Clinical Study Of Immediate Implantation In Patients With Anterior Periodontal Disease And Non-periodontal Disease After Trauma

Objective Immediate implantation after trauma is the preferred scheme to repair missing teeth.Compared with periodontal healthy patients,whether immediate implantation in individuals with periodontal disease will lead to the increase of bone resorption and the occurrence of peri-implant inflammation,and then lead to the loss and failure of implant stability has clinical significance.In this study,we evaluated the effect of different degrees of periodontal disease on the patient’s peri-implant soft and hard tissue health status,implant crown restoration efficacy: pink and white esthetic scores,implant retention rates and complications,and other clinical parameters during the first 12 months after immediate implant placement by traumatic injury in the anterior tooth area,in order to provide some reference for the clinical work.Methods The clinical data of 65 patients(90 implants in total)who underwent immediate implantation in the anterior dental area due to trauma in the dental implant center of the Affiliated Hospital of Inner Mongolia Medical University from December 2019 to January 2022 were collected.They were divided into non-periodontal disease group,mild periodontal disease group,moderate periodontal disease group and severe periodontal disease group according to whether they were periodontal disease patients and the different degrees of periodontal disease.The following indexes were tested by manual measurement and CBCT(cone beam computed tomography)examination:implant modified bleeding index(m SBI,modified sulcus bleeding index),implant modified plaque index(m PLI,modified plaque index),peri-implant probing depth(PD,probing depth),implant marginal bone absorption(MBL,marginal bone loss),labial bone wall thickness absorption(d),final patient satisfaction(VAS,visual analogue scale),red aesthetic score(PES,pink esthetic scores),white aesthetic score(WES,white esthetic scores),The implant survival rate and complications were analyzed.Results Implant modified plaque index(m PLI): at 7 months after implantation,there was significant difference between moderate and severe periodontal disease group and non-periodontal disease group;At the follow-up visit in December,the mild,moderate and severe groups were statistically significant compared with the non-periodontal disease group;Implant modified bleeding index(m SBI): there was no significant difference between mild and moderate groups and non-periodontal disease groups 7 months after operation,and there was significant difference between severe group and nonperiodontal disease group;At the follow-up visit in December,there were significant differences between moderate and severe periodontal disease group and non-periodontal disease and mild periodontal disease group;Peri-implant probing depth(PD): there was significant difference between moderate and severe group and non-periodontal disease group,but there was no significant difference between mild group and non-periodontal disease group;Marginal bone loss(MBL): there were significant differences among non-periodontal disease group,mild group,moderate group and severe group at the follow-up visit in July after operation;At 12 months,the moderate and severe groups had statistical significance with non-periodontal disease and mild group,but there was no statistical significance between mild group and non-periodontal disease group,and between severe group and moderate group;Labial bone wall thickness absorption(d): there was no significant difference between mild periodontal disease group and non-periodontal disease group,but there was significant difference between mild periodontal disease group and non-periodontal disease group;Compared with non-periodontal disease group,the absorption of crown formula(d1),middle formula(d2)and root formula(d3)in moderate and severe periodontal disease group were statistically different;There were statistically significant differences in the amount of bone wall resorption on the labial side of the crown(d1),middle(d2)between the moderate and severe and mild groups;And the crown square of the severe group(d1)was statistically different from that of the moderate group(d1);The results of implant crown restoration(PES and WES): there was no significant difference in PES scores between mild periodontal disease group and non-periodontal disease group;The PES scores of moderate periodontal disease group and severe periodontal disease group were significantly different from those of non-periodontal disease group.White aesthetic score(WES): there was no significant difference between mild periodontal disease group and non-periodontal disease group;Moderate group and severe group were lower than non-periodontal disease group,which was statistically significant;Peri-implant disease and survival rate: there was significant difference in the prevalence of peri-implant inflammation between moderate and severe periodontal disease group and non-periodontal disease and mild periodontal disease group.Moderate and severe periodontal disease group had a higher risk of peri-implant inflammation;The overall survival rate of implants was 96.77%.Conclusion Periodontal disease is not a contraindication to immediate implantation in the anterior tooth area after trauma.Immediate implantation in patients with mild periodontal disease and non-periodontal disease can achieve similar clinical effects.Although patients with moderate and severe periodontal disease have certain effects,immediate implantation for missing teeth after trauma is still the best option,And active periodontal maintenance after operation plays an important role in maintaining the health of implants.