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。

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.