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实验性种植体周围炎重建性外科治疗后的再骨整合:一项临床前体内研究。

Re-osseointegration following reconstructive surgical therapy of experimental peri-implantitis. A pre-clinical in vivo study.

机构信息

Department of Periodontology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Department of Oral & Maxillofacial Radiology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

出版信息

Clin Oral Implants Res. 2019 May;30(5):447-456. doi: 10.1111/clr.13430. Epub 2019 May 3.

Abstract

OBJECTIVE

To evaluate the effect of bone substitute materials on hard and soft tissue healing in reconstructive surgical therapy of experimental peri-implantitis at implants with different surface characteristics.

MATERIAL AND METHODS

Six female, Labrador dogs were used. 3 months after tooth extraction, four implants with two different surface characteristics (A and B) were installed on each side of the mandible. Experimental peri-implantitis was induced 3 months later. During surgical treatment of peri-implantitis, the implants were cleaned with curettes and cotton pellets soaked in saline. The implant sites were allocated to one of four treatment categories; (a) Group C; no augmentation, (b) Group T1; bone defect filled with deproteinized bovine bone mineral (c) Group T2; bone defect filled with a biphasic bone graft material, (d) Group T3; bone defect filled as T1 and covered with a collagen membrane. Clinical and radiological examinations were performed, and biopsies were obtained and prepared for histological analysis 6 months after peri-implantitis surgery.

RESULTS

Implant B (smooth surface) sites showed significantly (a) larger radiographic bone level gain, (b) enhanced resolution of peri-implantitis lesions, and (c) larger frequency of re-osseointegration than implant A (moderately rough surface) sites. Implant B sites also showed superior preservation of the mucosal margin. Differences between bone substitute materials and control procedures were overall small with limited advantages for T1 and T2 sites.

CONCLUSION

Healing following reconstructive surgical treatment of experimental peri-implantitis was superior around implants with a smooth surface than implants with a moderately rough surface. Benefits of using bone substitute materials during surgical therapy were overall small.

摘要

目的

评估骨替代材料在不同表面特性种植体的实验性种植体周围炎重建手术治疗中对软硬组织愈合的影响。

材料与方法

使用 6 只雌性拉布拉多犬。拔牙后 3 个月,在每只下颌骨的两侧安装 4 个具有两种不同表面特性(A 和 B)的种植体。3 个月后,诱导实验性种植体周围炎。在种植体周围炎的手术治疗过程中,使用刮匙和生理盐水浸泡的棉片清洁种植体。将种植体部位分配到以下 4 个治疗组之一:(a)C 组;不进行增强,(b)T1 组;用脱蛋白牛骨矿物质填充骨缺损,(c)T2 组;用双相骨移植物填充骨缺损,(d)T3 组;如 T1 填充骨缺损并用胶原膜覆盖。术后 6 个月进行临床和影像学检查,并获取活检进行组织学分析。

结果

光滑表面的种植体 B 部位(a)具有更大的放射学骨水平增加,(b)改善了种植体周围炎病变的缓解,(c)再骨整合的频率更高,而中度粗糙表面的种植体 A 部位。种植体 B 部位也显示出对黏膜边缘的更好保存。与对照组相比,骨替代材料之间的差异总体较小,T1 和 T2 部位略有优势。

结论

与中度粗糙表面的种植体相比,在实验性种植体周围炎重建手术治疗中,光滑表面的种植体周围愈合更好。在手术治疗中使用骨替代材料的总体益处较小。

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