种植体周炎发病影响因素及诊治新进展

doi:10.12337/zgkqzzxzz.2023.12.003

中国口腔种植学杂志 ›› 2023, Vol. 28 ›› Issue (6): 402-409.DOI: 10.12337/zgkqzzxzz.2023.12.003

种植体周炎发病影响因素及诊治新进展

闫福华, 宋诗源

南京市口腔医院南京大学医学院附属口腔医院 210006

收稿日期:2023-08-30 出版日期:2023-12-30 发布日期:2024-01-04
通讯作者: 闫福华,Email：yanfh@nju.edu.cn,电话：025-83620362
作者简介:闫福华南京大学医学院附属口腔医院副院长、教授、博士生导师。中华口腔医学会牙周病学专业委员会主任委员，享受国务院政府特殊津贴专家，江苏省特聘医学专家。“十四五”规划教材《牙周病学》主编，“十三五”规划教材《牙周病学》副主编。主要研究领域为：组织工程与牙周再生治疗、牙周病与系统性疾病的关系、牙周病的种植修复治疗等。主持省部级及以上科研项目18项（其中国家自然科学基金项目8项），参与十四五国家科技重点研发项目1项。发表论文300余篇，主编、主译学术专著26部。带领学科团队获：国家临床重点建设专科、江苏省临床重点专科、江苏省重点学科、江苏省创新团队等荣誉。获教育部科技进步奖二等奖1项（1/15），江苏省医学新技术引进一等奖1项（1/3），中华口腔医学会科技奖二等奖1项（2/8），福建省科学技术进步奖二等奖1项（1/5），福建省教学成果奖二等奖1项（2/6）。培养毕业博士29人、硕士55人。作为合作导师指导博士后出站2人。现正指导博士后6人、在读博士研究生7人、硕士研究生7人。
基金资助:
江苏省医学重点学科建设单位（JSDW202246）; 南京大学医学院附属口腔医院3456骨干人才资助项目（0222R201）

Recent advances in the factors affecting the pathogenesis, diagnosis, and treatment of peri-implantitis

Yan Fuhua, Song Shiyuan

Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210006, China

Received:2023-08-30 Online:2023-12-30 Published:2024-01-04
Contact: Yan Fuhua, Email: yanfh@nju.edu.cn, Tel: 0086-25-83620362
Supported by:
Jiangsu Provincial Medical Key Discipline Cultivation Unit (JSDW202246); The "3456" Cultivation Program for Junior Talents of Nanjing Stomatological School, Medical School of Nanjing University (0222R201)

摘要/Abstract

摘要： 口腔种植治疗是目前修复牙列缺损和缺失的常用方法之一。种植体周炎是种植治疗的常见生物学并发症,其以种植体周黏膜炎症和支持骨的进行性丧失为特征。种植体周炎的发生会影响种植修复的预后甚至导致种植失败,对患者健康状况和生活质量产生很大影响。因此,减少种植体周炎的危险因素、及时诊断和有效治疗,对于改善种植治疗的预后具有极为重要的意义。本文介绍了种植体周炎的发病影响因素、目前的诊断标准以及治疗方法,并就一些具有临床应用前景的治疗新方法及研究进展进行了探讨。

关键词: 种植体周炎, 危险因素, 诊治, 新策略

Abstract: Oral implant therapy is one of the most common methods for restoring defective and missing dentition. Peri-implantitis is a prevalent biological complication of implant therapy, characterized by inflammation of the peri-implant mucosa and subsequent progressive loss of supporting bone. The occurrence of peri-implantitis can impact the prognosis of implant restorations or even lead to implant failure, significantly affecting the patient's health and quality of life. Therefore, reducing the risk factors of peri-implantitis, timely diagnosis and effective treatments are of great importance to enhance the prognosis of implant therapy. This review describes the factors influencing the pathogenesis of peri-implantitis, the current diagnostic criteria, and therapeutic methods. Furthermore, it discusses emerging treatment modalities with potential clinical applications and reviews ongoing research progress.

Key words: Peri-implantitis, Risk factors, Diagnosis and treatment, Emerging treatment modalities

闫福华,等宋诗源. 种植体周炎发病影响因素及诊治新进展[J]. 中国口腔种植学杂志, 2023, 28(6): 402-409. DOI: 10.12337/zgkqzzxzz.2023.12.003

Yan Fuhua, Song Shiyuan. Recent advances in the factors affecting the pathogenesis, diagnosis, and treatment of peri-implantitis[J].Chinese Journal of Oral Implantology, 2023, 28(6): 402-409.DOI: 10.12337/zgkqzzxzz.2023.12.003.

参考文献

[1] Schwarz F, Derks J, Monje A, et al.Peri-implantitis[J]. J Periodontol, 2018,89(Suppl 1):S267-S290. DOI: 10.1002/JPER.16-0350.
[2] Lee CT, Huang YW, Zhu L, et al.Prevalences of peri-implantitis and peri-implant mucositis: systematic review and meta-analysis[J]. J Dent, 2017,62:1-12. DOI: 10.1016/j.jdent.2017.04.011.
[3] Konstantinidis IK, Kotsakis GA, Gerdes S, et al.Cross-sectional study on the prevalence and risk indicators of peri-implant diseases[J]. Eur J Oral Implantol, 2015,8(1):75-88.
[4] Serino G, Ström C.Peri-implantitis in partially edentulous patients: association with inadequate plaque control[J]. Clin Oral Implants Res, 2009,20(2):169-174. DOI: 10.1111/j.1600-0501.2008.01627.x.
[5] Truhlar RS, Morris HF, Ochi S.The efficacy of a counter-rotational powered toothbrush in the maintenance of endosseous dental implants[J]. J Am Dent Assoc, 2000,131(1):101-107. DOI: 10.14219/jada.archive.2000.0028.
[6] Frisch E, Vach K, Ratka-Krueger P.Impact of supportive implant therapy on peri-implant diseases: a retrospective 7-year study[J]. J Clin Periodontol, 2020,47(1):101-109. DOI: 10.1111/jcpe.13206.
[7] Lin CY, Chen Z, Pan WL, et al.The effect of supportive care in preventing peri-implant diseases and implant loss: a systematic review and meta-analysis[J]. Clin Oral Implants Res, 2019,30(8):714-724. DOI: 10.1111/clr.13496.
[8] Stacchi C, Berton F, Perinetti G, et al.Risk factors for peri-implantitis: effect of history of periodontal disease and smoking habits. A systematic review and meta-analysis[J]. J Oral Maxillofac Res, 2016,7(3):e3. DOI: 10.5037/jomr.2016.7303.
[9] Arunyanak SP, Sophon N, Tangsathian T, et al.The effect of factors related to periodontal status toward peri-implantitis[J]. Clin Oral Implants Res, 2019,30(8):791-799. DOI: 10.1111/clr.13461.
[10] Dhingra K, Jeng JH.Are partially edentulous patients with a history of severe periodontitis more prone to develop peri-implantitis over the long term?[J]. Evid Based Dent, 2022,23(2):81-83. DOI: 10.1038/s41432-022-0269-4.
[11] Cho-Yan Lee J, Mattheos N, Nixon KC, et al. Residual periodontal pockets are a risk indicator for peri-implantitis in patients treated for periodontitis[J]. Clin Oral Implants Res, 2012,23(3):325-333. DOI: 10.1111/j.1600-0501.2011.02264.x.
[12] Reis I, do Amaral G, Hassan MA, et al. The influence of smoking on the incidence of peri-implantitis: a systematic review and meta-analysis[J]. Clin Oral Implants Res, 2023,34(6):543-554. DOI: 10.1111/clr.14066.
[13] Ahn DH, Kim HJ, Joo JY, et al.Prevalence and risk factors of peri-implant mucositis and peri-implantitis after at least 7 years of loading[J]. J Periodontal Implant Sci, 2019,49(6):397-405. DOI: 10.5051/jpis.2019.49.6.397.
[14] Levin L, Ofec R, Grossmann Y, et al.Periodontal disease as a risk for dental implant failure over time: a long-term historical cohort study[J]. J Clin Periodontol, 2011,38(8):732-737. DOI: 10.1111/j.1600-051X.2011.01745.x.
[15] Johannsen A, Susin C, Gustafsson A.Smoking and inflammation: evidence for a synergistic role in chronic disease[J]. Periodontol 2000, 2014,64(1):111-126. DOI: 10.1111/j.1600-0757.2012.00456.x.
[16] Monje A, Catena A, Borgnakke WS.Association between diabetes mellitus/hyperglycaemia and peri-implant diseases: systematic review and meta-analysis[J]. J Clin Periodontol, 2017,44(6):636-648. DOI: 10.1111/jcpe.12724.
[17] 宋应亮, 张思佳. 糖尿病患者口腔种植治疗研究现状[J]. 口腔疾病防治,2019,27(4):205-211. DOI: 10.12016/j.issn.2096-1456.2019.04.001.
[18] Lamster IB, Cheng B, Burkett S, et al.Periodontal findings in individuals with newly identified pre-diabetes or diabetes mellitus[J]. J Clin Periodontol, 2014,41(11):1055-1060. DOI: 10.1111/jcpe.12307.
[19] Le Guéhennec L, Soueidan A, Layrolle P, et al.Surface treatments of titanium dental implants for rapid osseointegration[J]. Dent Mater, 2007,23(7):844-854. DOI: 10.1016/j.dental.2006.06.025.
[20] Rakic M, Galindo-Moreno P, Monje A, et al.How frequent does peri-implantitis occur? A systematic review and meta-analysis[J]. Clin Oral Investig, 2018,22(4):1805-1816. DOI: 10.1007/s00784-017-2276-y.
[21] Sánchez-Siles M, Muñoz-Cámara D, Salazar-Sánchez N, et al.Incidence of peri-implantitis and oral quality of life in patients rehabilitated with implants with different neck designs: a 10-year retrospective study[J]. J Craniomaxillofac Surg, 2015,43(10):2168-2174. DOI: 10.1016/j.jcms.2015.10.010.
[22] He J, Zhao B, Deng C, et al.Assessment of implant cumulative survival rates in sites with different bone density and related prognostic factors: an 8-year retrospective study of 2,684 implants[J]. Int J Oral Maxillofac Implants, 2015,30(2):360-371. DOI: 10.11607/jomi.3580.
[23] Song X, Li L, Gou H, et al.Impact of implant location on the prevalence of peri-implantitis: a systematic review and meta-analysis[J]. J Dent, 2020,103:103490. DOI: 10.1016/j.jdent.2020.103490.
[24] Broggini N, McManus LM, Hermann JS, et al. Persistent acute inflammation at the implant-abutment interface[J]. J Dent Res, 2003,82(3):232-237. DOI: 10.1177/154405910308200316.
[25] Linkevicius T, Vindasiute E, Puisys A, et al.The influence of the cementation margin position on the amount of undetected cement. A prospective clinical study[J]. Clin Oral Implants Res, 2013,24(1):71-76. DOI: 10.1111/j.1600-0501.2012.02453.x.
[26] Mattheos N, Schittek Janda M, Zampelis A, et al.Reversible, non-plaque-induced loss of osseointegration of successfully loaded dental implants[J]. Clin Oral Implants Res, 2013,24(3):347-354. DOI: 10.1111/clr.12009.
[27] Caton JG, Armitage G, Berglundh T, et al. A new classification scheme for periodontal and peri-implant diseases and conditions-introduction and key changes from the1999 classification[J]. J Clin Periodontol, 2018,45(Suppl 20:)S1-S8. DOI: 10.1111/jcpe.12935.
[28] Berglundh T, Armitage G, Araujo MG, et al.Peri-implant diseases and conditions: Consensus report of workgroup 4 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions[J]. J Clin Periodontol, 2018,45(Suppl 20):S286-S291. DOI: 10.1111/jcpe.12957.
[29] Lang NP, Wilson TG, Corbet EF.Biological complications with dental implants: their prevention, diagnosis and treatment[J]. Clin Oral Implants Res, 2000,11(Suppl 1):S146-S155. DOI: 10.1034/j.1600-0501.2000.011s1146.x.
[30] Wright S, Archer C.An exploratory study to investigate if patients are able to aid the early diagnosis of peri-implant complications[J]. Br Dent J, 2015,218(11):637-640. DOI: 10.1038/sj.bdj.2015.503.
[31] Zafar MS.Comparing the effects of manual and ultrasonic instrumentation on root surface mechanical properties[J]. Eur J Dent, 2016,10(4):517-521. DOI: 10.4103/1305-7456.195162.
[32] Heo S, Kim HJ, Joo JY, et al.Simplified nonsurgical treatment of peri-implantitis using chlorhexidine and minocycline hydrochloride[J]. J Periodontal Implant Sci, 2018,48(5):326-333. DOI: 10.5051/jpis.2018.48.5.326.
[33] Barbato L, Cavalcanti R, Rupe C, et al.Clinical efficacy of adjunctive methods for the non-surgical treatment of peri-implantitis: a systematic review and meta-analysis[J]. BMC Oral Health, 2023,23(1):375. DOI: 10.1186/s12903-023-03058-z.
[34] Aldosari L, Hassan S, Alshadidi A, et al.Short-term influence of antimicrobial photodynamic therapy as an adjuvant to mechanical debridement in reducing soft-tissue inflammation and subgingival yeasts colonization in patients with peri-implant mucositis[J]. Photodiagnosis Photodyn Ther, 2023,42:103320. DOI: 10.1016/j.pdpdt.2023.103320.
[35] 施斌, 晏奇, 赵耀宇. 抗菌光动力疗法在种植体周疾病中的应用[J]. 中国口腔种植学杂志, 2021,26(3):152-158. DOI: 10.12337/zgkqzzxzz.2021.06.002.
[36] Alshehri FA.The role of lasers in the treatment of peri-implant diseases: a review[J]. Saudi Dent J, 2016,28(3):103-108. DOI: 10.1016/j.sdentj.2015.12.005.
[37] Najeeb S, Khurshid Z, Zafar MS, et al.Applications of light amplification by stimulated emission of radiation (lasers) for restorative dentistry[J]. Med Princ Pract, 2016,25(3):201-211. DOI: 10.1159/000443144.
[38] Clem D, Gunsolley JC.Peri-implantitis treatment using er:YAG laser and bone grafting. A prospective consecutive case series evaluation: 1 year posttherapy[J]. Int J Periodontics Restorative Dent, 2019,39(4):479-489. DOI: 10.11607/prd.4158.
[39] Peleteiro B, Bastos A, Ferro A, et al.Prevalence of helicobacter pylori infection worldwide: a systematic review of studies with national coverage[J]. Dig Dis Sci, 2014,59(8):1698-1709. DOI: 10.1007/s10620-014-3063-0.
[40] Schwarz F, Schmucker A, Becker J.Efficacy of alternative or adjunctive measures to conventional treatment of peri-implant mucositis and peri-implantitis: a systematic review and meta-analysis[J]. Int J Implant Dent, 2015,1(1):22. DOI: 10.1186/s40729-015-0023-1.
[41] Gotfredsen K, Wiskott A.Consensus report-reconstructions on implants. The third EAO Consensus Conference 2012[J]. Clin Oral Implants Res, 2012,23(Suppl 6):S238-S241. DOI: 10.1111/j.1600-0501.2012.02549.x.
[42] Romeo E, Ghisolfi M, Murgolo N, et al.Therapy of peri-implantitis with resective surgery. A 3-year clinical trial on rough screw-shaped oral implants. part I: clinical outcome[J]. Clin Oral Implants Res, 2005,16(1):9-18. DOI: 10.1111/j.1600-0501.2004.01084.x.
[43] de Tapia B, Valles C, Ribeiro-Amaral T, et al. The adjunctive effect of a titanium brush in implant surface decontamination at peri-implantitis surgical regenerative interventions: a randomized controlled clinical trial[J]. J Clin Periodontol, 2019,46(5):586-596. DOI: 10.1111/jcpe.13095.
[44] Stavropoulos A, Bertl K, Eren S, et al.Mechanical and biological complications after implantoplasty-a systematic review[J]. Clin Oral Implants Res, 2019,30(9):833-848. DOI: 10.1111/clr.13499.
[45] Berglundh T, Wennström JL, Lindhe J.Long-term outcome of surgical treatment of peri-implantitis. A 2-11-year retrospective study[J]. Clin Oral Implants Res, 2018,29(4):404-410. DOI: 10.1111/clr.13138.
[46] Derks J, Ortiz-Vigón A, Guerrero A, et al.Reconstructive surgical therapy of peri-implantitis: a multicenter randomized controlled clinical trial[J]. Clin Oral Implants Res, 2022,33(9):921-944. DOI: 10.1111/clr.13972.
[47] Schwarz F, Sahm N, Bieling K, et al.Surgical regenerative treatment of peri-implantitis lesions using a nanocrystalline hydroxyapatite or a natural bone mineral in combination with a collagen membrane: a four-year clinical follow-up report[J]. J Clin Periodontol, 2009,36(9):807-814. DOI: 10.1111/j.1600-051X.2009.01443.x.
[48] Isler SC, Soysal F, Ceyhanlı T, et al.Regenerative surgical treatment of peri-implantitis using either a collagen membrane or concentrated growth factor: a 12-month randomized clinical trial[J]. Clin Implant Dent Relat Res, 2018,20(5):703-712. DOI: 10.1111/cid.12661.
[49] Sun G, Cao L, Li H.Effects of platelet-rich fibrin combined with guided bone regeneration in the reconstruction of peri-implantitis bone defect[J]. Am J Transl Res, 2021,13(7):8397-8402.
[50] Matarasso S, Iorio Siciliano V, Aglietta M, et al.Clinical and radiographic outcomes of a combined resective and regenerative approach in the treatment of peri-implantitis: a prospective case series[J]. Clin Oral Implants Res, 2014,25(7):761-767. DOI: 10.1111/clr.12183.
[51] Trinh HA, Dam VV, Le B, et al.Indirect sinus augmentation with and without the addition of a biomaterial: a randomized controlled clinical trial[J]. Implant Dent, 2019,28(6):571-577. DOI: 10.1097/ID.0000000000000941.
[52] Rakašević D, Šćepanović M, Mijailović I, et al.Reconstructive peri-implantitis therapy by using bovine bone substitute with or without hyaluronic acid: a randomized clinical controlled pilot study[J]. J Funct Biomater, 2023,14(3):149. DOI: 10.3390/jfb14030149.
[53] Amato M, Di Spirito F, D'Ambrosio F, et al. Probiotics in periodontal and peri-implant health management: biofilm control, dysbiosis reversal, and host modulation[J]. Microorganisms, 2022,10(11):2289. DOI: 10.3390/microorganisms10112289.
[54] Laleman I, Pauwels M, Quirynen M, et al.The usage of a lactobacilli probiotic in the non-surgical therapy of peri-implantitis: a randomized pilot study[J]. Clin Oral Implants Res, 2020,31(1):84-92. DOI: 10.1111/clr.13555.
[55] Radaic A, Brody H, Contreras F, et al.Nisin and nisin probiotic disrupt oral pathogenic biofilms and restore their microbiome composition towards healthy control levels in a peri-implantitis setting[J]. Microorganisms, 2022,10(7):1336. DOI: 10.3390/microorganisms10071336.
[56] Park SY, Kim KH, Gwak EH, et al.Ex vivo bone morphogenetic protein 2 gene delivery using periodontal ligament stem cells for enhanced re-osseointegration in the regenerative treatment of peri-implantitis[J]. J Biomed Mater Res A, 2015,103(1):38-47. DOI: 10.1002/jbm.a.35145.
[57] Li X, Qi M, Sun X, et al.Surface treatments on titanium implants via nanostructured ceria for antibacterial and anti-inflammatory capabilities[J]. Acta Biomater, 2019,94:627-643. DOI: 10.1016/j.actbio.2019.06.023.
[58] Lee EH, Lee SW, Seo Y, et al.Manganese oxide nanozyme-doped diatom for safe and efficient treatment of peri-implantitis[J]. ACS Appl Mater Interfaces, 2022,14(24):27634-27650. DOI: 10.1021/acsami.2c05166.

种植体周炎发病影响因素及诊治新进展

Recent advances in the factors affecting the pathogenesis, diagnosis, and treatment of peri-implantitis

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