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迄今为止欧洲骨结合学会(EAO)共识研讨会共成功举办了四届。其中第三届EAO共识研讨会于2012年2月在瑞士Pf(a|¨)ffikon举办。此次研讨会分成4个工作组,讨论了当前牙科种植领域四大方面问题:(1)种植体的存留和并发症;(2)种植体周围组织的破坏;(3)计算机辅助的牙种植治疗以及硬组织和软组织方面处理;(4)种植修复重建。本文着重介绍种植体周围组织破坏工作组讨论内容和主要共识。1.种植体周围炎的流行病学:文献报道在种植体植入5一10年后,10%的种植体和20%的患者发生种植体周围炎。文献对种植体周围炎的定义不同,报道的患病率差别很大(11%一47%)。已被证实影响种植体周围炎患病率的因素包括吸烟,口腔卫生差,以及牙周炎病史。2.种植体周围炎非手术治疗种植体周围粘膜炎到种植体周围炎的界限难以确定。因此重要的是在出现早期炎症征象时给予及时治疗,以预防或限制种植体边缘骨的吸收。种植体周围粘膜炎采用非手术的机械清创术可治愈。3.手术方法控制种植体周围炎手术治疗至少应包括:去除肉芽组织(牙合)彻底清创污染表面以及辅助措施(粘膜下抛光,ER:YAG激光治疗,局部使用抗菌剂)可大大减少探诊出血和探诊深度。然而疗效并不确定,而且会受一些目前尚不完全清楚因素的影响。4.过度负荷和骨/种植体丧失基于3项动物实验得出以下结论:有证据表明种植体周围骨组织对所施加的载荷的不同的反应取决于种植体周围组织健康状况,健康的种植体周围组织,不仅没有发生骨吸收甚至有骨量的增加。在炎症的种植体周围组织,会增加边缘骨吸收。
To date, the European Association for Bone Oscillation (EAO) consensus seminar has been successfully held for four times. The third EAO Consensus Workshop was held in Pf (Switzerland, February 2012) in Ffikon, Switzerland. The workshop was divided into four working groups to discuss four major aspects of the current dental field: (1) implant survival and complications; (2) tissue destruction around the implant; (3) computer-assisted dental implantations Treatment and treatment of hard tissue and soft tissue; (4) implant repair and reconstruction. This article highlights the discussion and main consensus of the working group on tissue destruction around implants. Epidemiology of peri-implantitis: It has been reported in the literature that peri-implantitis occurs in 10% of implants and in 20% of patients after 5 to 10 years of implants. The literature defines peri-implantitis as different, and the prevalence varies widely (11% -47%). Factors that have been shown to affect the prevalence of peri-implantitis include smoking, poor oral hygiene, and a history of periodontitis. Peri-implantitis non-surgical treatment of peri-implantitis around peri-implantitis inflammation is difficult to determine the boundaries. It is therefore important to give timely treatment in the presence of early signs of inflammation to prevent or limit the absorption of the marginal bone of the implant. Surgical mucositis around the implant was treated with a non-surgical mechanical debridement. 3. Surgical management of peri-implantitis Surgical treatment should at least include: Removal of granulation tissue (occlusal) Complete debridement of contaminated surfaces and assistive devices (submucosal polishing, ER: YAG laser treatment, topical use of antimicrobial agents) can greatly reduce exploration Bleeding and probing depth. However, the efficacy is not certain and will be affected by some factors that are not yet fully understood. 4. Overload and Bone / Implant Loss The following conclusions were reached based on three animal experiments: There is evidence that different responses of the bone tissue around the implant to the applied load depend on the health of the tissue surrounding the implant, that healthy implants Around the organization, not only did not occur bone resorption and even increased bone mass. Tissue around inflammatory implants increases edge bone resorption.