不同洁治器械对钛种植体基台表面的影响

碳纤维洁治器头（ｃａｒｂｏｎｔｉｐ）是一种新型的超声洁治工具，它由隔热绝缘材料制成，在自然牙的洁治过程中可减少因产热和静电所造成的损伤与不适，其在种植体的应用，国内尚未见报道。为观察它对钛种植体表面的影响，本研究采用碳纤维、塑料及金属洁治器对钛种植体...     

超声洁治和局部用甲硝唑治疗轻、中度种植体周围炎

目的：评价用碳纤维工作头的超声洁牙机和25％甲硝唑凝胶治疗种植体周围炎的疗效。方法：将27颗患轻中度种植体周围炎的种植牙随机分为洁牙机治疗组和甲硝唑治疗组，在基线、1、2、6和12周时检查种植体的临床和生物学指标。结果： 两种治疗方法均可使菌斑指数、龈沟出血指数、龋下微生物的酶活性检查等指标改善。治疗期间未发现任何不良反应。结论；碳纤维头超声洁治和局部用25％甲硝唑凝胶是治疗牙种植体周围炎的安全有效的方法。     

25例种植体周围黏膜炎治疗的临床研究

目的：观察口腔卫生指导配合碳纤维工作头洁治治疗种植体周围黏膜炎的临床疗效。方法：25例种植体周围黏膜炎患者，用碳纤维工作头对种植体周围进行洁治，同时对患者进行口腔卫生指导以控制菌斑。记录前后种植体周围改良菌斑指数（mPLI）、改良龈沟出血指数（mSBI）、探诊深度（PD）等相关指标。结果：用碳纤维工作头洁治种植体周围和口腔卫生指导可使mPLI、mSBI、PD等指标明显改善。结论：口腔卫生指导和碳纤维工作头洁治术对种植体周围黏膜炎的临床治疗是有效的。     

种植体周围炎非手术治疗的临床疗效分析

目的：比较两种种植体周围炎非手术治疗的临床疗效。方法：选择44例种植体周围炎患者（44枚种植体），随机分组，分别进行树脂洁治和超声洁治，分别在基线、4周和8周时测龈沟出血指数、探诊深度和最深探诊深度，进行统计学分析。结果：两种治疗方法均可明显改善牙龈出血，但不能改善探诊深度和最深探珍深度。结论：树脂洁治和超声洁治对种植体周围炎的治疗仅为有限效果。     

牙周治疗对种植体周围炎龈沟液中白介素-8表达的影响

目的：观察采用牙周洁治和牙周冲洗对种植体周围组织炎症治疗后,种植体周围龈沟液（PICF）中细胞因子白介素-8（IL-8）的表达变化.方法：对周围龈组织有炎症表现的16枚种植体进行牙周洁治和牙周冲洗治疗,Whatman3#滤纸取治疗前后龈沟液,ELISA法检测PICF中IL-8的含量.结果：经过牙周洁治和牙周冲洗治疗后的PICF样本中,IL-8含量较治疗前显著降低,且软组织炎症有明显缓解.结论：PICF中IL-8的含量与种植体周围组织的炎症程度具有相关性.IL-8有可能成为种植体周围炎客观性的诊断指标之一.     

口腔种植学

双种植体支持单个磨牙种植义齿的5年临床效果观察，骨增量技术在种植修复上颌前牙缺失的临床应用，闭合式上颌窦提升术同期种植体植入临床报告，透明质酸钠治疗种植体周粘膜炎的临床研究，种植覆盖义齿修复牙槽骨严重萎缩的无牙下颌[编者按]     

牙周治疗对种植体周围龈沟液中IL-1β、IL-6和TNF-α表达的影响

目的:观察采用牙周洁治和牙周冲洗对种植体周围组织炎症治疗后,种植体周围龈沟液中细胞因子IL-1,βIL-6和TNF-α的表达变化。方法:对周围龈组织有炎症表现的31枚种植体进行牙周洁治和牙周冲洗治疗,治疗前、后均采用whatman1#滤纸条吸取种植体龈沟液(PICF)。ELISA法检测PICF中细胞因子IL-1β、IL-6和TNF-α的含量。结果:经过牙周洁治和牙周冲洗治疗后的PICF样本中,IL-1β、IL-6和TNF-α含量较治疗前显著降低,且软组织炎症有明显缓解。结论:PICF中IL-1β、IL-6和TNF-α的含量与种植体周围组织的炎症程度具有相关性,具有作为评价种植体周围组织炎症指标的可能性。     

洁治与派丽奥局部应用对种植体周围炎治疗的疗效比较

目的:观察种植体周围洁治、派丽奥药物局部应用和二者联合治疗对种植体周围炎的临床治疗效果。方法:选择15个患种植体周围炎的病人,且每个病人至少有2个种植体,随机将这些病人分为洁治组、药物组、洁治 药物组,在基线期、治疗后4周、12周检查种植体周围组织的相关变化。结果:三种治疗方法均可使菌斑指数、龈沟出血指数和探诊深度等指标明显改善,但洁治 药物治疗的疗效持久。结论:种植体周围洁治与留置派丽奥药物治疗方法均具有明显的治疗作用,二者结合应用效果更好。     

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目的探讨盐酸二甲胺环素配合治疗种植体周围黏膜炎的临床对照疗效。方法2004年6月至2007年8月在青岛市口腔医院口腔种植中心,将患有种植体周围黏膜炎的患者种植体24颗随机分为试验组和对照组,试验组行碳纤维刮治器洁刮治+抛光喷砂+局部应用盐酸二甲胺四环素软膏;对照组应用碳纤维刮治器洁刮治+抛光喷砂治疗。结果两组治疗后菌斑指数、龈沟出血指数及种植体周围探诊深度较治疗前均明显降低(P<0.05),但两种治疗方法间疗效差异无统计学意义。结论使用机械性洁治和抛光以及有效控制菌斑是治疗种植体周围黏膜炎的有效方法,局部应用盐酸二甲胺四环素软膏短期内有一定疗效。     

超声和手用器械龈下洁治后牙根面的扫描电镜观察

目的：通过超声和手用器械对牙周炎患牙根面处理的比较，来评价超声龈下洁治在牙周治疗中的作用。方法：选择１０个新鲜拔除的牙周炎患牙，随机分别用手用器械（第１组）和超声（第２组）洁治；选择４个临床诊断需拔除的牙周炎患牙分别行手用器械（第３组）和超声（第４组）龈下洁治，然后将患牙拔除。所有牙齿均在扫描电镜下观察。结果：超声龈下洁治能有效去除龈下菌斑及牙石，使根面较光滑平整，与手用器械洁治相比，无明显差异。结论：超声龈下洁治器是一种进行龈下洁治和根面平整的有效工具。     

种植体周围黏膜炎龈下微生物群落多样性研究

目的:检测种植体周围黏膜炎龈下微生物群落的多样性,研究种植体周围黏膜炎龈下微生物种类、数量以及群落分布,找出特异性微生物,为临床上选择适当的维护与干预方法提供依据。方法:采集10例患黏膜炎的种植体龈沟液样本(A组)及14例健康种植体的龈沟液样本(B组),提取样本龈沟液中的微生物总DNA作为模板,采用细菌的16S rDNA V3区通用引物进行扩增,扩增产物进行DGGE电泳分析及克隆测序分析。结果:A组较B组龈沟液量多,差异有显著统计学意义(P﹤0.01)。AB两组样本整体相似性为18%,A组各样本群落相似性为29.9%~60.2%,B组各样本相似性30.8%~74%。A组测得5种菌门,包括15种菌属,B组测得4种菌门,12种菌属。A组G^-厌氧杆菌比例为69.65%,B组为64.51%。结论:发生种植体周围黏膜炎时龈沟液量较健康种植体增加,龈沟液量可一定程度上反映种植体周围软组织的健康状况。种植体周围组织在健康状态和发生黏膜炎时的龈沟液中微生物群落均具有高度多样性,但菌群结构差异较大。健康种植体及种植体周围黏膜炎龈下微生物群落均以G^-厌氧杆菌为主,后者G^-厌氧杆菌比例更高。     

Proinflammatory cytokines (IL-1β and TNF-α) and chemokines (IL-8 and MIP-1α) as markers of peri-implant tissue condition

Analysis of peri-implant crevicular fluid (PICF) offers a non-invasive means of studying the host response in peri-implant disease and may provide an early indication of patients at risk for active disease. This study examined the PICF levels of interleukin-1beta (IL-1β), tumour necrosis factor alpha (TNF-α), interleukin-8 (IL-8) and macrophage inflammatory protein-1alpha (MIP-1α) in patients with non-manifesting inflammation, early and late stages of mucositis. The study group comprised 90 adult healthy volunteers with endosseal titanium implants inserted. Samples were taken from peri-implant sulcus using a filter paper technique. Implant tissues were categorized clinically as healthy, early mucositis or advanced mucositis. Clinical manifestations were determined by: gingival index and bleeding on probing, plaque index and radiographic analyses. Cytokine concentrations were assesed using commercially available enzyme-linked immunosorbent assay kits. Patients from the control group (healthy patients) have significantly lower concentrations of IL-1β, TNF-α, IL-8 and MIP-1α in PICF compared with both groups with mucositis. Positive correlation was noted in the control group between IL-1β and TNF-α and between MIP-1α and IL-8 in the group with early mucositis. The results suggest that cytokines could be prognostic markers of implant failure.     

Clinical response to 2 different therapeutic regimens to treat peri-implant mucositis

BACKGROUND: Maintenance of implants is imperative, since implants, like teeth, are susceptible to bacterial plaque accumulation and calculus formation, and thus at risk of developing peri-implant mucositis or peri-implantitis. METHODS: This study determined the clinical effects of chlorhexidine treatment on peri-implant mucositis at 1 and 3 months as determined by the modified plaque index, the modified sulcus bleeding index, clinical attachment level, and probing depth. Through DNA probes, the effect of chlorhexidine on the microbial flora of mucositic lesions was also evaluated. The population consisted of 16 adult male and female subjects (ages 34 to 76). After the baseline examination, the subjects received a dental prophylaxis and were randomly assigned to the test or control group. Subjects in the test group received antiseptic therapy (Treatment 1), which included mechanical cleansing and oral hygiene instructions supplemented by the local irrigation with chlorhexidine 0.12%, using a plastic syringe, and the topical application of a 0.12% chlorhexidine gel. The subjects in the control group received only mechanical cleansing and oral hygiene instructions (Treatment 2). RESULTS: Both modalities of treatment were effective in reducing peri-implant mucositis and probing depths, and improving attachment levels. The trends suggested that mechanical cleansing alone may be sufficient to treat and reduce peri-implant mucositis at 1 and 3 months after treatment. The addition of chlorhexidine to mechanical debridement did not enhance the results as compared to mechanical debridement alone. CONCLUSIONS: Mechanical debridement as well as mechanical debridement supplemented with chlorhexidine can be beneficial to patients with peri-implant mucositis. Both treatments resulted in a reduction of plaque, inflammation, and probing depth, as well as a gain in clinical attachment level, and are effective in suppressing or eradicating the pathogenic bacteria often associated with peri-implant inflammation.     

Effect of mechanical and antiseptic therapy on peri-implant mucositis: an experimental study in monkeys

OBJECTIVES: This experiment was performed to evaluate clinically and histologically the effect of mechanical therapy with or without antiseptic therapy on peri-implant mucositis lesions in nine cynomolgus monkeys. MATERIAL AND METHODS: Two ITI titanium implants were inserted into each side of the mandibles. After 90 days of plaque control and soft tissue healing, a baseline clinical examination was completed. Peri-implant lesions were induced by placing silk ligatures and allowing plaque to accumulate for 6 weeks. The clinical examination was then repeated, and the monkeys were randomly assigned to three treatment groups: group A, mechanical cleansing only; group B, mechanical cleansing and local irrigation with 0.12% chlorhexidine (CHX) and application of 0.2% CHX gel; and group C, control, no treatment. The implants in treatment groups A and B were treated and maintained according to the assigned treatment for two additional months. At the end of the maintenance period, a final clinical examination was performed and the animals were sacrificed for biopsies. RESULTS: The mean probing depths (PD) values at mucositis were: 3.5, 3.7, and 3.4 mm, and clinical attachment level (CAL) = 3.8, 4.1, and 3.9 mm for treatment groups A, B and C, respectively. The corresponding values after treatment were: PD = 1.7, 2.1, and 2.5 mm, and CAL=2.6, 2.6, and 3.1 mm. ANOVA of mean changes (Delta) in PD and CAL after treatment showed no statistical difference between the treatment groups. Comparison of the mean changes in PD and CAL after treatment yielded statistical differences between the control and treatment groups P < 0.01. According to the t-test, no statistical difference was found between treatment groups A and B for the PD reduction but there was a significant difference for the CAL change, P < 0.03. Group A had significantly more recession and less CAL gain than group B. Non-parametric tests yielded no significant differences in modified plaque index (mPlI) and gingival index (GI) after treatment between both treatment groups. Frequencies and percent distributions of the mPlI and GI scores changed considerably for both treatment groups when compared with the changes in the control group after treatment. With regard to the histological evaluation, no statistical differences existed between the treatments for any linear measurement. The proportion of inflammation found in the mucosal tissues of the control implants was greater than the one found for both treatment groups, P < 0.01. More importantly, both treatment groups showed a similar low proportion of inflammation after 2 months of treatment. CONCLUSIONS: Within the limitations of this experiment, and considering the supportive plaque control rendered, it can be concluded that for pockets of 3-4 mm: (1) mechanical therapy alone or combined with CHX results in the clinical resolution of peri-implant mucositis lesions, (2) histologically, both treatments result in minimal inflammation compatible with health, and (3) the mechanical effect alone is sufficient to achieve clinical and histologic resolution of mucositis lesions.     

个体化口腔卫生指导对种植体周围黏膜炎治疗效果的影响

目的:探讨个体化口腔卫生指导对种植体周围黏膜炎的临床疗效的影响。方法:将36名种植体周围黏膜炎患者随机分为实验组和对照组。对照组用碳纤维工作头对种植体周围进行刮治,不作口腔卫生指导;实验组用同样方法刮治后进行个体化口腔卫生指导。分别于术后第1,3,6周记录改良菌斑指数(mPLI)、改良龈沟出血指数(mSBI)、探诊深度(PD)以评价口腔卫生指导的效果。结果:在第1周,两组病例各指标差异无统计学意义(P>0.05)。到第3,6周,实验组与对照组相比mPLI及mSBI改善效果明显,两组PD稳定。结论:个体化口腔卫生指导可以有效提高种植体周围黏膜炎的治疗效果。     

盐酸米诺环素软膏与奥硝唑治疗种植体周围黏膜炎的临床疗效比较

目的探讨比较局部使用盐酸米诺环素软膏和口服奥硝唑治疗种植体周围黏膜炎的临床疗效。方法选择种植体周围黏膜炎患者24例,对种植体进行龈上洁治、龈下刮治后,随机分为盐酸米诺环素软膏组和口服奥硝唑组,分别于基线、治疗后4周和治疗后8周行临床牙周指数检测。结果在治疗后4周和8周时,2组种植体周围改良菌斑指数、改良龈沟出血指数、探诊深度均明显下降,与基线时相比较,差异均有统计学意义（P〈0.05）。在治疗后4周和治疗后8周,盐酸米诺环素治疗组种植体周围改良菌斑指数、改良龈沟出血指数、探诊深度均低于口服奥硝唑组,且组间差异均有统计学意义（P〈0.05）。结论对于种植体周围黏膜炎,局部使用盐酸米诺环素软膏治疗或口服奥硝唑治疗均有效果;使用盐酸米诺环素软膏治疗更加有效。     

Expression of IL-6, IL-10, IL-17 and IL-33 in the peri-implant crevicular fluid of patients with peri-implant mucositis and peri-implantitis

ObjectivesThe aim of this study was to compare the levels of IL-6, IL-10, IL-17 and IL-33 in the peri-implantar crevicular fluid (PICF) and in parotid gland saliva (PGS) of healthy patients, and peri-implantitis and peri-implant mucositis patients.Materials and methodsThe PICF was collected from 40 implants as follows: 10 peri-implant mucositis patients, 20 peri-implantitis patients and 10 healthy patients. The PICF and PGS samples collected from each patient were quantified for IL-6, IL-10, IL-17 and IL-33 by enzymatic immunosorbent assay (ELISA).ResultsIL-6, IL-17 and IL-33 levels on PIFC were significantly higher in peri-implantitis group when compared to healthy group. IL-17 and IL-33 levels in PIFC were significantly higher in peri-implant mucositis group than in healthy group. There was no significant difference when comparing IL-6, IL-10, IL-17 and IL-33 levels in PGS among healthy, peri-implant mucositis and peri-implantitis groups.ConclusionsTherefore, as in patients with peri-implantitis there were significantly higher levels of IL-6, IL-17 and IL-33 in PICF, we believe that these cytokines were intensifying local inflammatory process, and contributing to clinical aspects such as increased marginal bleeding and probing depth found in patients with peri-implantitis. Furthermore, as IL-17 and IL-33 were increased in patients with peri-implant mucositis, hypothesized that these cytokines were also contributing to the inflammatory process observed in this disease.     

Single-blind randomized clinical trial to evaluate clinical and radiological outcomes after one year of immediate versus delayed implant placement supporting full-arch prostheses

Purpose: To evaluate and compare peri-implant health, marginal bone loss and success of immediate and delayed implant placement for rehabilitation with full-arch fixed prostheses. Material and Methods: The present study was a prospective, randomized, single-blind, clinical preliminary trial. Patients were randomized into two treatment groups. In Group A implants were placed immediately post-extraction and in Group B six months after extraction. The following control time-points were established: one week, six months and twelve months after loading. Measurements were taken of peri-implant crevicular fluid volume, plaque index, gingival retraction, keratinized mucosa, probing depth, modified gingival index and presence of mucositis. Implant success rates were evaluated for the two groups. The study sample included fifteen patients (nine women and six men) with a mean average age of 63.7 years. One hundred and forty-four implants were placed: 76 placed in healed sites and 68 placed immediately. Results: At the moment of prosthetic loading, keratinized mucosa width and probing depth were higher in immediate implants than delayed implants, with statistically significant differences. However, after six and twelve months, differences between groups had disappeared. Bone loss was 0.54 ± 0.39 mm for immediate implants and 0.66 ± 0.25 mm for delayed implants (p=0.201). No implants failed in either group. Conclusions: The present study with a short follow-up and a small sample yielded no statistically significant differences in implant success and peri-implant marginal bone loss between immediate and delayed implants with fixed full-arch prostheses. Peri-implant health showed no statistically significant differences for any of the studied parameters (crevicular fluid volume, plaque index, gingival retraction, keratinized mucosa, probing depth, modified gingival index and presence of mucositis) at the twelve-month follow-up. Key words:Immediate implants, delayed implants, peri-implant health, success rate.