Peri-implant Diseases and Treatments

Yıl 2025, Cilt: 34 Sayı: 1, 13 - 24, 31.03.2025

Çağrı Esen

https://doi.org/10.17827/aktd.1489140

Öz

The main cause of the loss in crestal bone surrounding an osseointegrated dental implant is local inflammation around the implant resulting from peri-implant diseases. Peri-implant diseases and conditions are classified as peri-implant health, peri-implant mucositis, and peri-implantitis. Peri‐implant mucositis is an inflammatory lesion of the mucosa surrounding an endosseous implant without loss of supporting peri‐implant bone. Peri-implantitis is a pathological condition occurring in tissues around dental implants, characterized by inflammation in the peri-implant connective tissue and progressive loss of supporting bone. Peri‐implant mucositis is considered to be the precursor of peri‐implantitis. In the treatment of peri-implant mucositis, mechanical debridement is performed and antimicrobials are used. Peri-implantitis treatment is performed in two ways: non-surgical and surgical. Non-surgical peri-implantitis treatment includes mechanical debridement with various curettes or ultrasonic devices, similar to peri-implant mucositis treatment. Open flap debridement, resective treatment, augmentation treatment, and combined treatment can be performed as surgical peri-implantitis treatment. Peri-implantitis treatment is followed by supportive therapy, including regular check-ups and hygiene practices. Although there are many treatment models for peri-implantitis, the superiority of one treatment over the other has not been fully demonstrated. More complex approaches do not always show additional benefits over simpler treatments. Although the aim of peri-implantitis treatments is to create surfaces where patients can maintain hygiene, aesthetic concerns in the anterior areas can prevent this goal. The success rates of regenerative treatments involving the recovery of lost peri-implant hard and soft tissues are still quite limited.

Anahtar Kelimeler

Dental implants, peri-implant mucositis, peri-implantitis

Peri-implant Hastalıklar ve Tedavileri

Öz

Osseoentegre bir dental implantı çevreleyen kret kemiğindeki kaybın başlıca sebebi, peri-implant hastalıklar kaynaklı gelişen implant çevresindeki lokal enflamasyondur. Peri-implant hastalıklar ve durumlar; peri-implant sağlık, peri-implant mukozitis ve peri-implantitis olarak sınıflandırılmaktadır. Peri-implant mukozitis, destekleyici peri-implant kemik kaybı olmaksızın, endosseoz bir implantı çevreleyen mukozanın enflamatuar bir lezyonudur. Peri-implantitis ise, dental implantlarının çevresindeki dokularda meydana gelen, peri-implant bağ dokusunda iltihaplanma ve destekleyici kemiğin ilerleyici kaybı ile karakterize edilen patolojik bir durumdur. Peri-implant mukozitisin peri-implantitisin öncüsü olduğu düşünülmektedir. Peri-implant mukozitis tedavisinde mekanik debridman yapılmakta ve antimikrobiyallerden faydalanılmaktadır. Peri-implantitis tedavisi ise cerrahi olmayan veya cerrahi tedavi olarak iki şekilde yapılmaktadır. Cerrahi olmayan peri-implantitis tedavisi peri-implant mukozitis tedavisine benzer olarak çeşitli küretler veya ultrasonik cihazlarla yapılan mekanik debridmanı içerir. Cerrahi peri-implantitis tedavisi olarak; açık flep debridmanı, rezektif tedavi, ogmentasyon tedavisi ve kombine tedavi yapılabilir. Peri-implantitis tedavisini düzenli kontrolleri ve hijyen uygulamalarını kapsayan destekleyici tedavi izler. Peri-implantitis için birçok tedavi modeli olsa da bu tedavi modelleri içerisinde bir tedavinin diğerine üstünlüğü tam olarak gösterilememiştir. Daha karmaşık yaklaşımlar, basit tedavilere göre her zaman ek faydalar göstermemektedir. Peri-implantitis tedavilerinde amaç hastaların hijyeni sağlayabileceği yüzeyler oluşturmak olsa da ön bölgelerdeki estetik kaygılar bu amacın önüne geçebilmektedir. Kaybedilen peri-implant sert ve yumuşak dokuların geri kazanılmasını içeren rejeneratif tedavilerin başarı oranları halen oldukça kısıtlıdır.

Anahtar Kelimeler

Dental implantlar, peri-implant mukozitis, peri-implantitis

Kaynakça

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