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
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
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DOI：
10.1002/jper.17-0739
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发表时间：
2018-06-01
影响因子：
4.3
通讯作者：
Zitzmann, Nicola
中科院分区：
文献类型：
--
作者：
Berglundh, Tord;Armitage, Gary;Zitzmann, Nicola
提出了种植体周围疾病和条件的分类。重点讨论了种植体周围健康、种植体周围粘膜炎、种植体周围炎以及软硬组织缺陷的特征。种植体周围健康的特点是没有红斑、探查时出血、肿胀和化脓。不可能确定与健康相适应的探测深度范围；种植体周围的健康可以存在于骨支持减少的种植体周围。种植体周围粘膜炎的主要临床特征是轻微探诊出血。也可能出现红斑、肿胀和/或化脓。在种植体周围粘膜炎的情况下，由于肿胀或探探阻力降低，常观察到探探深度增加。从动物和人体实验研究中有强有力的证据表明，菌斑是种植体周围粘膜炎的病因。种植周炎是一种与牙菌斑相关的病理状况，发生在种植体周围的组织中，其特征是种植体周围粘膜的炎症和随后的支撑骨的进行性损失。种植体周围炎部位表现为炎症、探诊时出血和/或化脓、探诊深度增加和/或粘膜边缘萎缩以及x线骨质丢失。关于角化粘膜对种植体周围组织长期健康的影响，证据是模棱两可的。然而，角质化的粘膜似乎在患者舒适和易于清除斑块方面具有优势。介绍了日常临床实践和流行病学或疾病监测研究中关于种植体周围健康、种植体周围粘膜炎和种植体周围炎的病例定义。所提出的病例定义应该在没有通用种植体的背景下看待，并且有许多种植体设计具有不同的表面特征，手术和加载方案。建议临床医生在完成种植体支持的假体后进行基线放射和探针测量。
A classification for peri-implant diseases and conditions was presented. Focused questions on the characteristics of peri-implant health, peri-implant mucositis, peri-implantitis, and soft- and hard-tissue deficiencies were addressed.Peri-implant health is characterized by the absence of erythema, bleeding on probing, swelling, and suppuration. It is not possible to define a range of probing depths compatible with health; Peri-implant health can exist around implants with reduced bone support.The main clinical characteristic of peri-implant mucositis is bleeding on gentle probing. Erythema, swelling, and/or suppuration may also be present. An increase in probing depth is often observed in the presence of peri-implant mucositis due to swelling or decrease in probing resistance. There is strong evidence from animal and human experimental studies that plaque is the etiological factor for peri-implant mucositis.Peri-implantitis is a plaque-associated pathological condition occurring in tissues around dental implants, characterized by inflammation in the peri-implant mucosa and subsequent progressive loss of supporting bone. Peri-implantitis sites exhibit clinical signs of inflammation, bleeding on probing, and/or suppuration, increased probing depths and/or recession of the mucosal margin in addition to radiographic bone loss.The evidence is equivocal regarding the effect of keratinized mucosa on the long-term health of the peri-implant tissue. It appears, however, that keratinized mucosa may have advantages regarding patient comfort and ease of plaque removal.Case definitions in day-to-day clinical practice and in epidemiological or disease-surveillance studies for peri-implant health, peri-implant mucositis, and peri-implantitis were introduced. The proposed case definitions should be viewed within the context that there is no generic implant and that there are numerous implant designs with different surface characteristics, surgical and loading protocols. It is recommended that the clinician obtain baseline radiographic and probing measurements following the completion of the implant-supported prosthesis.