不同治疗方案对牙种植周围感染的疗效对比研究  

Effects of different treatment programs on peri-implantitis:a comparative study

作　　者：杨名辉[1] 王岩莉[1] 马玉琢[1] 孙长寿 崔军[3] 

机构地区：[1]滨州市人民医院口腔科,山东滨州256610 [2]山东省无棣县结防所,山东无棣县251900 [3]济南市口腔医院种植中心,山东济南250001

出　　处：《中华医院感染学杂志》2016年第13期3060-3062,共3页Chinese Journal of Nosocomiology

基　　金：山东省优秀中青年科学家科研基金资助项目(BS2013YY056)

摘　　要：目的对比分析翻瓣刮治联合引导骨再生术和超声洁治联合药物治疗种植体周围感染的疗效,为牙种植感染的治疗提供指导。方法选择2009年1月-2013年12月于滨州市人民医院进行种植修复发生种植体周围感染26例患者,有28颗种植体;应用随机数字表法分为A组13例15颗种植体和B组13例13颗种植体,A组行翻瓣刮治联合引导骨再生术治疗,B组行超声洁治联合药物治疗,采集标本进行病原菌鉴定,记录两组患者治疗前、治疗后1、6、12个月菌斑指数(PLI)、牙周袋探诊指数(PD)、龈沟出血指数(SBI)和X线数据。结果 312颗种植体28颗发生感染,感染率8.97%;共分离得到52株病原菌,其中以产黑色素普雷沃菌为主占34.62%、其次为口腔链球菌占23.08%;A、B两组患者治疗后1、6个月和12个月菌斑指数、牙周袋探诊指数、龈沟出血指数均显著降低;A组患者治疗后1、6个月牙种植体边缘骨高度均显著提高,B组患者6个月牙种植体边缘骨高度显著提高,与治疗前比较,差异均有统计学意义(P<0.05)。结论翻瓣刮治联合引导骨再生术和超声洁治联合药物治疗种植体周围感染均具有较好的临床疗效;翻瓣刮治联合引导骨再生术可更好的促进骨与种植体的结合。OBJECTIVE To observe and compare the effects of flap curettage combined with guided bone regeneration and ultrasonic scaling in combination with drug therapy on treatment of peri-implant infections so as to provide guidance for treatment of dental implant infections.METHODS A total of 26patients（28implants）who received implant restoration and had peri-implant infections in Binzhou People′s Hospital from Jan 2009 to Dec 2013 were enrolled in the study and were randomly divided into the group A with 13cases（15implants）and the group B with 13cases（13implants）.The group A was treated with flap curettage combined with guided bone regeneration,while the group B was given ultrasonic scaling in combination with drug therapy.The specimens were collected for identification of pathogens;the plaque index（PLI）,probing depth（PD）,sulcular bleeding index（SBI）,and X-ray data of the two groups of patients were recorded before the treatment and after the treatment for 1,6,and 12 months.RESULTS Of the 312 implants,28had the infections,with the infection rate 8.97%.Totally 52 strains of pathogens were isolated,of which 34.62% were Prevost melaninogenica,and 23.08% were oral Streptococci.The PLI,PD,and SBI of the group A and the group B were significantly reduced after the treatment for1,6,and 12 months.The dental implant marginal bone heights of the group A were remarkably increased before the treatment and after the treatment for 1and 6months;the dental implant marginal bone heights of the group B were remarkably increased after the treatment for 6 months,as compared with those before the treatment（P〈0.05）.CONCLUSION Both the flap curettage combined with guided bone regeneration and the ultrasonic scaling in combination with drug therapy can achieve significant clinical effect on treatment of the peri-implant infections;the flap curettage combined with guided bone regeneration may better promote the combination of bone and implant.

关 键 词：种植体 周围感染 翻瓣刮治 引导骨再生术 

分 类 号：R782.12[医药卫生—口腔医学]