种植体周炎治疗时种植体表面的清洁去污处理

doi:10.12337/zgkqzzxzz.2023.12.008

摘要/Abstract

摘要： 种植体表面清洁去污的难度大于天然牙,清洁不足是导致种植体周炎治疗失败的重要原因之一。本文回顾了主要的种植体表面清洁去污方法：机械性方法、化学性方法和物理性方法。机械性方法是目前研究证据支持最多的清洁方法,是种植体周炎治疗的基础。目前尚无种植体表面清洁去污的金标准,鼓励多种方法合并使用。

关键词: 种植体周炎, 种植牙, 表面去污

Abstract: Surface decontamination of implants is much more difficult than that of natural teeth. Incomplete decontamination is the main reason causing peri-implantitis treatment failure. This article reviews the implant surface decontamination modalities: mechanical decontamination methods, chemical decontamination methods and physical methods. Mechanical decontamination methods are the treatment most well documented. It is the foundation for peri-implantitis treatment. Nowadays, there is no gold standard for management of peri-implantitis. A combination of different decontamination modalities is recommended.

Key words: Peri-implantitis, Dental implant, Decontamination

董潇潇. 种植体周炎治疗时种植体表面的清洁去污处理[J]. 中国口腔种植学杂志, 2023, 28(6): 437-443. DOI: 10.12337/zgkqzzxzz.2023.12.008

Dong Xiaoxiao. Surface decontamination in peri-implantitis management[J].Chinese Journal of Oral Implantology, 2023, 28(6): 437-443.DOI: 10.12337/zgkqzzxzz.2023.12.008.

参考文献

[1] 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.
[2] Derks J, Tomasi C.Peri-implant health and disease. A systematic review of current epidemiology[J]. J Clin Periodontol, 2015,42(Suppl 16):S158-S171. DOI: 10.1111/jcpe.12334.
[3] Romandini M, Berglundh J, Derks J, et al.Diagnosis of peri-implantitis in the absence of baseline data: a diagnostic accuracy study[J]. Clin Oral Implants Res, 2021,32(3):297-313. DOI: 10.1111/clr.13700.
[4] Romandini M, Lima C, Pedrinaci I, et al.Prevalence and risk/protective indicators of peri-implant diseases: a university-representative cross-sectional study[J]. Clin Oral Implants Res, 2021,32(1):112-122. DOI: 10.1111/clr.13684.
[5] Meyle J,Mechanical, chemical and laser treatments of the implant surface in the presence of marginal bone loss around implants[J]. Eur J Oral Implantol, 2012,5(Suppl):S71-S81.
[6] Khoury F, Keeve PL, Ramanauskaite A, et al.Surgical treatment of peri-implantitis-consensus report of working group 4[J]. 2019,69(Suppl 2):18-22.DOI: 10.1111/idj.12505
[7] Baima G, Citterio F, Romandini M, et al.Surface decontamination protocols for surgical treatment of peri-implantitis: a systematic review with meta-analysis[J]. Clin Oral Implants Res, 2022,33(11):1069-1086. DOI: 10.1111/clr.13992.
[8] Monje A, Amerio E, Cha JK, et al.Strategies for implant surface decontamination in peri-implantitis therapy[J]. Int J Oral Implantol (Berl), 2022,15(3):213-248.
[9] Schenk G, Flemmig TF, Betz T, et al.Controlled local delivery of tetracycline HCl in the treatment of periimplant mucosal hyperplasia and mucositis. A controlled case series[J]. Clin Oral Implants Res. 1997,8(5):427-433. DOI: 10.1034/j.1600-0501.1997.080510.x.
[10] Heitz-Mayfield LJ, Salvi GE, Botticelli D, et al.Anti-infective treatment of peri-implant mucositis: a randomised controlled clinical trial[J]. Clin Oral Implants Res, 2011,22(3):237-241. DOI: 10.1111/j.1600-0501.2010.02078.x.
[11] Máximo MB, de Mendonça AC, Renata Santos V, et al. Short-term clinical and microbiological evaluations of peri-implant diseases before and after mechanical anti-infective therapies[J]. Clin Oral Implants Res, 2009,20(1):99-108. DOI: 10.1111/j.1600-0501.2008.01618.x.
[12] Porras R, Anderson GB, Caffesse R, et al.Clinical response to 2 different therapeutic regimens to treat peri-implant mucositis[J]. J Periodontol, 2002,73(10):1118-1125. DOI: 10.1902/jop.2002.73.10.1118.
[13] Mann M, Parmar D, Walmsley AD, et al.Effect of plastic-covered ultrasonic scalers on titanium implant surfaces[J]. Clin Oral Implants Res, 2012,23(1):76-82. DOI: 10.1111/j.1600-0501.2011.02186.x.
[14] Thöne-Mühling M, Swierkot K, Nonnenmacher C, et al.Comparison of two full-mouth approaches in the treatment of peri-implant mucositis: a pilot study[J]. Clin Oral Implants Res, 2010,21(5):504-512. DOI: 10.1111/j.1600-0501.2009.01861.x.
[15] Cochis A, Fini M, Carrassi A, et al.Effect of air polishing with glycine powder on titanium abutment surfaces[J]. Clin Oral Implants Res, 2013,24(8):904-909. DOI: 10.1111/j.1600-0501.2012.02490.x.
[16] Schmage P, Kahili F, Nergiz I, et al.Cleaning effectiveness of implant prophylaxis instruments[J]. Int J Oral Maxillofac Implants, 2014,29(2):331-337. DOI: 10.11607/jomi.2524.
[17] Sahrmann P, Ronay V, Hofer D, et al.In vitro cleaning potential of three different implant debridement methods[J]. Clin Oral Implants Res, 2015,26(3):314-319. DOI: 10.1111/clr.12322.
[18] Drago L, Del Fabbro M, Bortolin M, et al.Biofilm removal and antimicrobial activity of two different air-polishing powders: an in vitro study[J]. J Periodontol, 2014,85(11):e363-e369. DOI: 10.1902/jop.2014.140134.
[19] Schmidt KE, Auschill TM, Heumann C, et al.Influence of different instrumentation modalities on the surface characteristics and biofilm formation on dental implant neck, in vitro[J]. Clin Oral Implants Res, 2017,28(4):483-490. DOI: 10.1111/clr.12823.
[20] 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.
[21] Toma S, Brecx MC, Lasserre JF.Clinical evaluation of three surgical modalities in the treatment of peri-Implantitis: a randomized controlled clinical trial[J]. J Clin Med, 2019,8(7):966. DOI: 10.3390/jcm8070966.
[22] Carcuac O, Derks J, Abrahamsson I, et al.Risk for recurrence of disease following surgical therapy of peri-implantitis-a prospective longitudinal study[J]. Clin Oral Implants Res, 2020,31(11):1072-1077. DOI: 10.1111/clr.13653.
[23] Pommer B, Haas R, Mailath-Pokorny G, et al.Periimplantitis treatment: long-term comparison of laser decontamination and implantoplasty surgery[J]. Implant Dent, 2016,25(5):646-649. DOI: 10.1097/ID.0000000000000461
[24] Lasserre JF, Brecx MC, Toma S.Implantoplasty versus glycine air abrasion for the surgical treatment of peri-implantitis: a randomized clinical trial[J]. Int J Oral Maxillofac Implants, 2020,35(35):197-206.DOI:10.11607/jomi.6677.
[25] Ramanauskaite A, Becker K, Juodzbalys G, et al.Clinical outcomes following surgical treatment of peri-implantitis at grafted and non-grafted implant sites: a retrospective analysis[J]. Int J Implant Dent, 2018,4(1):27. DOI: 10.1186/s40729-018-0135-5.
[26] Sivaranjani M, Liu F, White AP.Synergistic activity of tetrasodium EDTA, ethanol and chlorhexidine hydrochloride against planktonic and biofilm cells of clinically relevant pathogens[J]. J Glob Antimicrob Resist, 2021,24:148-157. DOI: 10.1016/j.jgar.2020.12.002.
[27] Gamal AY, Abdel-Ghaffar KA, Iacono VJ.A novel approach for enhanced nanoparticle-sized bone substitute adhesion to chemically treated peri-implantitis-affected implant surfaces: an in vitro proof-of-principle study[J]. J Periodontol, 2013,84(2):239-247. DOI: 10.1902/jop.2012.120023.
[28] Kolonidis SG, Renvert S, Hämmerle CH, et al.Osseointegration on implant surfaces previously contaminated with plaque. An experimental study in the dog[J]. Clin Oral Implants Res, 2003,14(4):373-380. DOI: 10.1034/j.1600-0501.2003.01871.x.
[29] Alhag M, Renvert S, Polyzois I, et al.Re-osseointegration on rough implant surfaces previously coated with bacterial biofilm: an experimental study in the dog[J]. Clin Oral Implants Res, 2008,19(2):182-187. DOI: 10.1111/j.1600-0501.2007.01429.x.
[30] Pranno N, Cristalli MP, Mengoni F, et al.Comparison of the effects of air-powder abrasion, chemical decontamination, or their combination in open-flap surface decontamination of implants failed for peri-implantitis: an ex vivo study[J]. Clin Oral Investig, 2021,25(5):2667-2676. DOI: 10.1007/s00784-020-03578-w.
[31] Herrera D, Berglundh T, Schwarz F, et al.Prevention and treatment of peri-implant diseases-the EFP S3 level clinical practice guideline[J]. J Clin Periodontol, 2023,50(Suppl 26):S4-S76. DOI: 10.1111/jcpe.13823.
[32] Lin GH, Suárez López Del Amo F, Wang HL. Laser therapy for treatment of peri-implant mucositis and peri-implantitis: an American Academy of Periodontology best evidence review[J]. J Periodontol, 2018,89(7):766-782. DOI: 10.1902/jop.2017.160483.
[33] Stubinger S, Etter C, Miskiewicz M, et al.Surface alterations of polished and sandblasted and acid-etched titanium implants after Er:YAG, carbon dioxide, and diode laser irradiation[J]. Int J Oral Maxillofac Implants, 2010,25(1):104-111.
[34] Strever JM, Lee J, Ealick W, et al.Erbium, chromium:yttrium-scandium-gallium-garnet laser effectively ablates single-species biofilms on titanium disks without detectable surface damage[J]. J Periodontol, 2017,88(5):484-492. DOI: 10.1902/jop.2016.160529.
[35] Romanos GE, Montanaro NJ, Sacks D, et al.Various tip applications and temperature changes of Er,Cr:YSGG-laser irradiated implants in vitro[J]. Int J Periodontics Restorative Dent, 2017,37(3):387-392. DOI: 10.11607/prd.3258.
[36] Kreisler M, Al Haj H, d'Hoedt B. Temperature changes at the implant-bone interface during simulated surface decontamination with an Er:YAG laser[J]. Int J Prosthodont, 2002,15(6):582-587.
[37] Taniguchi Y, Aoki A, Mizutani K, et al.Optimal Er:YAG laser irradiation parameters for debridement of microstructured fixture surfaces of titanium dental implants[J]. Lasers Med Sci, 2013,28(4):1057-1068. DOI: 10.1007/s10103-012-1171-7.
[38] Shibli JA, Martins MC, Nociti FH Jr, et al.Treatment of ligature-induced peri-implantitis by lethal photosensitization and guided bone regeneration: a preliminary histologic study in dogs[J]. J Periodontol, 2003,74(3):338-345. DOI: 10.1902/jop.2003.74.3.338.
[39] Shibli JA, Martins MC, Ribeiro FS, et al.Lethal photosensitization and guided bone regeneration in treatment of peri-implantitis: an experimental study in dogs[J]. Clin Oral Implants Res, 2006,17(3):273-281. DOI: 10.1111/j.1600-0501.2005.01167.x.
[40] Schlee M, Naili L, Rathe F, et al.Is Complete re-osseointegration of an infected dental implant possible? Histologic results of a dog study: a short communication[J]. J Clin Med, 2020,9(1):235. DOI: 10.3390/jcm9010235.
[41] Bosshardt DD, Brodbeck UR, Rathe F, et al.Evidence of re-osseointegration after electrolytic cleaning and regenerative therapy of peri-implantitis in humans: a case report with four implants[J]. Clin Oral Investig, 2022,26(4):3735-3746. DOI: 10.1007/s00784-021-04345-1.
[42] Schlee M, Rathe F, Brodbeck U, et al.Treatment of peri-implantitis-electrolytic cleaning versus mechanical and electrolytic cleaning-a randomized controlled clinical trial-six-month results[J]. J Clin Med, 2019,8(11):1909. DOI: 10.3390/jcm8111909.
[43] Assunção MA, Botelho J, Machado V, et al.Dental implant surface decontamination and surface change of an electrolytic method versus mechanical approaches: a Pilot in vitro study[J]. J Clin Med, 2023,12(4):1703. DOI: 10.3390/jcm12041703.