Int J Stomatol

Int J Stomatol ›› 2026, Vol. 53 ›› Issue (5): 728-741.doi: 10.7518/gjkq.2026125

• Review • Previous Articles    

Application of implant polishing plastic surgery in the treatment of peri-implantitis

Jingyi Sun(),Yanfeng Li()   

  1. Dept. of Stomatology, the Fourth Medical Center of PLA General Hospital, Beijing 100142, China
  • Received:2025-07-02 Revised:2025-12-27 Online:2026-09-01 Published:2026-08-28
  • Contact: Yanfeng Li E-mail:asjyzgh@foxmail.com;949427779@qq.com

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Abstract:

Peri-implantitis is a chronic inflammatory disease that affects the long-term success rate of dental implants, characterized by inflammation of the peri-implant soft tissues and bone loss. In this review, the etiology and influencing factors of peri-implantitis are summarized, and the current treatment methods, including mechanical treatment, chemical/pharmacological therapy, photodynamic therapy, and surgical treatment, are discussed. The importance of implant surface treatment is emphasized, detailing the role of implant polishing plastic surgery in reducing plaque attachment, improving biocompatibility, and optimizing the peri-implant microenvironment.

Key words: peri-implantitis, implant polishing plastic surgery, mechanical therapy, biocompatibility, peri-implant microenvironment

CLC Number: 

  • R783.4

TrendMD: 

Tab 1

Comparison of different mechanical treatment methods"

治疗方式原理与方法主要特点优势常用材料/工具
钛刷清理使用专用钛刷物理接触清理种植体表面强力去除细菌与生物膜促进骨结合与生物相容性钛制刷头[14]
超声清洗高频振动产生冲击力清除牙菌斑、结石清除深层牙周袋污物高效、微创超声洁治器[15-16]
机械刮治手动刮治器械刮除感染组织传统，依赖经验直接清除病灶手动刮治器
喷砂处理高压喷射微粉末清理生物膜、菌斑保持种植体表面完整性高效、安全、表面保护良好碳酸氢钠、甘氨酸、赤藓糖醇[17-18]
激光清除高能激光束精准作用种植体表面新兴技术，辅助软组织愈合去除牙菌斑同时促进愈合不同类型激光器[25-28]

Tab 2

Comparison of different topical medications"

药物类别代表药物作用机制优点局限性与不良反应临床注意事项
抗生素

米诺环素、

多西环素

抑制细菌蛋白质合成、广谱抗菌，抑制基质金属蛋白酶对革兰阴性厌氧菌有效；可控炎症反应酸性环境影响药效[31]注意感染部位pH变化；局部浓度控制
抗菌剂氯己定破坏细胞膜，抑制细菌酶系统广谱抗菌；黏附性强，作用时间长长期使用可致牙石堆积[44]、菌群失衡、表面着色[45]限期使用（＜2周）；避免与着色饮食（如茶、咖啡）共用
化学去污剂次氯酸钠氧化有机物、破坏生物膜快速杀菌，有效破坏生物膜高浓度或长时间接触可腐蚀种植体表面[46]控制使用浓度与接触时间（推荐≤1%浓度，≤5 min）[47]
其他药物过氧化氢释放自由基，破坏细菌蛋白质和膜结构有氧环境下抗菌效果好，泡沫促进清创高浓度可引起组织毒性[48]；对种植体材料有潜在影响[49]通常使用3%浓度，短时应用
柠檬酸酸化环境、去除牙石和污垢，部分抗菌去污能力强，有助于软组织附着高浓度腐蚀钛表面，影响表面能和粗糙度[42]建议使用10%浓度，＜4 min处理时间[50]
EDTA螯合钙离子，清除无机成分可辅助去除污垢，与机械清创联合效果佳高浓度造成细胞毒性[51]建议17%浓度局部短时应用，冲洗彻底[52]

Tab 3

Comparison of different polishing tools"

器械类型操作方式主要适用场景注意事项
碳化钨车针低速旋转，较大接触压力初步去除硬性沉积、重度污染表面损伤风险高，应配合后续抛光使用
金刚砂磨头中速旋转，稳定手法中重度污染区域的精细清理不建议直接用于最终抛光，可能留下细微划痕
碳化硅磨石中低速旋转，中等接触力去除中等程度污染、初步平整表面表面处理适中，适合作为连接粗磨与精抛的中间步骤
硅胶抛光器低速轻压打磨表面抛光、改善种植体微观粗糙度适合终末处理阶段，需保持低压力避免磨损
阿肯色石手工或低速设备抛光表面光滑化处理、预防再污染磨削力极低，主要用于最终精抛，结合水冷效果更佳

Tab 4

Surface roughness variability analysis"

研究编号分组名称平均值（Ra）标准差（SD）样本量CV/%
1[93]碳化钨车针序列0.330.061018.18
金刚石加布尔斯钻序列0.420.03107.14
2[4]阿肯色石序列0.390.13733.33
短金刚石序列0.710.22730.99
完整金刚石序列0.980.3730.61
3[90]金刚石加阿肯色石序列0.760.141518.42
碳化硅加阿肯色石加硅胶抛光序列0.380.151539.47
4[83]碳化物钻头0.100.021020.00
未处理0.760.081010.53
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