Int J Periodontics Restorative Dent. 2024 Jul 26;44(4):466-476. doi: 10.11607/prd.6756.
Diverse surgical approaches, such as resective, reconstructive, and combined therapy, have been proposed for peri-implantitis treatment. A resective surgical approach with an adjunctive modified implantoplasty refers to the modification of the implant body into a constricted area to mimic a 'waist' silhouette. This modified technique forms an adequate concave smooth area that may favor the outcomes of resective surgical therapy for soft tissue adaptation, biofilm control, and possible peri-implant bone gain over the long term. The present case series aimed to exhibit the long-term clinical and radiographic outcomes of resective surgery with adjunctive implantoplasty over a 6- to 11-year follow-up. Four patients presenting four implants (one per patient) diagnosed with peri-implantitis (according to an established case definition) were included in the present case series. Patients underwent resective surgery, a modified implantoplasty approach, and implant surface decontamination. After surgical therapy, clinical and radiographic outcomes such as bleeding on probing (BoP), suppuration on probing (SoP), probing depth (PD), marginal recession (MR), modified plaque index (mPI), and marginal bone levels (MBLs) were recorded over a long-term follow-up period. Over the 6- to 11-year follow-up, mean BoP, PD, and SoP scores amounted to 17% ± 24%, 3.2 ± 0.66 mm, and 0%, respectively. Mean BoP, PD, and SoP scores were reduced by 67% ± 24%, 2.5 ± 1.26 mm, and 100%, respectively. Radiographic analysis revealed a mean radiographic bone gain of 3.1 ± 1.84 mm. Peri-implant marginal bone loss surface area decreased by 5.7 ± 3.77 mm2 over the long-term follow-up. Resective therapy with adjunctive implantoplasty promoted favorable clinical and radiographic outcomes at treated peri-implantitis sites over a long-term period.
多种手术方法,如切除术、重建术和联合治疗,已被提出用于治疗种植体周围炎。切除性手术联合改良种植体成形术是指将种植体体部修改为狭窄区域,以模拟“腰部”轮廓。这种改良技术形成了足够的凹面光滑区域,可能有利于切除性手术治疗的软组织适应、生物膜控制和长期潜在的种植体周围骨获得。本病例系列旨在展示切除性手术联合种植体成形术在 6 至 11 年的长期临床和影像学结果。本病例系列纳入了 4 名患者的 4 个种植体(每个患者 1 个),这些种植体被诊断为种植体周围炎(根据既定的病例定义)。患者接受了切除性手术、改良种植体成形术和种植体表面去污治疗。手术治疗后,在长期随访期间记录了临床和影像学结果,如探诊出血(BoP)、探诊溢脓(SoP)、探诊深度(PD)、边缘退缩(MR)、改良菌斑指数(mPI)和边缘骨水平(MBLs)。在 6 至 11 年的随访中,平均 BoP、PD 和 SoP 评分分别为 17%±24%、3.2±0.66mm 和 0%。BoP、PD 和 SoP 评分分别降低了 67%±24%、2.5±1.26mm 和 100%。影像学分析显示平均影像学骨获得为 3.1±1.84mm。种植体边缘骨丧失表面积在长期随访中减少了 5.7±3.77mm2。切除性手术联合改良种植体成形术在长期随访中促进了治疗种植体周围炎部位的良好临床和影像学结果。