ABSTRACT
Objective:To investigate the functional and structural recovery of posterior teeth in patients with chronic local periodontitis after single implant restoration.Methods:A total of 133 patients with tooth loss who need single posterior tooth fixation and implantation in Shaoxing People's Hospital from January to December 2019 were included in this study. These patients were divided into periodontitis ( n = 40) and periodontitis-free ( n = 93) groups according to whether they had chronic local periodontitis. All patients were followed up for 6 months. Probing depth (PD), gingival thickness, papilla index score (PIS), modified sulcus bleeding index (mSBI) and marginal bone resorption were compared between the two groups at 1, 3 and 6 months after implant repair. The success rate of tooth implant was compared between the two groups. Results:There was no significant difference in success rate of tooth implant between periodontitis and periodontitis-free groups [100.0% (93/93) vs. 95.0% (38/40), χ2 = 1.94, P = 0.163]. There was no significant difference in the incidence of postoperative complications between periodontitis and periodontitis-free groups [0.0% (0/93) vs. 2.5% (1/40), χ2 = 0.19, P = 0.663]. In the periodontitis group, PD was significantly greater at 3 and 6 months after surgery than that at 1 month after surgery ( t = 2.31, 4.30, P = 0.020, < 0.001). In the periodontitis group, mSBI was lower at 6 months after surgery than that at 1 month after surgery ( t = 1.97, P = 0.048). In the periodontitis-free group, mSBI was lower at 3 and 6 months after surgery than that at 1 month after surgery ( t = 3.64, 4.50, both P < 0.001). There were significant differences in PD and mSBI between periodontitis and periodontitis-free groups at 6 months after surgery ( t = 2.06, 2.13, P = 0.041, 0.035). At 6 months after surgery, marginal bone resorption in both periodontitis and periodontitis-free groups improved compared with that immediately after surgery. In the periodontitis group, marginal bone resorption at 1 month after surgery was not significantly different from that at 3 and 6 months after surgery ( t = 1.64, 0.63, P = 0.100, 0.524). In the periodontitis-free group, marginal bone resorption at 1 month after surgery was not significantly different from that at 3 and 6 months after surgery ( t = 1.70, 1.18, P = 0.088, 0.236). In the periodontitis group, gingival thickness at 1 month after surgery was not significantly different from that at 3 and 6 months after surgery ( t = 0.99, 0.49, P = 0.321, 0.620). In the periodontitis-free group, gingival thickness at 1 month after surgery was not significantly different from that at 3 and 6 months after surgery ( t = 0.87, 1.36 P = 0.379, 0.173). Gingival thickness and marginal bone resorption at 1 month after surgery were not significantly different from those at 3 and 6 months after surgery in each group ( t = 0.49, 0.39, 0.54, 0.77, 0.55, 0.38, P = 0.623, 0.693, 0.590, 0.439, 0.580, 0.699). Conclusion:Single implant restoration exhibits good short-term effects on tooth loss combined with chronic local periodontitis. Single implant restoration does not have a great impact on gingival thickness and marginal bone absorption, but it leads to a higher incidence of peri-implantitis in patients with periodontitis than in patients with healthy periodontal tissue.
ABSTRACT
Objective@#To investigate the distribution of pathogenic bacteria and the risk factors of bacterial infections around dental implants.@*Methods@#From January 2017 to December 2018, 427 patients with oral implantation in Xixi Hospital were selected inthe study.According to the occurrence of bacterial infections around oral implants, the patients were divided into infection group(46 patients) and the non-infection group(381 patients). Pathogenic bacteria were isolated and identified from the bottom of gingival sulcus of infected patients.The risk factors of bacterial infection around dental implants were analyzed by multivariate logistic regression analysis.@*Results@#A total of 59 pathogenic bacteria were isolated from 46 patients with bacterial infection around dental implants, including 38 anaerobic bacteria, 17 aerobic bacteria and 4 beneficial bacteria.Univariate analysis showed that there were no statistically significant differences in sex, age, BMI and hypertension between the two groups (χ2=0.003, 3.393, 0.744, 0.200, all P>0.05). The infection group complicated with diabetes mellitus (19.57%), chronic periodontitis (30.43%), smoking (58.70%), drinking (69.57%), periimplantal alveolar bone defects (50.00%) and overloading (30.43%) were higher than those without infection (5.77%, 6.82%, 29.40%, 34.91%, 23.12%, 11.29%), there werestatistically significant differences (χ2=9.636, 24.241, 16.048, 20.793, 16.655, 13.011, all P<0.05). The results of logistic regression analysis showed that diabetes mellitus, history of chronic periodontitis, smoking, alcohol consumption, poor alveolar bone around implants and overloading were risk factors for bacterial infection around implants.@*Conclusion@#Anaerobic bacteria are the main pathogens of bacterial infection around dental implants.Infection is affected by many factors, including diabetes mellitus, history of chronic periodontitis, smoking, alcohol consumption, poor alveolar bone around implants and excessive load.
ABSTRACT
O planejamento e a instalação de implantes osseointegráveis em maxila anterior devem ser conduzidos por rigorosa disciplina técnica. A anatomia óssea, o fenótipo gengival, assim como a avaliação dentofacial, necessitam de criteriosa análise para resultar em um diagnóstico preciso, possibilitando otimizar tridimensionalmente o implante a ser instalado. Adequar a abordagem cirúrgica e/ou protética, levando-se em consideração a biologia dos tecidos circundantes em cada situação clínica em questão, também constitui-se em conduta de igual importância a ser adotada. O presente artigo traz alguns aspectos do planejamento interdisciplinar para reabilitação unitária, fundamentados em importantes princípios biológicos e estéticos, e ilustrados por um caso clínico realizado em maxila anterior, em sistema de função imediata.
The planning and installation of dental implants in anterior maxilla must be driven by systematic technical discipline. The bone anatomy, gingival phenotype, as well as dentofacial evaluation, require careful analysis to result in an accurate diagnosis, in order to optimize tridimensional position of the implant to be installed. It's important to adapt surgical and prothetic approachs due to different biology of the surrounding tissues, considering individual situations of each case. This paper shows some aspects of interdisciplinary planning for single prosthesis rehabilitation, based on important biological and aesthetic principies, illustrated by a case report conducted in the anterior maxilla, in immediate loading.