国际口腔医学杂志

国际口腔医学杂志 ›› 2020, Vol. 47 ›› Issue (4): 463-470.doi: 10.7518/gjkq.2020068

• 综述 • 上一篇    下一篇

种植体周围炎药物治疗与激光治疗的研究进展

张敏1,万浩元2()   

  1. 1.彭水苗族土家族自治县人民医院口腔科 重庆 409600
    2.陆军军医大学大坪医院口腔科 重庆 400042
  • 收稿日期:2019-09-18 修回日期:2020-03-29 出版日期:2020-07-01 发布日期:2020-07-10
  • 通讯作者: 万浩元
  • 作者简介:张敏,住院医师,学士,Email：824576147@qq.com

Research progress on drug and laser therapy for peri-implantitis

Zhang Min1,Wan Haoyuan2()   

  1. 1. Dept. of Stomatology, People’s Hospital of Pengshui Miao & Tujia Autonomous County, Chongqing 409600, China
    2. Dept. of Stomatology, Daping Hospital, Army Military Medical University, Chongqing 400042, China
  • Received:2019-09-18 Revised:2020-03-29 Online:2020-07-01 Published:2020-07-10
  • Contact: Haoyuan Wan

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摘要：

种植已成为牙列缺损及牙列缺失的主要修复方案之一,种植体周围炎是导致种植失败的主要原因,种植修复后应当重视后期的维护、种植体周围炎的预防及治疗。种植体周围炎治疗的方法较多,大致可分为非手术治疗和手术治疗。目前,对于种植体周围炎仍首选非手术治疗,仅在有严重骨吸收、非手术治疗效果不佳时选择手术治疗。非手术治疗的方法主要有机械清创、药物治疗、激光治疗、高压氧治疗等,药物治疗和激光治疗是目前临床上应用较多且行之有效的2种治疗方法。本文就种植体周围炎药物治疗与激光治疗的研究进展作一综述。

关键词: 种植体周围炎, 药物治疗, 激光治疗, 研究进展

Abstract:

Implantation has become one of the main restoration schemes for dentition defect and loss, and peri-implantitis is the main cause of implant failure. After implantation restoration, attention should be provided to the subsequent maintenance, prevention, and treatment of peri-implantitis. Many methods can be used to treat peri-implantitis. These methods can be roughly divided into nonsurgical and surgical treatments. At present, nonsurgical treatment is ineffective and is still preferred for peri-implantitis, and surgical treatment is only selected when bone resorption is severe. Nonsurgical treatment methods mainly include mechanical debridement, drug therapy, laser therapy, and hyperbaric oxygen therapy. Drugs and lasers are currently two widely used clinical methods and effective treatments. This article reviews the research progress on drug and laser therapy treatments for peri-implantitis.

Key words: peri-implantitis, drug therapy, laser therapy, research progress

中图分类号: 

  • R781.4+2
[1] Berglundh T, Armitage G, Araujo MG, et al. 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[J]. J Periodontol, 2018,89(Suppl 1):S313-S318.
doi: 10.1002/JPER.17-0739
[2] Tey VHS, Phillips R, Tan K. Five-year retrospective study on success, survival and incidence of com-plications of single crowns supported by dental im-plants[J]. Clin Oral Implants Res, 2017,28(5):620-625.
doi: 10.1111/clr.12843 pmid: 27334865
[3] Roos-Jansåker AM, Lindahl C, Renvert H, et al. Nine- to fourteen-year follow-up of implant treat-ment. Part Ⅱ: presence of peri-implant lesions[J]. J Clin Periodontol, 2006,33(4):290-295.
pmid: 16553638
[4] Sousa V, Nibali L, Spratt D, et al. Peri-implant and periodontal microbiome diversity in aggressive pe-riodontitis patients: a pilot study[J]. Clin Oral Im-plants Res, 2017,28(5):558-570.
[5] Romanos GE, Delgado-Ruiz R, Sculean A. Concepts for prevention of complications in implant therapy[J]. Periodontol 2000, 2019,81(1):7-17.
pmid: 31407435
[6] Carcuac O, Derks J, Abrahamsson I, et al. Surgical treatment of peri-implantitis: 3-year results from a randomized controlled clinical trial[J]. J Clin Perio-dontol, 2017,44(12):1294-1303.
[7] Schou S, Berglundh T, Lang NP. Surgical treatment of peri-implantitis[J]. Int J Oral Maxillofac Implants, 2004,19(Suppl):140-149.
[8] Serino G, Wada M. Non-surgical mechanical treat-ment of peri-implant mucositis: the effect of sub-mucosal mechanical instrumentation following supra-mucosal plaque removal. A 7-month prospective single cohort study[J]. Eur J Oral Implantol, 2018,11(4):455-466.
pmid: 30515485
[9] Xu L, Wang YY, Nguyen VT, et al. Effects of topical antibiotic prophylaxis on wound healing after flapless implant surgery: a pilot study[J]. J Periodontol, 2016,87(3):275-280.
pmid: 26537369
[10] Heo S, Kim HJ, Joo JY, et al. Simplified nonsurgical treatment of peri-implantitis using chlorhexidine and minocycline hydrochloride[J]. J Periodontal Implant Sci, 2018,48(5):326-333.
doi: 10.5051/jpis.2018.48.5.326 pmid: 30405940
[11] Chen WL, Zhi M, Feng ZJ, et al. Sustained co-delivery of ibuprofen and basic fibroblast growth factor by thermosensitive nanoparticle hydrogel as early local treatment of peri-implantitis[J]. Int J Nanomedicine, 2019,14:1347-1358.
doi: 10.2147/IJN.S190781 pmid: 30863065
[12] 王飞翔, 贺慧霞, 贾雅丽, 等. 牙髓、牙周膜及脐带间充质干细胞三系分化能力的体外比较研究[J]. 口腔颌面修复学杂志, 2016,17(3):129-134.
Wang FX, He HX, Jia YL, et al. Comparison of dif-ferentiation potentials of mesenchymal stem cells derived from dental pulp, periodontal ligament and umbilical cord[J]. Chin J Prosthodont, 2016,17(3):129-134.
[13] Diniz IM, Chen C, Ansari S, et al. Gingival mesen-chymal stem cell (GMSC) delivery system based on RGD-coupled alginate hydrogel with antimicrobial properties: a novel treatment modality for peri-im-plantitis[J]. J Prosthodont, 2016,25(2):105-115.
pmid: 26216081
[14] Wang GS, Mishra B, Lau K, et al. Antimicrobial peptides in 2014[J]. Pharmaceuticals (Basel), 2015,8(1):123-150.
[15] 费涛, 李冀寅, 王一宇, 等. 富含色氨酸抗菌肽对种植体周围炎主要致病菌生长抑制作用的研究[J]. 中国微生态学杂志, 2016,28(2):156-158, 168.
Fei T, Li JY, Wang YY, et al. Inhibitory effect of tryptophan-rich antimicrobial peptides on peri-im-plantitis pathogens in vitro[J]. Chin J Microecol, 2016,28(2):156-158, 168.
[16] Wang D, Haapasalo M, Gao Y, et al. Antibiofilm peptides against biofilms on titanium and hydroxya-patite surfaces[J]. Bioact Mater, 2018,3(4):418-425.
doi: 10.1016/j.bioactmat.2018.06.002 pmid: 30003180
[17] 王冰杰, 王雪, 段子文, 等. 维药买朱尼对种植体周围炎中龈下微生物的影响研究[J]. 西北国防医学杂志, 2018,39(4):216-220.
Wang BJ, Wang X, Duan ZW, et al. Effect of Maizhuni on subgingival microorganism in peri-implantitis[J]. Med J Natl Defending Forces Northwest China, 2018,39(4):216-220.
[18] 古丽再努·依不拉音, 吐逊阿依·阿迪力, 任家卉, 等. 维药买朱尼对种植体周围炎龈沟液中白细胞介素-1β和牙周指数的影响[J]. 口腔医学研究, 2017,33(7):762-765.
Gulizainv·Y, Tuxunayin·A, Ren JH, et al. Effect of Uygur medicine Maizhuni on IL-1β in crevicular fluid and periodontal index in peri-implantitis[J]. J Oral Sci Res, 2017,33(7):762-765.
[19] 陈飞, 焦鹏, 车鸿泽, 等. 中药双黄补联合西帕依固龈液对种植体周围炎患者牙周炎症的改善作用及其临床意义[J]. 吉林大学学报(医学版), 2017,43(6):1226-1230.
Chen F, Jiao P, Che HZ, et al. Improvement effect of Shuanghuangbu combined with Xipayi Mouth Rinse on periodontal in flammation of peri-implantitis patients and its clinical significance[J]. J Jilin Univ (Med Ed), 2017,43(6):1226-1230.
[20] 曾飞跃. 牛黄清胃丸联合盐酸米诺环素治疗种植体周围炎的临床研究[J]. 现代药物与临床, 2016,31(5):667-672.
doi: 10.7501/j.issn.1674-5515.2016.05.024
Zeng FY. Clinical study on Niuhuang Qingwei pills combined with periocline in treatment of peri-im-plantitis[J]. Drugs Clin, 2016,31(5):667-672.
doi: 10.7501/j.issn.1674-5515.2016.05.024
[21] 黄涛, 刘琳. 黄连上清软胶囊辅助治疗种植体周围炎的临床观察[J]. 中国药房, 2016,27(18):2491-2493.
Huang T, Liu L. Clinical observation of Huanglian Shangqing soft capsule in the adjuvant treatment of inflammation around implant[J]. China Pharm, 2016,27(18):2491-2493.
[22] 金权, 许立硕, 黄玉, 等. 穿心莲内脂联合黄芩素治疗种植体周围炎的临床疗效观察[J]. 全科口腔医学电子杂志, 2018,5(30):32-33.
Jin Q, Xu LS, Huang Y, et al. Clinical observation of andrographolide combined with baicalein in the treat-ment of peri-implant inflammation[J]. Gen J Stomatol, 2018,5(30):32-33.
[23] 董滢, 蒋柳宏, 闫春歌. 仙灵骨葆对犬种植体周围炎龈沟液中IL-1、IL-6含量影响实验分析[J]. 辽宁中医药大学学报, 2015,17(5):38-40.
Dong Y, Jiang LH, Yan CG. Effects of Xianling Gu-bao on IL-1 IL-6 in peri-implant sulcular fluid of experimental peri-implantitis[J]. J Liaoning Univ Tradit Chin Med, 2015,17(5):38-40.
[24] 周峰, 祝岩. 补肾扶脾汤治疗口腔种植体周围炎疗效及对患者龈沟液IL-1β、IL-6的影响[J]. 陕西中医, 2018,39(8):1101-1104.
Zhou F, Zhu Y. Bushen Fupi decoction in the treat-ment of oral implant periarthritis and observation of IL-1 and IL-6[J]. Shanxi J Tradit Chin Med, 2018,39(8):1101-1104.
[25] 蒋柳宏, 董滢, 闫春歌, 等. 玉女煎对实验性犬种植体周围炎的治疗作用[J]. 河南中医, 2015,35(5):960-962.
Jiang LH, Dong Y, Yan CG, et al. The research on functions of jade maid decoction in treating of peri-implant inflammation of experimental dogs[J]. Henan Tradit Chin Med, 2015,35(5):960-962.
[26] Kunimatsu R, Nakajima K, Awada T, et al. Compara-tive characterization of stem cells from human ex-foliated deciduous teeth, dental pulp, and bone marrow-derived mesenchymal stem cells[J]. Biochem Biophys Res Commun, 2018,501(1):193-198.
doi: 10.1016/j.bbrc.2018.04.213 pmid: 29730288
[27] 林毅, 陈詹宏, 陈玉英. 地塞米松喷雾剂联合牙髓干细胞治疗糖尿病Beagle犬种植体周围炎的实验研究[J]. 中国临床药理学杂志, 2017,33(23):2398-2400.
Lin Y, Chen ZH, Chen YY. Experimental study of dexamethasone spray combined with dental pulp stem cells in the treatment of peri-implantitis of dia-betic mellitus Beagle dogs[J]. Chin J Clin Pharmacol, 2017,33(23):2398-2400.
[28] Haydari M, Bardakci AG, Koldsland OC, et al. Com-paring the effect of 0.06% -, 0.12% and 0.2% Chlor-hexidine on plaque, bleeding and side effects in an experimental gingivitis model: a parallel group, double masked randomized clinical trial[J]. BMC Oral Health, 2017,17(1):118.
doi: 10.1186/s12903-017-0400-7 pmid: 28821290
[29] 王一宇, 孙盼盼, 史艳芬, 等. 复方氯己定对口腔种植体周围炎病原菌生物膜的影响[J]. 济宁医学院学报, 2016,39(6):395-398.
Wang YY, Sun PP, Shi YF, et al. Effect of compound chlorhexidine on the biofilm of the pathogen of oral peri-implantitis[J]. J Jining Med Univ, 2016,39(6):395-398.
[30] 刘雪阳, 刘海江, 荆得宝. 康复新液对种植体周围炎疗效的观察[J]. 口腔材料器械杂志, 2017,26(3):159-163.
Liu XY, Liu HJ, Jing DB. Study on the clinical effect of Kanfuxin solution on the treatment of peri-im-plantitis[J]. Chin J Dent Mater Devices, 2017,26(3):159-163.
[31] 刘朴. 银菊含漱液对种植体周围粘膜炎的临床评估[D]. 泸州: 泸州医学院, 2013.
Liu P. Evaluation of YinJu in peri-implant mucositis[D]. Luzhou: Luzhou Medical College, 2013.
[32] Ulu M, Pekbagriyanik T, Ibis F, et al. Antibiofilm efficacies of cold plasma and Er: YAG laser on Sta-phylococcus aureus biofilm on titanium for nonsur-gical treatment of peri-implantitis[J]. Niger J Clin Pract, 2018,21(6):758-765.
doi: 10.4103/njcp.njcp_261_17 pmid: 29888724
[33] Norton MR. Efficacy of Er: YAG laser in the decon-tamination of peri-implant disease: a one-year pros-pective closed cohort study[J]. Int J Periodontics Restorative Dent, 2017,37(6):781-788.
doi: 10.11607/prd.3324 pmid: 29023606
[34] Yoshino T, Yamamoto A, Ono Y. Innovative rege-neration technology to solve peri-implantitis by Er: YAG laser based on the microbiologic diagnosis: a case series[J]. Int J Periodontics Restorative Dent, 2015,35(1):67-73.
doi: 10.11607/prd.2116 pmid: 25734708
[35] Schwarz F, Becker J. Treatment of periodontitis and peri-implantitis with an Er: YAG laser: experimental and clinical studies[J]. Med Laser Appl, 2005,20(1):47-59.
[36] Yan MD, Liu MM, Wang M, et al. The effects of Er: YAG on the treatment of peri-implantitis: a meta-analysis of randomized controlled trials[J]. Lasers Med Sci, 2015,30(7):1843-1853.
doi: 10.1007/s10103-014-1692-3 pmid: 25428598
[37] Batsukh N, Feng SW, Lee WF, et al. Effects of por-phyromonas gingivalis on titanium surface by dif-ferent clinical treatment[J]. J Med Biol Eng, 2017,37(1):35-44.
[38] Frazier-Bowers SA, Puranik CP, Mahaney MC. The etiology of eruption disorders—further evidence of a ‘genetic paradigm’[J]. Semin Orthod, 2010,16(3):180-185.
doi: 10.1053/j.sodo.2010.05.003 pmid: 20830195
[39] Chellini F, Giannelli M, Tani A, et al. Mesenchymal stromal cell and osteoblast responses to oxidized titanium surfaces pre-treated with λ=808 nm GaAlAs diode laser or chlorhexidine: in vitro study[J]. Lasers Med Sci, 2017,32(6):1309-1320.
doi: 10.1007/s10103-017-2243-5 pmid: 28551763
[40] Lerario F, Roncati M, Gariffo A, et al. Non-surgical periodontal treatment of peri-implant diseases with the adjunctive use of diode laser: preliminary clinical study[J]. Lasers Med Sci, 2016,31(1):1-6.
doi: 10.1007/s10103-015-1785-7
[41] Romanos GE, Nentwig GH. Regenerative therapy of deep peri-implant infrabony defects after CO2 laser implant surface decontamination[J]. Int J Periodontics Restorative Dent, 2008,28(3):245-255.
pmid: 18605600
[42] Deppe H, Horch HH, Neff A. Conventional versus CO2 laser-assisted treatment of peri-implant defects with the concomitant use of pure-phase beta-trical-cium phosphate: a 5-year clinical report[J]. Int J Oral Maxillofac Implants, 2007,22(1):79-86.
pmid: 17340900
[43] Giannelli M, Bani D, Tani A, et al. Effects of an erbium: yttrium-aluminum-garnet laser and ultrasonic scaler on titanium dioxide-coated titanium surfaces contaminated with subgingival plaque: an in vitro study to assess post-treatment biocompatibility with osteogenic cells[J]. J Periodontol, 2017,88(11):1211-1220.
doi: 10.1902/jop.2017.170195 pmid: 28691887
[44] Alagl AS, Madi M, Bedi S, et al. The effect of Er, Cr: YSGG and diode laser applications on dental implant surfaces contaminated with Acinetobacter baumannii and Pseudomonas aeruginosa[J]. Materials (Basel), 2019,12(13):E2073.
[45] Pirnat S, Lukac M, Ihan A. Study of the direct bac-tericidal effect of Nd: YAG and diode laser parame-ters used in endodontics on pigmented and nonpig-mented bacteria[J]. Lasers Med Sci, 2011,26(6):755-761.
doi: 10.1007/s10103-010-0808-7 pmid: 20582609
[46] Suzuki JB. Salvaging implants with an Nd: YAG laser: a novel approach to a growing problem[J]. Compend Contin Educ Dent, 2015,36(10):756-761.
pmid: 26625168
[47] Giannelli M, Bani D, Tani A, et al. In vitro evaluation of the effects of low-intensity Nd: YAG laser irra-diation on the inflammatory reaction elicited by bac-terial lipopolysaccharide adherent to titanium dental implants[J]. J Periodontol, 2009,80(6):977-984.
doi: 10.1902/jop.2009.080648 pmid: 19485829
[48] Gonçalves F, Zanetti AL, Zanetti RV, et al. Effec-tiveness of 980-mm diode and 1 064-nm extra-long-pulse neodymium-doped yttrium aluminum garnet lasers in implant disinfection[J]. Photomed Laser Surg, 2010,28(2):273-280.
doi: 10.1089/pho.2009.2496 pmid: 19811080
[49] Sayar F, Chiniforush N, Bahador A, et al. Efficacy of antimicrobial photodynamic therapy for elimination of Aggregatibacter actinomycetemcomitans biofilm on Laser-Lok titanium discs[J]. Photodiagnosis Pho-todyn Ther, 2019,27:462-466.
[50] Caccianiga G, Rey G, Baldoni M, et al. Clinical, ra- diographic and microbiological evaluation of high level laser therapy, a new photodynamic therapy protocol, in peri-implantitis treatment; a pilot ex-perience[J]. Biomed Res Int, 2016,2016:6321906.
doi: 10.1155/2016/6321906 pmid: 27379251
[51] Bassetti M, Schär D, Wicki B, et al. Anti-infective therapy of peri-implantitis with adjunctive local drug delivery or photodynamic therapy: 12-month out-comes of a randomized controlled clinical trial[J]. Clin Oral Implants Res, 2014,25(3):279-287.
doi: 10.1111/clr.12155 pmid: 23560645
[52] 王焱, 麻颖宜, 刘晓晓, 等. 光动力疗法治疗种植体周围炎的短期效果评价[J]. 河南医学研究, 2017,26(16):2890-2892.
Wang Y, Ma YY, Liu XX, et al. Short-term clinical effects on the treatment of peri-implantitis with pho-todynamic therapy[J]. Henan Med Res, 2017,26(16):2890-2892.
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[2] 王昆润. 长期单侧鼻呼吸对头颅发育有不利影响[J]. 国际口腔医学杂志, 1999, 26(05): .
[3] 彭国光. 颈淋巴清扫术中颈交感神经干的解剖变异[J]. 国际口腔医学杂志, 1999, 26(05): .
[4] 杨凯. 淋巴化疗的药物运载系统及其应用现状[J]. 国际口腔医学杂志, 1999, 26(05): .
[5] 康非吾. 种植义齿下部结构生物力学研究进展[J]. 国际口腔医学杂志, 1999, 26(05): .
[6] 柴枫. 可摘局部义齿用Co-Cr合金的激光焊接[J]. 国际口腔医学杂志, 1999, 26(04): .
[7] 孟姝,吴亚菲,杨禾. 伴放线放线杆菌产生的细胞致死膨胀毒素及其与牙周病的关系[J]. 国际口腔医学杂志, 2005, 32(06): 458 -460 .
[8] 费晓露,丁一,徐屹. 牙周可疑致病菌对口腔黏膜上皮的粘附和侵入[J]. 国际口腔医学杂志, 2005, 32(06): 452 -454 .
[9] 赵兴福,黄晓晶. 变形链球菌蛋白组学研究进展[J]. 国际口腔医学杂志, 2008, 35(S1): .
[10] 庞莉苹,姚江武. 抛光和上釉对陶瓷表面粗糙度、挠曲强度及磨损性能的影响[J]. 国际口腔医学杂志, 2008, 35(S1): .