The Role of Keratinized Mucosa in Peri-Implant Tissue Stability after Treatment of Peri-Implantitis. Clinical and Radiographic Outcomes of a Prospective Cohort Study after 3 Years.

Emmanuel Englezos, Wim Coucke, Ana B Castro, Wim Teughels, Andy Temmereman
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Abstract

This study prospectively evaluated the effect of keratinized mucosa (KM) on the healing of the peri- implant tissues after resective surgical therapy for peri-implantitis. It addressed the question of whether the absence of KM has a negative effect on peri-implant tissue stability after treatment. Patients referred to a private practice for peri-implantitis treatment were surgically treated with resective flap surgery and implantoplasty. They were followed for 3 years and measurements at implant level included presence of plaque, bleeding on probing, probing pocket depth, radiographically visible bone loss and the presence and width of KM before therapy, 3 month post-operatively, 1 year, 2 years, and 3 years after the surgical intervention. All clinical parameters improved and marginal bone levels remained stable 3 years after therapy. The width of the KM decreased significantly after the therapy. Soft tissue recession was frequently observed. The absence of KM does not seem to have a negative effect on healing after therapy for the studied period of 3 years. The authors conclude that resective surgery combined with implantoplasty seems to be a reliable method for arresting the progression of peri-implantitis.

角化粘膜在治疗种植体周围炎后种植体周围组织稳定性中的作用。一项前瞻性队列研究3年后的临床和放射学结果
这项研究前瞻性地评估了角化粘膜(KM)对种植体周围炎切除性手术治疗后种植体周围组织愈合的影响。该研究探讨了角质化粘膜的缺失是否会对治疗后种植体周围组织的稳定性产生负面影响。转诊到一家私人诊所接受种植体周围炎治疗的患者均接受了切除性皮瓣手术和种植体成形术。对这些患者进行了为期 3 年的随访,对种植体水平的测量包括治疗前、术后 3 个月、术后 1 年、术后 2 年和术后 3 年的菌斑存在情况、探诊出血情况、探诊袋深度、X 光片可见的骨质流失以及 KM 的存在和宽度。治疗后 3 年,所有临床指标均有所改善,边缘骨水平保持稳定。治疗后,KM 的宽度明显减少。软组织经常出现衰退。在研究的 3 年时间里,KM 的缺失似乎对治疗后的愈合没有负面影响。作者总结说,切除手术结合种植体成形术似乎是阻止种植体周围炎发展的可靠方法。
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