种植体周围炎的病因分析和治疗

目的：探讨种植体周围炎的病因和临床治疗。材料与方法：对７８例ＢＬＢＣ种植体中１０例种植体的周围炎患者进行病因分析,临床及Ｘ线诊断局部超声洁治、甲硝唑缓释和全身药物治疗并随访２年。结果：１０例患者病因主要是种植体周围卫生差,口腔卫生差及种植体材料等原因。通过系统的治疗后,９例在短期内痊愈,随访２年,未见复发。纣：种植体周围炎发病与种植材料、种植前口腔卫生、种植术后患者口腔卫生习惯密切相关。其治疗方法     

种植体周围炎的诊断和治疗新进展

种植体周围骨结合区的软组织和硬组织的炎症导致了种植体周围袋形成和骨吸收.微生物学研究发现种植体周围炎的致病微生物与天然牙矛周炎相似，都是由口腔厌氧菌引起.本文着重对种植体周围炎的最新诊断和治疗方法进行综述。     

种植体周围炎的治疗

种植体周围炎在不同种植系统的发病率大约为4%-15%。目前对种植体周围炎的治疗研究大多是建立在动物模型上。在临床应用和动物模型研究的基础上,本文主要就种植体周围炎的治疗方法的研究进展作一综述。     

种植体周围炎治疗方法的研究进展

种植体周围炎是牙种植术后常见的并发症之一,可使支持骨丧失、骨性结合失败,甚至导致已经形成骨结合并行使功能的种植体脱落。目前临床上常用的治疗种植体周围炎的方法主要有手术治疗、激光治疗、超声洁治加局部用药单独或联合治疗等。手术治疗可以恢复因炎症导致的骨缺损,较大程度地治疗种植体周围的各种软硬组织损伤;激光治疗便于操作,副作用小并且除菌彻底,越来越被临床医生所重视;洁治加局部用药治疗是传统的治疗方式,疗效好,创伤小易被广大医生及患者接受。各种治疗方法适应症略有不同,针对不同的患者选择最佳的治疗方式是保证治疗成功的关键。     

种植体周围炎的治疗

种植体周围炎是骨性结合种植体周围软硬组织的炎症,能使支持骨丧失,导致骨性结合失败。种植体周围炎是导致种植义齿修复失败的主要原因。早期治疗利于种植体周围组织恢复到健康状态。种植体周围炎的治疗方法有局部清洁、药物治疗、手术治疗等。本文即从这几方面对种植体周围炎的治疗进行综述。     

种植体周围炎的治疗

随着人们生活水平提高,种植牙修复成为缺失牙患者主要选择之一,与之相应的种植体周围炎患者日趋增多。目前应用的各种治疗方案均有其优缺点,缺少一种治疗种植体周围炎的金标准,本文对各种治疗方案做一综述。     

种植体周围炎防治的初步探讨

近年来,随着牙种植理论研究的不断深入与完善,种植成功率的提高,骨性结合种植体在临床上已得到广泛应用,骨内牙种植是目前国内外最常用的一种种植方式。然而,种植体周围炎已成为影响其远期成功率的一个主要因素,大大阻碍了其在临床上的进一步推广应用,因此对种植体...     

种植体周围炎的防治策略和进展

种植体周围炎症是导致种植体失败的主要原因,应改善口腔卫生环境,去除吸烟等危险因素以预防炎症发生,在定期复诊中通过一般检查、探诊、X线片等方法实现早期诊断并及早治疗,治疗可采用累积、截断、支持、治疗方案,即CIST系统,根据病情采取相应的治疗措施。     

种植体周围炎病因、诊断、治疗与种植体周维护

种植体周围炎是指发生于种植体周围软硬组织的炎症性损害,并伴有支持骨的丧失。种植体周围炎的危险因素包括菌斑、牙周病史、吸烟、糖尿病等。临床诊断标准包括探诊出血、种植体周袋内有溢脓、探诊深度≥5 mm以及影像学显示边缘骨丧失≥2 mm。种植体周围炎的治疗包括机械清创联合药物治疗的非手术治疗,以及切除性和再生性手术等手术治疗。种植体周维护治疗可以保护种植体周围组织的健康和提高种植成功率。因此,要重视种植体周的维护,预防种植体周围炎的发生。     

种植体周围炎的治疗方法及进展

种植体周围炎是导致种植体失败的主要原因.目前国内外治疗种植体周围炎的方法主要包括洁刮治术、抗菌药物治疗、外科手术治疗、激光治疗及引导骨组织再生技术等,临床上通过上述方法消除种植体周围炎症,抑制种植体周围骨组织的持续性吸收,甚至促进新的骨组织形成,但长期治疗效果尚不肯定.     

盐酸二甲胺四环素治疗种植体周围炎临床效果观察

目的探讨和评估盐酸二甲胺四环素治疗种植体周围炎的临床疗效,为其在种植体周围炎的临床应用提供初步依据.方法对30例患者种植修复0.5年以上共32枚种植体发生的种植体周围炎局部以盐酸二甲胺四环素治疗,在用药前和用药后1、3、6周检查菌斑指数（PLI）、探诊深度（PD）、龈沟出血指数（SBI）,并随访半年.用SPSS10.0统计软件包配对t检验进行统计分析.结果盐酸二甲胺四环素治疗种植体周围炎后PD、SBI同用药前相比显著降低,其中无窦道型种植体周围炎药效至少能维持至停药后4周,近期治疗效果满意.结论盐酸二甲胺四环素是治疗无窦道型种植体周围炎有效的局部用药.而有窦道型种植体周围炎需结合外科手术治疗,盐酸二甲胺四环素还可作为有效的术前辅助用药控制局部炎症.     

超声龈下刮治同步药物冲洗对牙周炎的治疗作用

目的探讨超声龈下刮治同步药物冲洗对牙周炎的治疗效果。方法选取中、重度慢性牙周炎患牙34颗,随机分为三组：A组（蒸馏水组）超声龈下刮治同步无菌蒸馏水冲洗（11颗牙）;B组（消炎痛组）超声龈下刮治同步0.1%消炎痛药物冲洗（13颗牙）;C组（甲硝唑组）超声龈下刮治同步0.2%甲硝唑药物冲洗（10颗牙）。比较龈上洁治、龈下刮治前后28日临床检查指标,及治疗后7、28日龈沟液的量和龈沟液中IL-6的水平变化。结果三组治疗后菌斑指数（PLI）、探诊深度（PD）、龈沟出血指数（SB I）、龈沟液的量及龈沟液中IL-6水平明显降低,有显著性差异;附着丧失（AL）降低不明显;消炎痛组和甲硝唑组治疗后龈沟液中IL-6水平降低程度大于蒸馏水组,有显著性差异。结论超声龈下刮治同步药物冲洗能够明显提高牙周炎的治疗效果。     

35例种植体周围炎临床治疗效果观察

目的：针对种植体周围炎的致病相关因素采取系统治疗后,进行临床疗效评价。方法：35枚种植体根据临床检查指标确诊为种植体周围炎或种植体周围黏膜炎,采取对症治疗,局部以双氧水、生理盐水交替冲洗,龈袋内注入派力奥等方法,从病因上和症状上进行控制。记录用药前、用药后6周的菌斑指数,探诊出血指数,改良出血指数,探诊深度,牙龈乳头指数,并进行统计学分析。结果：探诊出血指数和改良出血指数有明显改变（P〈0.05）,菌斑指数,探诊深度,牙龈乳头指数,无明显统计学改变（P〉0.05）,种植体边缘骨吸收趋于稳定。结论：对症治疗对早期种植体周围炎有良好治疗效果。     

牙周基础治疗对胃内幽门螺杆菌根除率的影响

目的 :分析牙周炎与胃内幽门螺杆菌 (Helicobacterpylori ,Hp)的关系以及牙周基础治疗对胃内幽门螺杆菌根除率的影响。方法 :选择有慢性牙周炎且胃镜活检尿素酶阳性、病理诊断为慢性胃炎、胃或十二指肠溃疡患者91人进行三联药物治疗 ,其中 3 3人还同时进行了牙周基础治疗。三联药物治疗后分析胃内幽门螺杆菌根除率与患者牙周临床指数的关系 ,以及牙周基础治疗对胃内Hp根除率的影响。 结果 :4个位点平均牙周袋深 <4mm组的患者三联药物治疗 4周后及 1年后的Hp根除率明显高于平均袋深≥ 4mm组的患者 (80 %vs5 2 .2 % ,62 .9%vs 3 4.5 % ,P <0 .0 5 )。经过牙周基础治疗的患者 1年后的Hp根除率显著高于未做牙周基础治疗的患者 (63 .6%vs 3 4.5 % ,P <0 .0 5 )。结论 :药物治疗Hp的根除率与患者的牙周状况和口腔卫生状况有关。口腔Hp可能是胃Hp再感染的病原因素 ,因此对胃内Hp感染同时伴有牙周炎的患者在进行三联药物治疗的同时应配合牙周基础治疗。     

Pain and morbidity after non-surgical and surgical treatment of peri-implantitis

Objective: Not much information exists on post-treatment pain related to peri-implantitis. The purpose of this study was to evaluate intensity and quality of pain after non-surgical and surgical treatment of peri-implantitis.

Material and methods: A total of 30 patients with a diagnosis of peri-implantitis were included in the study. The patients registered pain using a VAS scale after non-surgical and surgical treatment of peri-implantitis. The data were registered for one week after each treatment. The patients also recorded quality of pain and if analgesics were taken. Factors included in the study were number of implants, severity of peri-implantitis (millimetre bone loss at most severely affected implant), implant localization, smoking and gender.

Results: Statistically significant difference in intensity of pain was found between day zero and day one for both non-surgical and surgical treatment of peri-implantitis (p?Conclusion: Levels of pain are found to be low to moderate for most patients after treatment of peri-implantitis. The pain was most pronounced on the first two days post-treatment. Throbbing/soreness and numbness were the most frequently reported quality of pain.     

The effect of low-level laser therapy as an adjunct to non-surgical periodontal treatment

Background: The aim of this study is to evaluate the effect of low‐level laser therapy (LLLT) as an adjunct to non‐surgical periodontal therapy of smoking and non‐smoking patients with moderate to advanced chronic periodontitis. Methods: All 36 systemically healthy patients who were included in the study initially received non‐surgical periodontal therapy. The LLLT group (n = 18) received GaAlAs diode laser therapy as an adjunct to non‐surgical periodontal therapy. A diode laser with a wavelength of 808 nm was used for the LLLT. Energy density of 4 J/cm² was applied to the gingival surface after periodontal treatment on the first, second, and seventh days. Each of the LLLT and control groups was divided into two groups as smoking and non‐smoking patients to investigate the effect of smoking on treatment. Gingival crevicular fluid samples were collected from all patients and clinical parameters were recorded on baseline, the first, third, and sixth months after treatment. Matrix metalloproteinase‐1, tissue inhibitor matrix metalloproteinase‐1, transforming growth factor‐β1, and basic‐fibroblast growth factor levels in the collected gingival crevicular fluid were measured. Results: The primary outcome variable in this study was change in gingival bleeding and inflammation. At all time points, the LLLT group showed significantly more improvement in sulcus bleeding index (SBI), clinical attachment level, and probing depth (PD) levels compared to the control group (P <0.001). There were clinically significant improvements in the laser‐applied smokers' PD and SBI levels compared to smokers to whom a laser was not applied, between the baseline and all time points (P <0.001) (SBI score: control group 1.12, LLLT group 1.49; PD: control group 1.21 mm, LLLT group 1.46 mm, between baseline and 6 months). Transforming growth factor‐β1 levels and the ratio of matrix metalloproteinase‐1 to tissue inhibitor matrix metalloproteinase‐1 decreased significantly in both groups at 1, 3, and 6 months after periodontal therapy (P <0.001). Basic‐fibroblast growth factor levels significantly decreased in both groups in the first month after the treatment, then increased in the third and sixth months (P <0.005). No marker level change showed significant differences between the groups (P <0.05). Conclusion: LLLT as an adjunctive therapy to non‐surgical periodontal treatment improves periodontal healing.     

牙周非手术治疗对根面牙本质敏感症形成的影响

目的：观察牙周非手术治疗对导致根面牙本质敏感症的影响，并探讨其机理。方法：对52例慢性牙周炎患者的1453颗牙进行龈下刮冶及根面平整术，随访3个月。总结冶疗后患者根面牙本质敏感症的发生情况。结果：52例患者中，39例共432颗牙发生了不同程度的根面牙本质敏感症，给予积极治疗后症状大多消失。龈下刮治术和根面平整术可使部分牙本质小管敞开暴露于口腔环境中，使外来刺激遵循液体动力学原理激发痛觉。结论：脱敏治疗应纳入牙周治疗计划中。