NLRP3炎症小体对种植体植入的影响

核苷酸结合寡聚化结构域样受体热蛋白结构域相关蛋白（NLRP）3炎症小体在种植体周围骨稳定的保持中发挥重要作用。NLRP3通过其下游的促炎性细胞因子白介素-1β和白介素-18,以及胱天蛋白酶-1介导的细胞焦亡,促进种植体周围骨吸收。通过抑制NLRP3炎症小体的产生可能有利于种植过程中提高患者的舒适度和种植后的骨稳定。种植体周围环境中存在的金属颗粒和菌斑可以激活NLRP3炎症小体进而促进骨吸收。已有研究多聚焦于骨科植入物周围骨组织和牙周炎,针对种植体周围炎的研究较少。本文就NLRP3炎症小体对种植体周围骨形成、骨吸收及种植体植入所致疼痛产生的影响展开综述,并对NLRP3炎症小体作为预防种植体周围炎的可能进行阐述。     

预测糖尿病患者牙种植术后发生种植体周围炎风险的列线图模型建立与分析

目的: 探讨糖尿病患者牙种植术后发生种植体周围炎的危险因素,并建立相关列线图预测模型。方法: 回顾性分析2016年1月—2018年12月行牙种植修复治疗的257例糖尿病患者的临床资料,采用整群随机抽样法将数据分为训练集（n=153）和验证集（n=104）。分别使用单因素和Logistic回归分析,确定糖尿病患者发生种植体周围炎的独立危险因素;同时建立相关列线图预测模型,采用Bootstrap 法对模型进行内部验证,外部验证通过验证集自抽样法完成。采用SPSS 22.0软件包对数据进行统计学分析。结果: 吸烟指数>200支/年（OR=6.364,95%CI：1.943~20.840）、HbA1c>7%（OR=4.680,95%CI：1.497~14.628）、牙周病史（OR=3.779,95%CI：1.359~10.507）、前牙区种植（OR=7.183,95%CI：2.371~21.756）、刷牙频率≤1次/d（OR=4.796,95%CI：1.471~15.637）和未定期洁治（OR=4.994,95%CI：1.745~14.295）是糖尿病患者种植牙术后发生周围炎的独立危险因素（P<0.05）。基于以上6项危险因素建立预测糖尿病患者发生种植体周围炎的列线图模型,校准曲线验证显示,训练集和验证集的预测值与实测值基本一致。ROC曲线验证显示,训练集和验证集的C指数分别为0.867和0.822,说明列线图模型具有良好的预测精准度。结论: 吸烟指数>200支/年、HbA1c>7%、牙周病史、前牙区种植、刷牙频率≤1次/d和未定期洁治是糖尿病患者发生种植体周围炎的独立危险因素,基于以上危险因素建立的列线图模型能够直观、准确预测糖尿病患者发生种植体周围炎的概率。     

比较分析超声洁治联合药物治疗与翻瓣刮治联合引导骨再生术治疗种植体周围炎的临床疗效

目的对比研究采用超声洁治联合药物治疗与翻瓣刮治联合引导骨再生术治疗种植体周围炎的临床疗效。方法随机从我院2014年5月~2015年5月接收并治疗的种植体周围炎患者62例,根据不同治疗方法分为两组,A组采用超声洁治联合药物治疗,B组采用翻瓣刮治联合引导骨再生术治疗,分析两组临床疗效。结果治疗前后SBI、PLI、PD比较,P0.05,差异具有统计学意义;但治疗后两组之间比较,P0.05,差异不具有统计学意义;治疗后,B组种植体骨高度改善程度优于A组,P0.05,差异具有统计学意义。结论超声洁治联合药物治疗与翻瓣刮治联合引导骨再生术治疗种植体周围炎的临床疗效相当,但后者种植体与骨的结合度更好。     

Effect of 308-nm excimer laser light on peri-implantitis-associated bacteria—an in vitro investigation

Dental implants are becoming increasingly important in prosthodontic rehabilitation. Bacterial infections, however, can induce bone loss and jeopardize clinical success. Recent literature has demonstrated that infrared CO₂ laser light is suitable for the decontamination of exposed implant surfaces. The aim of the present study was to investigate the influence of 308-nm excimer laser irradiation on peri-implantitis-associated bacteria in vitro. In this study, a XeCl excimer laser (308 nm) was used (Summit Technology, Boston, USA). Both aerobe (Streptococcus mutans, S. sanguis, Actinomyces naeslundii) and anaerobe microorganisms (A. odontolyticus, Prevotella melaninogenica) were tested. According to previous studies, a constant energy of 0.8 J/cm² and a constant frequency of 20 Hz were used for all irradiations. Colony-forming units after laser irradiation were counted. Excimer laser irradiation showed significant influence on the growth of all microorganisms. As compared to S. mutans and S. sanguis, A. naeslundii demonstrated higher sensitivity to laser irradiation. Anaerobe microorganisms, in contrast, demonstrated that a total of 200 pulses were sufficient to reduce the replication of these germs for more than 99.9%. Excimer laser irradiation (λ = 308 nm) can significantly reduce both aerobe and anaerobe microorganisms. Depending on the parameters chosen, 200 pulses are sufficient for sterilization. New studies are necessary to evaluate if this wavelength is more of value in the treatment of peri-implantitis than other wavelengths or conventional therapies.     

Er:YAG laser therapy for peri-implant infection: a histological study

The purpose of this study was to evaluate the effects of Er:YAG laser on degranulation and implant surface debridement in peri-implant infection. The peri-implant infection was experimentally induced in dogs, and the treatment was performed using an Er:YAG laser or a plastic curet. Animals were sacrificed after 24 weeks, and undecalcified histological sections were prepared and analyzed. Degranulation and implant surface debridement were obtained effectively and safely by Er:YAG laser. Histologically, a favorable formation of new bone was observed on the laser-treated implant surface, and the laser group showed a tendency to produce greater bone-to-implant contact than the curet group. These results indicate that the Er:YAG laser therapy has promise in the treatment of peri-implantitis. Contract grant sponsor: 21^st Century Center of Excellence Program for Frontier Research on Molecular Destruction and Reconstruction of Tooth and Bone in Tokyo Medical and Dental University and a Grant-in-Aid for Scientific Research(c)(2) (No. 16592064) (A.A.), Ministry of Education, Culture, Sports, Science and Technology of Japan.     

种植体周围炎不同时期单核细胞趋化蛋白-1的水平变化

目的：观察实验性种植体周围炎不同时期龈沟液（PISF）中单核细胞趋化蛋白-1（MCP-1）的水平变化，探讨其在种植体周围炎发生发展过程中的作用。方法：采用丝线结扎法建立狗的实验性种植体周围炎模型，随机分为实验组A（丝线持续结扎4周）和实验组B（结扎2月后去除丝线并进行洁治），以口腔内另--N不进行丝线结扎的种植体为对照组。各组种植体分别在丝线结扎时（基点）和基点后1周、2月、3月和4月时记录牙周袋深度（PPD）、菌斑指数（PI）和改良龈沟出血指数（MBI），采集PISF，检测PISF的量以及其中MCP-1的水平。分析不同时间点和不同组别种植体各项临床指标、PISF量以及其中MCP-1水平的差异。结果：种植体周围炎早期，种植体周围PI和MBI均出现明显改变，在种植体周围炎中晚期，PI和MBI无明显变化，而PPD出现改变。在临床指标出现改变前，PISF的量以及其中MCP-1的水平开始变化。PISF的量在炎症早期随时间增加，炎症的中晚期保持比较稳定的水平，洁治后PISF量降低。MCP-1的变化规律与PISF的量相似，与PISF的量呈正相关。结论：MCP-1在种植体周围炎早期发挥重要作用，其水平在一定程度上反映种植体周围软组织的炎症状况，可能作为早期诊断和预测种植体周围炎的指标。     

IL-17 Gene Polymorphism Is Associated with Chronic Periodontitis and Peri-implantitis in Iranian Patients: A Cross-Sectional Study

Periodontal disease (PD) and peri-implantitis (PI) are characterized by an immune response leading to destructive inflammation. The prominent impact of genetic factors on periodontitis has been previously evaluated and IL-17 has found to play a critical role in this process. This cytokine has a controversial behavior. This study aimed at finding out whether the polymorphism of this cytokine plays a significant role in chronic periodontitis (CP) and PI or it is just a pro-inflammatory regulatory cytokine. Fresh human blood samples were obtained and three main genotypes were traced carefully. The samples were transferred into 96-well plates and sent to KBioscience Institute in the United Kingdom for genotyping the polymorphism using Competitive Allele Specific PCR (KASP) technique. SPSS version19 software and chi-square and Kruskal–Wallis tests were used for statistical differences considering p-value less than 0.05. A significant difference was detected between the three groups in terms of specific SNP studied in this experiment (P = 0.00). The CC genotype of IL17 polymorphism (rs10484879) may contribute to the pathogenesis of peri-implantitis and periodontitis. The association of IL-17 polymorphism with PI and CP is a promising finding that may help in future similar studies on other ethnicities and larger study populations.