性骨吸收的种植体外，其余种植体周围的骨吸收高度平均为（1．33±0．10）mm。108枚种植体的存留率为98．1％，37枚即刻种植体的存留率为97．3％。结论对重度慢性牙周炎患者行牙周治疗后拔除剩余牙齿并同期植入种植体，采用全颌种植义齿修复，可减少牙槽骨的吸收、缩短种植修复疗程，在定期的口腔卫生维护下获得理想的修复效果。     

Early colonization of non-submerged dental implants in patients with a history of advanced aggressive periodontitis

The aim of the study was to evaluate the early colonization of non-submerged implants over a 6-month period in partially edentulous patients treated for advanced aggressive periodontal disease. In 22 patients treated for advanced aggressive periodontitis and in a supportive maintenance program for a period between 12 and 240 months at implant surgery, a total of 68 non-submerged dental implants were installed. Patients had a plaque score below 20%, and less than 20% of the pockets around the teeth were bleeding on probing (BOP). Using DNA-probes (micro-IDent), the presence and concentration of five periodontal pathogens (Actinobacillus actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi), Tannerella forsythensis (Tf) and Treponema denticola (Td)) were determined in the five deepest pockets of the rest dentition pre-operatively and after 6 months as well as five places around each implant 10 days, 1 month, 3 months and 6 months after surgery. In each patient, a test to determine the genotype interleukin-1 (IL-1) was performed (PST - micro-IDent). After 6 months, no difference in microbial composition as compared with baseline was found around the teeth in five patients, in 12 minute differences and in five patients important differences were observed. Ten days after surgery, three patients had a complete similar bacterial composition between teeth and implants. In 14 patients, the composition was fairly similar, while large differences in composition and concentration occurred in five patients. This microbiota around the implants remained almost unchanged over a 6-month period and did not hamper the clinical and radiographic osseointegration and did not lead to peri-implantitis, mucositis or initiation of bone destruction.     

重度牙周炎患者即刻种植即刻负重后的临床效果观察

目的:对重度牙周炎患者即刻种植即刻负重后的临床效果进行评价.方法:选择2017年1月至2019年3月的23位重度牙周炎患者,术前控制急性炎症,术中拔除无保留价值的患牙后植入159枚种植体,其中62枚种植体植入新鲜拔牙窝,97枚种植体植入愈合牙槽窝.术后24小时内制作种植体支持的桥架式临时修复体即刻负重,最终修复完成于术后6个月内.观察这类治疗方案下的种植体存留率、种植体边缘骨吸收、种植体周软组织状况及并发症发生情况.结果:159枚种植体中有1枚在植入后4个月内失败,种植体2年总存留率为99.4％(158/159),即刻位点的种植体存留率为98.4％(61/62),愈合牙槽窝位点种植体存留率为100％(97/97);即刻种植体在永久修复时、修复后1年、2年的边缘骨吸收量分别为(0.52±0.16)mm、(0.76±0.22)mm、(0.88±0.27)mm,与愈合牙槽窝的(0.48±0.14)mm、(0.71±0.21)mm、(0.80±0.23)mm相比,差异无统计学意义(P＞0.05);即刻植入拔牙窝中的种植体与植入愈合牙槽窝中的种植体在改良菌斑指数、改良出血指数、种植体周围疾病发病率方面的差异无统计学意义(P＞0.05).结论:重度牙周炎患者即刻种植即刻负重后能够获得令人满意的临床效果,短期疗效可靠,但长期疗效仍需进一步观察.     

Clinical and microbial evaluation of dental scaling associated with subgingival minocycline in chronic periodontitis subjects

The aims of this double-blind randomized clinical trial were to evaluate the presence of periodontal pathogens and the clinical response of periodontal pockets treatment to scaling and root planing (SRP) associated with subgingival minocycline (SM). A total of 36 subjects, 26 to 60 years old (40.7 +/- 9.1), who had been previously diagnosed with chronic periodontitis, were included in the present study. Eighteen subjects were selected for the test group (TG), who were treated with SRP plus SM (new treatment), and 18 subjects for the control group (CG) who received SRP plus vehicle (current treatment). Two homologous sites in each subject with a probing depth (PD) > or = 6 mm were chosen. To evaluate the clinical response after treatment, PD was measured at baseline and at 90 days. Microbiological evaluation was performed to detect 7 periodontal pathogens using polymerase chain reaction at baseline, 30, and 120 days. A mean reduction in PD of 2.8 and 2.1 mm was observed in the TG and CG, respectively. At baseline, P. gingivalis was the most prevalent organism in both test (65.8%) and control (48.6%) groups. After 120 days it fell to 30.8% in TG and to 23.1% in CG. There were no statistically significant differences between the test and control groups concerning PD (p > 0.05 by Wilcoxon test) or presence of periodontal pathogens (p > 0.05 by Wilcoxon and chi-square; p > 0.01 by Signal test). The results observed showed that the new treatment was as effective as the current treatment in reducing periodontal pathogens and PD among chronic periodontitis subjects.     

Prospective evaluation of the systemic inflammatory marker C-reactive protein in patients with end-stage periodontitis getting teeth replaced with dental implants: a pilot investigation

OBJECTIVES: Serum C-reactive protein (CRP) has been shown to be a risk predictor for cardiovascular disease. Periodontal treatment reduces elevated CRP levels. The aim of this pilot investigation was to evaluate if dental implants placed after extractions in patients with end-stage periodontitis affect the serum CRP levels. MATERIAL AND METHODS: Serum CRP levels in 10 subjects with end-stage periodontitis were measured prior to tooth extraction and placement of dental implants, and at 3-month intervals for a year post-operatively. Univariate repeated measures analysis of variance was used to estimate and test the changes in CRP levels over time. RESULTS: Mean CRP levels decreased significantly following tooth extraction and replacement with dental implants from 3.45 to 1.55 mg/dl after 12 months (P < 0.01). Six-, 9-, and 12-month post-implant placement mean CRP values were statistically significantly different from the mean pre-operative CRP value (P < 0.01). CONCLUSIONS: The pilot data suggest that extraction of advanced periodontally involved teeth and their replacement with dental implants lead to a decrease in CRP levels, and dental implant placement does not change the lowered CRP levels over a 12-month period.     

Analysis of 435 screw-vent dental implants placed in 161 patients: software enhancement of clinical evaluation

This paper demonstrates how a computer software program was utilized in a private practice to supplement the clinical evaluation of one implant system. Clinical data were entered into a computer database at the time of implant placement and up to 13 years for follow-up appointments. Data were divided into two groups and subjected to lifetable analyses. The focus group consisted of a machined-titanium, screw-type implant with an internal abutment connection from one manufacturer. The residual database consisted of mixed implant designs with a variety of abutment connections and surfaces from several other manufacturers. Lifetable survival data between the two groups were generated. Cumulative survival rates from 0 to 13 years were 94.2% (n = 435) for the focus group and 90.1% (n = 2339) for the reference group. There were 25 implants lost in the focus group and 11 other implants were deemed "at risk." Survival results from other lifetable analyses are also presented for the two groups. Documentation of empirical clinical data in a computer software database over a period of time can help private practice clinicians better evaluate the dental implant systems used in their practices.