Primary prevention of peri-implantitis: Managing peri-implant mucositis
Primary prevention of peri-implantitis: Managing peri-implant mucositis
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DOI：
10.1111/jcpe.12369
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发表时间：
2015-04-01
影响因子：
6.7
通讯作者：
Zitzmann, Nicola U.
中科院分区：
文献类型：
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作者：
Jepsen, Soren;Berglundh, Tord;Zitzmann, Nicola U.
目的在过去的几十年里，种植体的放置已经成为一个常规的程序，在口腔修复的完全和部分缺牙患者。然而，受种植体周围疾病影响的患者/种植体数量正在增加。与牙周炎相比，目前还没有治疗种植体周围炎的既定和可预测的概念，因此一级预防至关重要。种植体周围粘膜炎的管理被认为是种植体周围炎发作的预防措施。因此，该工作组的职责是评估种植体周围疾病的患病率，以及种植体周围粘膜炎的风险，并评估种植体周围粘膜炎的管理措施。以及患者和专业管理措施对处理植入物周围粘膜炎的影响。该共识报告是基于这些系统评价的结果和专家意见的participators.ResultsKey结果包括：（i）荟萃分析估计种植体周围粘膜炎的加权平均患病率为43%（CI：32-54%），种植体周围炎为22%（CI：14-30%）;（ii）探诊出血被认为是区分种植体周围健康和疾病的关键临床指标;（iii）种植体周围粘膜炎患者缺乏常规支持治疗与种植体周围炎发病风险增加相关;（iv）尽管牙菌斑积聚已被确定为病因学因素，但吸烟被确定为可改变的患者相关因素，过量骨水泥被确定为发生种植体周围粘膜炎的局部风险指标;（V）患者施用的机械斑块控制（vi）包括口腔卫生指导和机械清创术的专业干预显示炎症的临床体征减少;（七）预防措施（防腐剂、局部和全身抗生素，空气研磨装置）没有发现提高疗效的专业管理菌斑去除减少临床症状的inflammation.ConclusionsConsensus达成共识的建议，为患者与牙科种植体和口腔卫生保健专业人员的疗效方面，管理种植体周围粘膜炎的措施。特别强调的是，种植体放置和假体重建需要允许适当的个人清洁，通过探测和专业的斑块去除进行诊断。
AimsOver the past decades, the placement of dental implants has become a routine procedure in the oral rehabilitation of fully and partially edentulous patients. However, the number of patients/implants affected by peri-implant diseases is increasing. As there are - in contrast to periodontitis - at present no established and predictable concepts for the treatment of peri-implantitis, primary prevention is of key importance. The management of peri-implant mucositis is considered as a preventive measure for the onset of peri-implantitis. Therefore, the remit of this working group was to assess the prevalence of peri-implant diseases, as well as risks for peri-implant mucositis and to evaluate measures for the management of peri-implant mucositis.MethodsDiscussions were informed by four systematic reviews on the current epidemiology of peri-implant diseases, on potential risks contributing to the development of peri-implant mucositis, and on the effect of patient and of professionally administered measures to manage peri-implant mucositis. This consensus report is based on the outcomes of these systematic reviews and on the expert opinion of the participants.ResultsKey findings included: (i) meta-analysis estimated a weighted mean prevalence for peri-implant mucositis of 43% (CI: 32-54%) and for peri-implantitis of 22% (CI: 14-30%); (ii) bleeding on probing is considered as key clinical measure to distinguish between peri-implant health and disease; (iii) lack of regular supportive therapy in patients with peri-implant mucositis was associated with increased risk for onset of peri-implantitis; (iv) whereas plaque accumulation has been established as aetiological factor, smoking was identified as modifiable patient-related and excess cement as local risk indicator for the development of peri-implant mucositis; (v) patient-administered mechanical plaque control (with manual or powered toothbrushes) has been shown to be an effective preventive measure; (vi) professional intervention comprising oral hygiene instructions and mechanical debridement revealed a reduction in clinical signs of inflammation; (vii) adjunctive measures (antiseptics, local and systemic antibiotics, air-abrasive devices) were not found to improve the efficacy of professionally administered plaque removal in reducing clinical signs of inflammation.ConclusionsConsensus was reached on recommendations for patients with dental implants and oral health care professionals with regard to the efficacy of measures to manage peri-implant mucositis. It was particularly emphasized that implant placement and prosthetic reconstructions need to allow proper personal cleaning, diagnosis by probing and professional plaque removal.