| Objective:With the development of society,implant restoration,with its advantages of not damaging adjacent teeth and comfortable taste,has become the main way to repair single tooth loss and multiple tooth loss.Chinese people have poor awareness of oral hygiene maintenance.Peri-implant inflammation has become a common biological complication after implant surgery,with a high incidence rate and rapid progress.The treatment of periimplant inflammation focuses on completely removing the plaque biofilm around the implant,eliminating inflammation,and promoting bone regeneration.However,it is difficult to completely remove the plaque biofilm between the implant threads during the treatment.It is difficult for traditional instruments to act between the exposed threads of the implant.The laser can be used for more thorough debridement through light irradiation.At present,there are many studies on laser assisted treatment of peri-implant inflammation in foreign countries,more animal experiments in China,and relatively few clinical studies,and most of them are used for auxiliary non-surgical treatment of mild peri-implant inflammation,and most of them use a single laser.The purpose of this study is to include patients with mild and moderate peri-implant inflammation through a randomized controlled clinical trial,and to treat mild peri-implant inflammation with Er:YAG/Nd: YAG laser-assisted traditional mechanical debridement,Er: YAG/Nd: YAG laser-assisted traditional mechanical debridement and GBR for moderate peri-implant inflammation with vertical bone defect,Er: YAG/Nd: YAG laser-assisted implant surface modification Traditional mechanical debridement and GBR treatment for moderate periimplant inflammation with mixed bone defects were compared with the control group without laser,respectively,to observe the improvement of clinical indicators,in order to provide some reference for clinical treatment of different degrees of peri-implant inflammation.Methods:From September 2020 to September 2022,49 patients(54 implants)with periimplant inflammation were treated in the Affiliated Stomatological Hospital of the School of Stomatology,Dalian Medical University,including 20 patients with mild peri-implant inflammation(22 implants).They were randomly divided into the experimental group(group A1)using Er: YAG/Nd: YAG laser assisted traditional mechanical debridement treatment and the control group(group A2)using traditional mechanical debridement treatment,The modified plaque index(m PLI),modified sulcus bleeding index(m SBI),probing depth(PD)and marginal bone loss(MBL)of the peri-implant were recorded before and after treatment for 1 month and 3 months.Twenty patients(22 implants)with moderate peri-implant inflammation and vertical bone defect were randomly divided into two groups: the experimental group(group B1)treated with Er: YAG/Nd: YAG laser assisted traditional mechanical debridement and GBR,and the control group(group B2)treated with traditional mechanical debridement and GBR.The m PLI,m SBI,PD,and MBL of the patients were recorded before and after 6 and 12 months of treatment.Nine patients(10 implants)with moderate peri-implant inflammation and mixed bone defects were randomly divided into experimental group(group C1)using Er: YAG/Nd: YAG laser assisted implant surface modification,traditional mechanical debridement and GBR treatment,and control group(group C2)using traditional mechanical debridement combined with implant surface modification and GBR treatment.The m PLI,m SBI,PD,and MBL of the patients were recorded before and after 6 and 12 months of treatment.All the three groups were followed up by telephone at 24 h,48h and 72 h after operation to record the pain value evaluated by the numerical rating scale(NRS).Results:1: Mild peri-implantitis group(Group A)(1): The m PLI values of A1 group(0.909 ± 0.50),(0.636 ± 0.505),A2 group(1.455 ±0.522),and(1.182 ± 0.603)were significantly lower than those before operation 1 month and 3 months after operation(P<0.05),and A1 group was significantly lower than A2group(P<0.05).(2): The m SBI value of A1 group(0.727 ± 0.467),(0.546 ± 0.522)A2 group(1.273 ±0.647)and(1.091 ± 0.539)at 1 month and 3 months after operation were significantly lower than that before operation(P<0.05),and A1 group was significantly lower than A2group(P<0.05).(3): The PD values of A1 group(3.000 ± 0.325 mm),(2.970 ± 0.267 mm),A2 group(3.424 ± 0.262 mm),and(3.379 ± 0.212 mm)were significantly lower than those before operation 1 month and 3 months after operation(P<0.05),and A1 group was significantly lower than A2 group(P<0.05).(4): The MBL values of A1 group(1.536 ± 0.173 mm),(1.514 ± 0.204 mm),A2 group(1.455 ± 0.119 mm),and(1.450 ± 0.128 mm)were not significantly different from those before the operation(P>0.05),and there was no significant difference between A1 group and A2 group(P>0.05).The MBL differences between A1 group and A2 group were(0.014 ± 0.023 mm),(0.036 ± 0.060 mm),and(0.014 ± 0.023 mm),(0.018 ± 0.034 mm),respectively,A1 group was slightly higher than A2 group.(5): The NRS value of group A1 was significantly lower than that of group A2 at 24 h,48h and 72 h after operation(P<0.05).2: Moderate peri-implantitis with vertical bone defect group(Group B)(1): The m PLI values of B1 group(0.727 ± 0.467),(0.455 ± 0.522),B2 group(1.273 ±0.467),and(1.000 ± 0.632)were significantly lower than those before operation 6 and 12 months after operation(P<0.05),and B1 group was significantly lower than B2 group(P<0.05).(2): The m SBI values of B1 group(0.182 ± 0.405),(0.091 ± 0.302),B2 group(0.636 ±0.505)and(0.727 ± 0.467)at 6 and 12 months after operation were significantly lower than those before operation(P<0.05),and B1 group was significantly lower than B2 group(P<0.05)(3): The PD values of B1 group(3.211 ± 0.225 mm),B2 group(3.515 ± 0.377 mm),and B2 group(3.516 ± 0.313 mm)were significantly lower than those before operation 6 and12 months after operation(P<0.05),and B1 group was significantly lower than B2 group(P<0.05).(4): At 6 and 12 months after operation,the MBL values in B1 group(0.777 ± 0.210mm),(0.941 ± 0.219mm),B2 group(1.196 ± 0.099mm)and(1.391 ± 0.132mm)were significantly lower than those before operation(P,B1 group was significantly higher than B2 group(P<0.05).(5): The NRS value of group B1 was significantly lower than that of group B2 at 24 h,48h and 72 h after operation(P<0.05).3: moderate peri-implantitis with mixed bone defect group(Group C)(1): 6 months and 12 months after surgery,the m PLI values of C1 group(0.600±0.548)and(0.400±0.548),C2 group(1.000±0.707)and(0.600±0.548)were significantly lower than those before surgery(P < 0.05),and C1 group was slightly lower than C2 group,with no statistical significance(P > 0.05).(2): At 6 months and 12 months after surgery,the m SBI values in group C1(0.200±0.447)and group C2(1.200±0.447)and group C2(1.000±0.707)were significantly lower than those before surgery(P < 0.05).At 6 months after surgery,the MSBI values in group C1 were significantly lower than those in group C2(P < 0.05).Twelve months after surgery,C1 group was slightly lower than C2 group(P > 0.05).(3): The PD values of C1 group(3.700±0.447mm),C2 group(4.400±0.418mm)and C2group(3.800±0.274mm)at 6 months and 12 months after surgery were significantly lower than those before surgery(P < 0.05).6 months after surgery,Group C1 was significantly lower than group C2(P < 0.05),and 12 months after surgery,group C1 was slightly lower than group C2(P > 0.05).(4): At 6 months and 12 months after surgery,the MBL values of C1 group(1.610±0.182mm)and(1.958±0.142mm)and C2 group(1.550±0.823mm)and(1.879±0.645mm)were significantly decreased compared with those before surgery(P <0.05).There was no significant difference between group C1 and group C2(P > 0.05).The difference of MBL between group C1 and group C2 at 6 months and 12 months after treatment was(2.075±0.624mm)and(1.769±0.553mm),and group C2 was(1.978±0.163mm)and(1.552±0.346mm).Group C1 was slightly higher than group C2(P > 0.05).(5): The NRS value in group C1 was significantly lower than that in group C2 at 24 h,48h and 72 h after operation(P < 0.05).Conclusion:1: Compared with traditional mechanical debridement,Er: YAG/Nd: YAG laser assisted mechanical debridement for mild peri-implant inflammation has excellent effect in reducing soft tissue inflammation,reducing the depth of peri-implant pocket,and reducing postoperative pain response of patients,but it has no obvious advantage in promoting new bone regeneration.2: Er: YAG/Nd: YAG laser-assisted mechanical debridement and GBR surgery in the treatment of moderate peri-implant inflammation with vertical bone defects,compared with the control group without laser,have excellent effects in reducing soft tissue inflammation,reducing the depth of pocket around the implant,promoting new bone regeneration,and reducing postoperative pain response of patients.3: Er: YAG/Nd: YAG laser-assisted implant surface modification,mechanical debridement and GBR surgery for moderate peri-implant inflammation with mixed bone defects can effectively reduce soft tissue inflammation,reduce the depth of peri-implant pocket,and reduce the postoperative pain response of patients in a short period of time,compared with the control group without laser,There is no obvious advantage in promoting the long-term effect of new bone regeneration. |
PDF Full Text Request