种植单冠修复后种植体周健康的相关分析

doi:10.19723/j.issn.1671-167X.2025.02.020

摘要/Abstract

摘要：

目的: 追踪观察第一磨牙种植单冠修复后种植体的健康情况，评估影响种植体周健康的相关因素。方法: 选择2008年1月至2020年12月就诊于北京大学口腔医院第二门诊部，行第一磨牙种植单冠修复的82位患者作为研究对象，共278个负重1年以上的种植体，记录种植体周的探诊深度(peri-implant probing depth, PPD)、改良出血指数(modified sulcus bleeding index, mSBI)、改良菌斑指数(modified plaque index, mPLI)、龈乳头指数(papilla index, PI)，进行临床资料回顾及X线片的测量分析，X线片分析内容包括修复体穿龈角度(restoration emergence angle, REA)、种植牙临床冠根比(clinical crown-implant ratio, cC/I)、种植牙与邻牙牙根之间的水平距离(horizontal tooth-implant distance, HTID)、邻间隙高度(contact point level, CPL)、邻间隙面积(embrasure surface area, ESA)等。结果: 患者平均手术年龄为(40.2±9.5)岁(19~84岁)，男性33例，女性49例，随访时间为(4.9±3.3)年(1~10年)。根据2018年的诊断标准，种植体周炎患病率在种植体水平为14.03%，患者水平为21.95%；种植体周健康率在种植体水平为19.06%，患者水平为18.29%；种植体周黏膜炎患病率在种植体水平为66.91%，患者水平为59.75%。种植体周健康组与种植体周炎组在负重1年时(基线)PPD、远中HTID、近中/远中CPL、cC/I，两组间差异具有统计学意义(P < 0.05)，而mSBI、mPLI、PI、近中HTID、近中/远中REA、近中/远中ESA组间差异无统计学意义(P>0.05)。在随访与基线之间的差值中，PPD、近中/远中HTID、近中/远中CPL、近中/远中ESA在两组间差异具有统计学意义(P < 0.05)。广义估计方程分析显示，PPD、近中/远中HTID、近中CPL以及近中ESA随访与基线的差值，与发生种植体周炎风险存在显著正相关。结论: 基于本研究结果，种植体周健康率仍不理想，种植体周探诊深度以及种植体与邻牙的关系(如HTID、CPL、ESA)与种植体周健康相关。

关键词: 种植体周炎, 口腔种植单冠修复, 患病率, 种植体周健康, 邻间隙面积

Abstract:

Objective: To observe the long-term health condition of the single-tooth dental implant at the first molar site, and to evaluate the related factors affecting the peri-implant health. Methods: In this study, 82 patients who were treated in the Second Clinical Division, Peking University School and Hos-pital of Stomatology from January 2008 to December 2020 were enrolled. Peri-implant tissue conditions were assessed by clinical and radiographic examination. The peri-implant probing depth (PPD), modified sulcus bleeding index (mSBI), modified plaque index (mPLI) and papilla index (PI) were recorded for 278 implants. The X-ray analysis included the restoration emergence angle (REA), the clinical crown-implant ratio (cC/I), the horizontal tooth-implant distance (HTID), the contact point level (CPL) and the embrasure surface area (ESA), etc. Kruskal-Wallis rank sum test and generalized estimation equation were used for statistical analysis. Results: The average age of the patients was (40.2±9.5) years (19 to 84 years), with 33 males and 49 females. The follow-up time was (4.9±3.3) years (1 to 10 years). According to the diagnostic criteria in 2018, the prevalence of peri-implantitis in this study was 14.03% on the implant level and 21.95% on the patient level. The peri-implant health rate was 19.06% on the implant level and 18.29% on the patient level. The prevalence of peri-implant mucositis was 66.91% on the implant level and 59.75% on the patient level. At the baseline, there were statistically significant differences between the peri-implant health group and peri-implantitis group in PPD, distal HTID and mesial/distal CPL, cC/I (P < 0.05), while there was no statistically significant difference in mSBI, mPLI, PI, mesial HTID, mesial/distal REA and mesial/distal ESA between the two groups. Among the differences between follow-up and baseline, there were statistically significant dif-ferences between the two groups in PPD, mesial/distal HTID, mesial/distal CPL and mesial/distal ESA (P < 0.05). Generalized estimation equation showed that PPD, mesial/distal HTID, mesial CPL, and mesial ESA had significant positive correlations with the risk of peri-implantitis in the difference between baseline and follow-up. Conclusion: Based on the results of this study, the peri-implant health rate is still unsatisfied, and the PPD, HTID, CPL, ESA may be related to the long-term health of the implant.

Key words: Peri-implantitis, Dental implants, single-tooth, Prevalence, Peri-implant health, Embrasure surface area

中图分类号:

R783.6

林芳汝, 唐志辉. 种植单冠修复后种植体周健康的相关分析[J]. 北京大学学报（医学版）, 2025, 57(2): 347-353.

Fangru LIN, Zhihui TANG. Correlation analysis of peri-implant health after single-tooth dental implant[J]. Journal of Peking University (Health Sciences), 2025, 57(2): 347-353.

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Items	Total	Health	PI	H/χ²	P
n	92	53	39
Mesial HTID/mm, M(P₂₅, P₇₅)	3.58 (2.77, 4.28)	4.03 (2.80, 4.56)	3.46 (2.56, 3.70)	3.00	0.083
Distal HTID/mm, M(P₂₅, P₇₅)	3.78 (3.13, 4.72)	4.30 (3.34, 5.02)	3.76 (2.76, 4.02)	4.52	0.033
Mesial CPL/mm, M(P₂₅, P₇₅)	4.86 (3.77, 5.73)	4.22 (3.37, 5.63)	5.30 (4.40, 5.73)	4.79	0.029
Distal CPL/mm, M(P₂₅, P₇₅)	4.20 (2.98, 5.39)	4.06 (2.28, 5.26)	4.25 (3.49, 6.06)	6.08	0.014
Mesial REA/(°), M(P₂₅, P₇₅)	27.96 (22.98, 32.46)	25.26 (19.80, 31.24)	28.08 (24.82, 33.52)	2.68	0.102
Distal REA/(°), M(P₂₅, P₇₅)	28.93 (20.17, 33.77)	26.91 (18.82, 39.46)	29.59 (22.74, 31.28)	0.01	0.937
Mesial ESA/mm², M(P₂₅, P₇₅)	7.44 (4.85, 12.29)	7.60 (4.42, 12.17)	7.30 (5.84, 13.07)	0.31	0.575
Distal ESA/mm², M(P₂₅, P₇₅)	5.58 (3.95, 8.92)	6.52 (3.10, 8.27)	5.58 (4.71, 9.60)	1.41	0.236
aC/I, M(P₂₅, P₇₅)	0.65 (0.59, 0.76)	0.65 (0.61, 0.76)	0.65 (0.59, 0.75)	0.29	0.588
cC/I, M(P₂₅, P₇₅)	0.92 (0.82, 1.01)	0.89 (0.78, 0.99)	0.98 (0.86, 1.07)	6.76	0.009
Max PPD/mm, M(P₂₅, P₇₅)	5.00 (3.00, 5.00)	3.00 (3.00, 5.00)	5.00 (4.00, 5.00)	10.72	0.001
Max mSBI, n(%)				5.76	0.124
0	12 (13.0)	10 (18.9)	2 (5.1)
1	8 (8.7)	6 (11.3)	2 (5.1)
2	39 (42.4)	24 (45.3)	15 (38.5)
3	33 (35.9)	13 (24.5)	20 (51.3)
Max mPLI, n(%)				4.96	0.174
0	19 (20.7)	16 (30.2)	3 (7.7)
1	32 (34.8)	16 (30.2)	16 (41.0)
2	34 (37.0)	18 (34.0)	16 (41.0)
3	7 (7.6)	3 (5.7)	4 (10.3)
Min PI, n(%)				2.69	0.443
0	18 (19.6)	14 (26.4)	4 (10.3)
1	7 (7.6)	4 (7.5)	3 (7.7)
2	25 (27.2)	12 (22.6)	13 (33.3)
3	42 (45.7)	23 (43.4)	19 (48.7)

Items	Total	Health	PI	H/χ²	P
Δmesial HTID/mm	0.07 (-0.09, 0.26)	-0.03 (-0.11, 0.18)	0.15 (0.00, 0.34)	6.43	0.011
Δdistal HTID/mm	-0.00 (-0.44, 0.32)	-0.17 (-0.54, 0.10)	0.20 (-0.27, 0.43)	8.43	0.004
Δmesial CPL/mm	0.16 (-0.35, 0.55)	0.13 (-0.53, 0.44)	0.17 (-0.13, 0.86)	2.66	0.013
Δdistal CPL/mm	0.13 (-0.11, 0.64)	0.05 (-0.38, 0.58)	0.41 (0.09, 1.03)	6.47	0.011
Δmesial ESA/mm	0.21 (-0.73, 1.36)	0.13 (-0.77, 0.53)	1.01 (-0.35, 1.97)	4.84	0.028
Δdistal ESA/mm	0.75 (-0.44, 2.34)	0.11 (-0.73, 1.56)	1.18 (-0.04, 2.90)	4.11	0.043
ΔPPD/mm	1.00 (0.00, 1.25)	0.00 (-0.25, 1.00)	1.00 (0.00, 2.00)	6.43	0.011

Items	OR(95%CI)	P
Δmesial HTID	6.12 (2.00, 8.77)	0.002
Δdistal HTID	2.89 (1.29, 6.45)	0.010
Δmesial CPL	1.47 (1.04, 2.07)	0.028
Δdistal CPL	1.69 (0.99, 2.90)	0.054
Δmesial ESA	1.29 (1.04, 1.60)	0.022
Δdistal ESA	1.15 (1.00, 1.33)	0.056
ΔPPD	1.78 (1.07, 2.95)	0.026

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