赤藓糖醇喷砂与超声治疗对种植体周黏膜炎疗效的随机对照临床研究

doi:10.19723/j.issn.1671-167X.2026.01.005

摘要/Abstract

摘要：

目的: 比较赤藓糖醇喷砂(erythritol air-polishing, EAP)和超声(ultrasonic debridement, US)两种方法治疗种植体周黏膜炎的短期临床疗效差异, 并评估患者报告的结局。方法: 为单盲、随机对照临床研究, 研究对象为2021年6月至2022年5月就诊于北京大学口腔医院牙周科的种植体周黏膜炎患者。共纳入36例患者(每例纳入1颗种植体), 随机分为EAP组(n=18)和US组(n=18)。分别于基线、治疗后1个月及3个月采集临床指标。主要结局指标为种植体周探诊深度(peri-implant probing depths, PPD)的变化, 次要结局指标为改良菌斑指数(modified plaque index, mPLI)、探诊出血(bleeding on probing, BOP)、探诊溢脓(suppuration on probing, SoP)、疼痛视觉模拟评分(visual analogue scale, VAS)。此外, 作为探索性分析, 还比较了两组患者PPD≥4 mm位点的比例。每次就诊均强化口腔卫生宣教, 并对种植体上部结构进行抛光。结果: EAP组和US组基线期临床指标具有可比性。对于主要结局指标平均PPD, EAP组较基线值(4.0±0.5) mm显著降低, 在治疗后1个月和3个月时分别降至(3.7±0.6) mm和(3.4±0.5) mm, 差异均具有统计学意义(P=0.011; P < 0.001);US组的平均PPD也较基线值(3.8±0.4) mm显著降低, 在治疗后1个月和3个月时分别降至(3.6±0.5) mm和(3.5±0.4) mm, 差异均具有统计学意义(P=0.038;P=0.018), 但两组间在各时间点的差异均无统计学意义(P>0.05)。次要结局指标中, 两组的平均mPLI(1、3个月均P < 0.001)与BOP(1个月P < 0.05; 3个月P < 0.001)均较基线显著改善, 治疗后VAS评分均较低, 但此三项指标的组间差异均无统计学意义(P>0.05)。治疗后3个月, EAP组PPD≥4 mm位点比例显著低于US组[(42.6±26.1)% vs.(57.4±25.1)%], 差异具有统计学意义(P=0.029)。研究期间未报告不良事件。结论: EAP与US均是治疗种植体周黏膜炎的有效方法, 总体疗效相当; 然而, 在减少深袋位点方面, EAP展现出短期潜力, 此结果尚需进一步验证。

关键词: 种植体周黏膜炎, 赤藓糖醇, 牙科喷砂

Abstract:

Objective: To evaluate the short-term clinical treatment effects of erythritol air-polishing(EAP) and ultrasonic debridement (US) on peri-implant mucositis and to report patient-reported outcomes. Methods: This study is a single-blind, randomized controlled clinical trial. It enrolled patients diagnosed with peri-implant mucositis at the Department of Periodontology, Peking University School of Stomatology between June 2021 and May 2022. A total of 36 patients (with one implant included per patient) were randomly allocated to either the EAP group (n=18) or the US group (n=18). Clinical parameters were collected at baseline, 1 month, and 3 months. The primary outcome was the change in peri-implant probing depth (PPD). Secondary outcomes included the modified plaque index (mPLI), bleeding on probing (BOP), suppuration on probing (SoP), and the visual analogue scale (VAS) score for pain. As an exploratory analysis, the proportion of sites with PPD ≥ 4 mm was calculated. Oral hygiene instructions were reinforced, and the implant crown was polished at each visit. Results: Baseline clinical parameters were comparable between the EAP and US groups. Regarding the primary outcome of mean PPD, the EAP group showed a significant reduction from the baseline value (4.0±0.5) mm to (3.7±0.6) mm at 1 month and (3.4±0.5) mm at 3 months (P=0.011 and P < 0.001, respectively). Similarly, the US group showed a significant reduction from baseline (3.8±0.4) mm to (3.6±0.5) mm at 1 month and (3.5±0.4) mm at 3 months (P=0.038 and P=0.018, respectively). No statistically significant differences were observed between the groups (P>0.05). For the secondary outcomes, both groups showed significant improvement from baseline in mean mPLI (1 and 3 months, both P < 0.001) and BOP (1 month, P < 0.05; 3 months, P < 0.001). Pain VAS scores were low in both groups. However, no statistically significant differences were observed between the groups for these three outcomes (all P>0.05). At 3 months, the proportion of sites with PPD ≥ 4 mm was significantly lower in EAP group than in US group [(42.6±26.1) % vs. (57.4±25.1) %, P=0.029]. No adverse events were reported. Conclusion: Both EAP and US effectively treated peri-implant mucositis with comparable overall efficacy. However, EAP showed superior potential in reducing deep pockets over the short term, though this finding required further validation.

Key words: Peri-implant mucositis, Erythritol, Dental polishing

中图分类号:

R781.4

孙菲, 王翠, 李思琪, 危伊萍, 余日月, 胡文杰. 赤藓糖醇喷砂与超声治疗对种植体周黏膜炎疗效的随机对照临床研究[J]. 北京大学学报（医学版）, 2026, 58(1): 37-42.

Fei SUN, Cui WANG, Siqi LI, Yiping WEI, Riyue YU, Wenjie HU. Treatment of peri-implant mucositis using an erythritol air-polishing or ultrasonic device: A randomized controlled trial[J]. Journal of Peking University (Health Sciences), 2026, 58(1): 37-42.

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参考文献 19

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Variable	EAP (n= 18)	US (n= 18)	P value
Age/years, ${\bar x}$±s	51.0±10.5	50.1±9.9	0.785
Male/female, n	10 / 8	6 / 12	0.176
History of periodontitis/%	66.7	83.3	0.738
Implant position, n (%)			0.345
Anterior maxilla	2 (11.1)	2 (11.1)
Posterior maxilla	8 (44.4)	6 (33.3)
Anterior mandible	4 (22.2)	1 (5.6)
Posterior mandible	4 (22.2)	9 (50.0)
Prosthesis retention, n (%)			0.705
Screw-retained	12 (66.7)	13 (72.2)
Cement-retained	6 (33.3)	5 (27.8)
Baseline clinical parameters
Mean PPD/mm, ${\bar x}$±s	4.0±0.5	3.8±0.4	0.187
Mean mPLI, ${\bar x}$±s	1.4±0.7	1.5±0.9	0.712
Mean BOP/%, ${\bar x}$±s	85.2±13.9	88.0±17.9	0.601
SoP/%	27.8	22.2	0.700

Parameters	Baseline	1 month	P value^a	3 months	P value^b
Mean PPD/mm, ${\bar x}$±s
EAP	4.0±0.5	3.7±0.6	0.011	3.4±0.5	＜0.001
US	3.8±0.4	3.6±0.5	0.038	3.5±0.4	0.018
P value^c	0.284	0.654		0.250
Mean mPLI, ${\bar x}$±s
EAP	1.4±0.7	0.6±0.7	＜0.001	0.2±0.2	＜0.001
US	1.5±0.9	0.5±0.6	＜0.001	0.3±0.2	＜0.001
P value^c	0.791	0.546		0.058
PPD≥4 mm sites/%, ${\bar x}$±s
EAP	73.1±24.8	53.7±22.8	＜0.001	42.6±26.1	＜0.001
US	62.0±21.4	55.6±24.5	0.009	57.4±25.1	0.039
P value^c	0.081	0.785		0.029
BOP/%, ${\bar x}$±s
EAP	85.2±13.9	64.8±31.8	0.016	53.7±29.5	＜0.001
US	88.0±17.9	70.4±31.1	0.012	59.2±28.7	＜0.001
P value^c	0.606	0.601		0.573
SoP/%
EAP	27.8	0	NA	0	NA
US	22.2	0	NA	0	NA
P value^c	0.700	NA		NA