口腔种植修复后龈沟液中炎症因子与种植体稳定的关联性分析

doi:10.19439/j.sjos.2024.05.017

摘要/Abstract

摘要： 目的： 探讨口腔种植修复后龈沟液中炎症因子水平及与种植体稳定性及预后的相关性。方法： 选择2022年8月—2023年8月收治的78例口腔种植修复患者为试验组,根据种植后1个月复诊时X线片检查结果分为预后不良亚组（n=33）和预后良好亚组（n=45）,选取同期60名健康体检者为对照组。收集所有研究对象的龈沟液,采用化学发光免疫法测定超敏C反应蛋白（high-sensitivity C-reactive proteinhs,CRP）,酶联免疫吸附法测定淀粉样蛋白A（serum amyloid A,SAA）和降钙素原（procalcitonin,PCT）水平,术后记录种植体稳定系数（implant stability quotient,ISQ）。采用Pearson法评估龈沟液中炎症因子与ISQ的相关性,采用多因素logistic回归分析法分析龈沟液中炎症因子与种植体预后的关系。采用SPSS 22.0软件包对数据进行统计学分析。结果： 试验组龈沟液hsCRP、SAA和PCT水平显著高于对照组（P<0.05）,预后不良亚组龈沟液hsCRP、SAA和PCT水平显著高于预后良好亚组（P<0.05）;试验组初期和二期ISQ值分别为（74.08±6.12）和（76.78±5.11）。Pearson相关性分析结果显示,口腔种植修复患者的龈沟液hsCRP、SAA、PCT与初期、二期ISQ呈显著负相关（P<0.05）。多因素logistic回归分析结果显示,龈沟液hsCRP、SAA和PCT是影响种植体预后的重要因素（P<0.05）。结论： 口腔种植修复后龈沟液中hsCRP、SAA和PCT水平显著升高,与种植体稳定性及预后相关。

关键词: 口腔种植修复, 龈沟液, 炎症因子, 种植体稳定性, 预后, 相关性

Abstract: PURPOSE: To study the correlation between the levels of inflammatory factors in gingival crevicular fluid and implant stability and prognosis after oral implant restoration. METHODS: A total of 78 patients who underwent oral implant restoration surgery from August 2022 to August 2023 were selected as the experimental group. According to the results of X-ray examination 1 month after implantation, the patients were divided into poor prognosis subgroup(n=33) and good prognosis subgroup(n=45), another 60 healthy subjects who underwent physical examination during the same period were selected as the control group. The gingival crevicular fluid of all research subjects was collected, and chemiluminescent immunoassay was used to determine high-sensitivity C-reactive protein (hsCRP), and enzyme-linked immunosorbent assay was used to determine amyloid A(SAA) and procalcitonin (PCT), implant stability quotient(ISQ) was recorded after surgery. Pearson's correlation analysis was used to evaluate the correlation between inflammatory factors in gingival crevicular fluid and ISQ, and multifactor logistic regression analysis was used to analyze the relationship between inflammatory factors in gingival crevicular fluid and implant prognosis. Statistical analysis was performed with SPSS 22.0 software package. RESULTS: The levels of hsCRP, SAA and PCT in the gingival crevicular fluid of the experimental group were significantly higher than the control group(P<0.05), the levels of hsCRP, SAA and PCT in the gingival crevicular fluid of the poor prognosis subgroup were significantly higher than the good prognosis subgroup (P<0.05). The initial and second-stage ISQ values of the patients in the experimental group were (74.08±6.12) and (76.78±5.11) respectively. Pearson's correlation analysis results showed that the gingival crevicular fluid hsCRP, SAA and PCT were significantly negatively correlated with initial and second-stage ISQ(P<0.05); multi-factor logistic regression analysis results showed that hsCRP, SAA and PCT in gingival crevicular fluid were important factors affecting the prognosis of patients with dental implants(P<0.05). CONCLUSIONS: The levels of hsCRP, SAA and PCT in the gingival crevicular fluid after oral implant restoration are significantly increased, which are related to the stability and prognosis of the implant.

Key words: Oral implant restoration, Gingival crevicular fluid, Inflammatory factors, Implant stability, Prognosis, Correlation

中图分类号:

R783.4

秦坤, 刘文静, 李梦琦, 汪俊兰. 口腔种植修复后龈沟液中炎症因子与种植体稳定的关联性分析[J]. 上海口腔医学, 2024, 33(5): 538-542.

QIN Kun, LIU Wen-jing, LI Meng-qi, WANG Jun-lan. Correlation between inflammatory factors in gingival crevicular fluid and implant stability after oral implant restoration[J]. Shanghai Journal of Stomatology, 2024, 33(5): 538-542.

参考文献

[1] Gamborena I, Sasaki Y, Blatz MB.Predictable immediate implant placement and restoration in the esthetic zone[J]. J Esthet Restor Dent, 2021, 33(1):158-172.
[2] Duong HY, Roccuzzo A, Stähli A, et al.Oral health-related quality of life of patients rehabilitated with fixed and removable implant-supported dental prostheses[J]. Periodontol 2000, 2022, 88(1): 201-237.
[3] Zhong S, Chen M, Gao R, et al . Dental implant restoration for dentition defects improves clinical efficacy, masticatory function and patient comfort[J]. Am J Transl Res, 2022, 14(9):6399-6406.
[4] 耿琪, 张志宏, 刘红红, 等.后牙区皮质骨松质骨厚度比率与种植体稳定性的相关性研究[J]. 口腔医学研究, 2022, 38(11): 1033-1036.
[5] 田田, 张志宏, 刘红红, 等. 上颌后牙种植区骨体积分数与种植体初期稳定性的相关性研究[J]. 临床口腔医学杂志, 2021, 37(5): 282-285.
[6] 曾晓川. 口腔种植修复术在牙列缺损中的治疗效果及对患者龈沟液中TNF-α、IL-6水平的影响[J]. 中国医学创新, 2022, 19(33): 42-46.
[7] 姜梅, 徐俊仙, 翁庭静. 血清脂联素,超敏C-反应蛋白, 白细胞介素6, 肿瘤坏死因子α联合检测在慢性牙周炎患者早期诊断中的应用价值[J]. 中国卫生检验杂志, 2020, 30(18): 2248-2251.
[8] Ardila CM, Guzmán IC.Comparison of serum amyloid A protein and C-reactive protein levels as inflammatory markers in periodontitis[J]. J Periodontal Implant Sci, 2015, 45(1): 14-22.
[9] Leira Y, Ameijeira P, Domínguez C, et al.High serum procalcitonin levels in patients with periodontitis and chronic migraine[J]. J Periodontol, 2018, 89(9): 1069-1074.
[10] 常忠福, 姜丹丹, 张志荣, 等. 口腔种植修复术在牙列缺损患者中的应用效果及对龈沟液中TNF-α、IL-6水平的影响[J]. 上海口腔医学, 2020, 29(2): 217-220.
[11] 周亦凝, 顾迎新. “盾构术”应用于美学区种植的研究进展[J].中国口腔颌面外科杂志, 2022, 20(2):198-201.
[12] Marcello-Machado RM, Faot F, Schuster AJ, et al.Mapping of inflammatory biomarkers in the peri-implant crevicular fluid before and after the occlusal loading of narrow diameter implants[J]. Clin Oral Investig, 2020, 24(3): 1311-1320.
[13] 谢雪梅, 张佳园, 张野,等. 龈沟液中sICAM-1、IL-1β和HIF-1α水平与义齿种植修复并发种植体周围炎的关系[J].上海口腔医学, 2023, 32(1):47-51.
[14] Skaleric E, Hropot Plesko N.Does full-mouth disinfection influence the size of the periodontal inflammatory burden and the level of hsCRP?[J]. Oral Health Prev Dent, 2024, 22:151-158.
[15] Ye RD, Sun L.Emerging functions of serum amyloid A in inflammation[J]. J Leukoc Biol, 2015, 98(6): 923-929.
[16] Hirai K, Furusho H, Kawashima N, et al.Serum amyloid A contributes to chronic apical periodontitis via TLR2 and TLR4[J]. J Dent Res, 2019, 98(1): 117-125.
[17] Schuetz P.How to best use procalcitonin to diagnose infections and manage antibiotic treatment[J]. Clin Chem Lab Med, 2022, 61(5):822-828.
[18] 赵辉, 柴治国, 张铁, 等. 龈沟液CRP、IL-17、RANKL与种植体周围炎患者牙周临床指标的相关性分析及其联合检测对治疗后预后的评估价值[J]. 现代生物医学进展, 2022, 22(18): 3558-3562.
[19] 胡玮玮, 李芳芳, 葛殿奎. 炎性指标对口腔种植修复术后牙槽骨吸收改建活跃期种植体评估的价值研究[J]. 中国煤炭工业医学杂志, 2019, 22(6): 565-571.
[20] Oliveira JA, de Oliveira Alves R, Nascimento IM, et al. Pro- and anti-inflammatory cytokines and osteoclastogenesis-related factors in peri-implant diseases: systematic review and meta-analysis[J]. BMC Oral Health, 2023, 23(1):420.
[21] 戴方毅, 刘敏. 种植体周围炎龈沟液炎症因子表达水平及其对骨吸收的影响[J]. 中国实验诊断学, 2018, 22(6): 1022-1024.