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。     

牙周袋内冲洗在治疗种植体周围黏膜炎中的临床观察

目的 对3种常用的牙周袋内冲洗液在种植体周围黏膜炎治疗中的临床疗效进行比较和评价。方法 32例种植体周围黏膜炎患者龈下刮治术后,实验组分别用0.1%碘氧液、3%过氧化氢液、0.2%洗必泰进行牙周袋内冲洗,术后每周冲洗1次,连续4周;对照组不进行牙周袋内冲洗。术前和术后4周分别检测菌斑指数(mPLI)、改良龈沟出血指数(modified sulcusbleeding index,mSBI)和牙周探诊深度(probing depth,PD)。结果 术后4周,实验组及对照组mPLI和PD的降低幅度各组间均无显著性差异(P>0.05);实验各组的mSBI降低幅度均大于对照组,差异有显著性(P0.05)。结论 含抗菌成分的牙周袋内冲洗液有助于改善种植体周围的牙周炎症状态。     

后牙区螺丝固位与黏结固位种植义齿修复效果的比较研究

目的探讨后牙区螺丝同位与黏结固位种植固定义齿临床修复效果的差异。方法选择上下颌后牙区牙列缺损患者42例共70枚种植体．其中24枚采用螺丝固位修复体．46枚采用黏结周位修复体。分别于修复后1年复诊．检测种植体周围边缘骨吸收量、改良菌斑指数（mPLI）、改良出血指数（mSBI）等临床指标以及患者对种植义齿的美观满意度。结果螺丝固位组及黏结固位组平均种植体周围边缘骨吸收量分别为0．78mm和0．68mm：螺丝组与黏结组mPLI平均水P50均为1，mSBI平均水平P50亦均为1：两组美观满意度平均得分P50为1。统计结果显示螺丝固位组与黏结固位组间种植体周围边缘骨吸收量、mPLI、mSBI以及患者满意度的差异均无统计学意义（P〉0．05）。结论后牙区螺丝固位与黏结固位种植义齿短期临床修复效果差异无统计学意义。     

吸烟患者牙种植疗效的临床研究

目的探讨吸烟对种植义齿临床疗效的影响。方法后牙缺失拟行种植修复的患者81例,分为吸烟组和非吸烟组,共植入124颗种植体,于负载后1年随访,检测种植体存留率、边缘骨吸收量、改良菌斑指数（modified plaque index,mPLI）和改良出血指数（modified sulcus bleeding index,mSBI）等临床指标。结果吸烟组有4颗种植体脱落,存留率为92%,非吸烟组种植体存留率为100%,2组差异有统计学意义（χ2=6.090,P=0.028）。吸烟组种植体周围边缘骨吸收量平均为（1.04±0.18）mm,mPLI和mSBI平均水平P50均为1。非吸烟组种植体周围边缘骨吸收量平均为（0.74±0.11）mm,mPLI和mSBI平均水平P50均为0。2组的边缘骨吸收量、mPLI、mSBI差异均有统计学意义（P〈0.05）。结论吸烟是导致种植义齿失败的一个危险因素,吸烟患者种植修复的预后较非吸烟者差。为提高种植义齿的成功率,吸烟患者应尽早戒烟,并保持口腔清洁卫生。     

贵金属烤瓷与氧化锆全瓷修复对种植体周围组织影响的临床比较

目的评价贵金属烤瓷、氧化锆全瓷单冠修复对种植体周围组织的影响。方法选择2008年6月—2010年12月间完成种植单冠修复的患者78例共120颗种植体,贵金属烤瓷修复与氧化锆全瓷修复各60颗。分别于修复后12个月复诊,检测种植体周围边缘骨吸收量(MBL)、牙周探诊深度(PD)、改良菌斑指数(mPLI)、改良龈沟出血指数(mSBI)、龈乳头指数等临床指标,以及调查患者对种植义齿的满意度。结果贵金属烤瓷与氧化锆全瓷修复在MBL、PD、mPLI、mSBI、龈乳头指数以及患者满意度方面的差异均无统计学意义(P>0.05)。结论贵金属烤瓷与氧化锆全瓷修复对种植体周围组织的影响无差异,均能取得较好的临床修复效果,长期效果有待于进一步观察。     

慢性牙周炎与种植体周围炎相关性的临床研究

目的：通过临床观察慢性牙周炎患者进行牙种植修复的早期临床效果,初步探讨慢性牙周炎与种植体周围炎发生发展的相关性。方法：选择15例慢性牙周炎患者24颗种植牙作为实验组,选择10例牙周健康者20颗种植牙作为对照组,二期修复负载时（种植体植入后4～6个月）检测两组患者种植体周围龈沟液量（PISF）、改良菌斑指数（mPLI）、改良龈沟出血指数（mBI）、探诊深度（PD）及附着丧失（AL）等各项临床指标,并进行比较。结果：慢性牙周炎患者种植体周的龈沟液量明显多于牙周健康患者（P〈0.05）;两组种植体周的各项临床指标均值除mPLI外均有显著性差异（P〈0.05）。结论：慢性牙周炎与种植体周围炎的发生可能具有一定的相关性。     

粘接固位与改良粘接固位修复后牙种植义齿单冠临床效果比较

目的    比较粘接固位和改良粘接固位在后牙种植义齿单冠修复中的临床效果,为临床选择牙种植修复体固位方法提供参考。方法    选择2012年6月至2013年8月于青岛大学附属医院口腔颌面外科已实施牙种植待单冠修复的后牙缺失患者80例,随机分为改良组40例和对照组40例,改良组行改良粘接固位,对照组行粘接固位。修复1年后,通过检测种植体周围骨吸收量、改良菌斑指数（mPLI）、改良出血指数（mSBI）等临床指标以及患者满意度进行效果评价。结果    2种固位方式在种植体周围骨吸收量、患者满意度方面差异均无统计学意义（P＞0.05）;mPLI、mSBI差异有统计学意义（P＜0.05）。结论    改良粘接固位的种植义齿短期修复效果优于传统粘接固位。     

混合固位在后牙种植义齿修复中的应用

目的:观察混合固位(改良粘接固位)在后牙种植义齿修复中的临床应用。方法:60例后牙牙列缺损患者共植入92枚种植体,其中50枚采用粘接固位修复体,42枚采用混合固位修复体。分别于修复1年后复诊,检测种植体周围边缘骨吸收量、改良菌斑指数(mPLI)、改良出血指数(mSBI)临床指标以及患者对种植义齿的满意度。结果:1年后,粘接固位组及混合固位组种植体周围边缘骨吸收量分别平均为0.531mm和0.492mm;两种固位组种植体周围边缘骨吸收量、mPLI、mSBI以及患者满意度方面均无统计学差异(P>0.05)。结论:混合固位种植义齿短期临床修复效果尚可,可用于种植义齿修复。     

两种固位方式下种植义齿周围组织情况及菌群分布的比较研究

目的：比较粘接固位与螺丝固位种植义齿修复后周围组织的健康情况及龈下菌群分布的差异。方法上下颌牙列缺损患者36例共68枚种植体,其中31枚采用螺丝固位修复体,37枚采用粘接固位修复体。分别于修复后第3个月、6个月、12个月复诊,检测种植义齿探诊深度（PD）、改良菌斑指数（mPLI）、改良出血指数（mSBI）等临床指标,比较种植体周围软组织健康状况,测量种植体边缘骨吸收（MBL）状况。采集种植体龈下菌群标本,比较两种固位方式修复后龈下菌群的差异。结果两组的mPLI、mSBI、PD、MBL在所有时间点差异均无统计学意义。在第3个月,螺丝固位组的种植义齿龈下厌氧菌总数高于粘接固位组（P<0.05）。在第6个月,螺丝固位组种植义齿龈下具核梭杆菌总数高于粘接固位组（P<0.05）。12个月时,两组龈下菌群数差异无统计学意义。结论螺丝固位与粘接固位两种固位方式对种植义齿周围软组织及边缘骨吸收的影响无显著差异。在修复后短期内,螺丝固位组厌氧菌总数、具核梭杆菌检出量较粘接固位组高,但在12个月时二者无明显差异。     

氯己定联合机械清创对种植体周围炎的治疗效果及对患者SF-36评分的影响

目的：研究氯己定联合机械清创对种植体周围炎的治疗效果及对患者SF-36评分的影响。方法：选取2015年1月—2019年1月浙江省人民医院收治的种植体周围炎患者100例,按照随机数字表法随机分为对照组和联合组各50例。2组患者均采用机械清创术进行治疗,联合组在机械清创术后使用氯己定漱口液含漱。对2组患者治疗前、后菌斑生物膜不同层面平均活性、改良菌斑指数（modified plaque index,mPLI）、探诊后出血指数（bleeding on probing,BOP）、改良龈沟出血指数（modification sulcus bleeding index,mSBI）、探诊深度（probing depth,PPD）、临床附着水平（clinical attachment level,AL）进行评价,并使用SF-36评分量表、VAS视觉疼痛评分法对2组患者生活质量、疼痛程度进行评价,评定治疗效果及统计并发症发生情况。采用SPSS 20.0软件包对数据进行统计学分析。结果：治疗前2组患者菌斑生物膜不同层面平均活性、mPLI、mSBI、AL、PPD、BOP、VAS、SF-36评分比较,无显著差异（P>0.05）;治疗后联合组患者菌斑生物膜不同层面平均活性、mPLI、mSBI、AL、PPD、BOP、VAS评分均低于对照组,SF-36评分高于对照组,治疗总有效率显著高于对照组（P<0.05）。联合组患者治疗过程中并发症发生率显著低于对照组（P<0.05）。结论：氯己定联合机械清创对种植体周围炎患者进行治疗,效果显著,可有效抑制菌斑生物膜活性,抑制菌斑形成,减轻患者疼痛,提高生活质量。     

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。     

透明质酸钠治疗种植体周粘膜炎的临床研究

目的：评价透明质酸钠治疗种植体周粘膜炎的临床效果。方法：对28例种植体周粘膜炎患牙，分别行碳纤维头超声洁治及局部应用透明质酸钠治疗，定期复查，观察牙周各项指标变化。结果：应用碳纤维头超声洁治及透明质酸钠治疗后，种植体周牙龈出血指数及菌斑指数均有显著降低，牙周探诊深度呈下降趋势。结论：透明质酸钠对种植体周粘膜炎有良好的治疗作用。     

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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。     

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.     

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.     

Treatment of titanium dental implants with three piezoelectric ultrasonic scalers: an in vivo study

BACKGROUND: Dental implants require regular maintenance. It is crucial that the instrument used for maintenance be able to remove plaque and calculus from the implant surface effectively and efficiently, while causing minimal damage to its circumference. Some ultrasonic scalers may be useful for implant maintenance; however, no clinical study has examined this. This study evaluated the treatment of titanium implants with three piezoelectric scalers in vivo. METHODS: Fourteen patients underwent implant treatment in which plaque and calculus were removed from the abutment surfaces with ultrasonic scalers. The abutments were treated with scalers with carbon (VS; N = 7), plastic (PS; N = 7), or metallic (ES; N = 7) tips. The abutment surface characteristics were examined after instrumentation using scanning electron microscopy. The amount of plaque remaining and roughness were estimated using a modification of the remaining plaque and calculus score and the modified roughness score, respectively. In addition, the abutment surfaces were imaged with a laser profilometer and a laser scanning electron microscope (SEM). RESULTS: The remaining plaque and calculus scores did not differ significantly among the VS, PS, and ES groups. VS and PS produced a significantly smoother abutment surface than ES. The laser SEM three-dimensional images also demonstrated that VS and PS produced smooth abutment surfaces, whereas ES resulted in damaged surfaces. CONCLUSIONS: VS and PS produced clean, smooth abutment surfaces. Piezoelectric scalers with non-metal tips are suitable for use in dental implant maintenance.     

Experimentally induced peri‐implant mucositis. A clinical study in humans.

The purpose of this study was to compare the clinical and microbiological (microscopic) parameters during the development of experimental gingigivitis and experimental peri-implant mucositis. Twenty partially edentulous patients were treated for moderate to advanced periodontal disease. Following active periodontal therapy consisting of motivation, instruction in oral hygiene practices, scaling and root planing and periodontal surgery where indicated, IMZ oral implants were incorporated in posterior edentulous areas. After 3 months of healing, the prosthetic abutments were connected, and the patients were closely supervised for another 2 months of healing. At this time, baseline data were obtained. Re‐examinations were scheduled at 3 and 6 months. Following this, the patients were asked to refrain from oral hygiene practices for 3 weeks. At all examinations including the end of the period of no oral hygiene, the following clinical parameters were obtained: Plaque Index, Gingival Index and Sulcus Bleeding Index, all modified by Mombelli et al. (1987) probing pocket depths and recession in mm. Furthermore, submucosal/subgingival plaque samples were obtained and analyzed using phase contrast microscopy. At the end of the 3‐week period of plaque accumulation: optimal oral hygiene was reinstituted. There were no statistically significant differences between the mean values of all parameters at implant compared to tooth sites at any observation periods. The period of no oral hygiene demonstrated a similar cause‐effect relationship between the accumulation of bacteria1 plaque and the development of peri-implant mucositis as established for the gingival units by the experimental gingivitis model.     

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.     

种植修复患者唾液与龈下菌斑微生物群落结构关联及其影响因素研究

目的 利用高通量测序技术研究种植修复患者唾液与龈下菌斑微生物群落结构的关联及其影响因素,为种植体周微生物研究的样本选择提供参考。方法 选取于2014年6月至2015年9月在第四军医大学口腔医院口腔修复科完成种植修复的10例患者（12颗种植体）,于2021年11月至2022年1月随访复诊时采集其唾液和种植体周龈下菌斑样本,行16S rRNA V3～V4区双端测序,通过Alpha多样性分析和LEfSe多级物种差异判别分析其微生物群落丰富度、多样性及物种丰度的差异性。结果 在Alpha多样性分析中,Sobs指数和Chao指数显示,唾液中微生物群落丰富度大于龈下菌斑,差异均有统计学意义（均P <0.05）;而Shannon指数和Simpson指数显示,唾液与龈下菌斑微生物群落多样性差异无统计学意义（P> 0.05）。进一步分析发现,种植体周围黏膜炎患者和吸烟患者的唾液与龈下菌斑微生物群落丰富度差异无统计学意义（均P> 0.05）;男性、不饮酒、种植体周最大探诊深度≥5 mm的患者唾液与龈下菌斑微生物群落多样性差异有统计学意义（均P <0.05）;其他因素如不同年龄、软垢...