中国实用口腔科杂志

中国实用口腔科杂志 ›› 2025, Vol. 18 ›› Issue (6): 697-702.DOI: 10.19538/j.kq.2025.06.009

• 论著 • 上一篇    下一篇

种植体周病风险评估工具在种植治疗患者中临床应用效果及改良方案初探

孙文萱，戴世爱，姜陆祎，冯向辉，释    栋，胡文杰   

  1. 北京大学口腔医学院·口腔医院牙周科，国家口腔医学中心，国家口腔疾病临床医学研究中心，口腔生物材料和数字诊疗装备国家工程研究中心，口腔数字医学北京市重点实验室，北京 100081
  • 出版日期:2025-11-30 发布日期:2025-11-30
  • 通讯作者: 冯向辉
  • 基金资助:
    2022国家重点研发子课题（2022YFC2504202-1）；北京大学医学部大学生创新实验项目（2023-SSDC-07）

  • Online:2025-11-30 Published:2025-11-30

摘要： 目的    初步探索种植体周病风险评估工具（implant disease risk assessment，IDRA）模型在种植治疗患者中的临床应用效果，并提出改良方案。方法    研究为回顾性病例对照研究，纳入2020年1月至2024年5月于北京大学口腔医院牙周科就诊的种植体周炎患者58例（种植体58颗）和种植体周健康患者33例（种植体33颗），分别记为种植体周炎组和种植体周健康组。收集2组患者牙周炎病史、出血指数（bleeding index，BI）、探诊深度（probing depth，PD）、牙周炎易感性、牙周支持治疗（supportive periodontal therapy，SPT）频率、修复体边缘至骨嵴顶距离及修复体自身因素等资料，计算牙周探诊出血（bleeding on probing，BOP）阳性率（BI ≥ 2位点百分比）、牙槽骨丧失程度与年龄比值（BL/Age），代入IDRA模型评估风险等级，并根据评估结果进行改良。结果    2组种植体周病高风险患者占比均为100%，且均有牙周炎病史。2组BOP阳性率、PD ≥ 5 mm位点数、PD ≥ 5 mm位点数分级、SPT频率分级、修复体自身因素分级比较，差异均有统计学意义（均P < 0.05）；其他因素组间比较，差异无统计学意义（P > 0.05）。对PD和BI这2个风险因素进行改良，依据PD ≥ 6 mm位点数、BI ≥ 3位点百分比进行风险等级判定分析显示，2组PD ≥ 6 mm位点数、PD ≥ 6 mm位点数分级、全口平均PD、BI ≥ 3位点百分比、BI ≥ 3位点百分比分级比较，差异均有统计学意义（均P < 0.05）。结论    IDRA模型在我国有牙周炎病史的种植治疗患者中应用效果可能欠佳。建议应用PD ≥ 6 mm位点数和BI ≥ 3位点百分比替代原模型中的PD ≥ 5 mm位点数和BOP阳性率，未来仍需进一步探索改良方式。

关键词: 种植体周炎, 牙周炎, 种植体周病风险评估工具

Abstract: Objective    To preliminarily explore the clinical application effect of the implant disease risk assessment（IDRA）model in patients undergoing implant treatment and propose an improvement plan. Methods    This was a retrospective case-control study. A total of 58 patients（with 58 implants）diagnosed with peri-implantitis and 33 patients（with 33 implants）diagnosed with healthy peri-implant status were enrolled，who visited the Department of Periodontology，Peking University School and Hospital of Stomatology from January 2020 to May 2024. They were divided into the peri-implantitis group and the healthy peri-implant group，respectively. Data of both groups were collected，including the history of periodontitis，bleeding index（BI），probing depth（PD），periodontitis susceptibility，frequency of supportive periodontal therapy（SPT），distance from the restorative margin of the implant-supported prosthesis to the bone，and implant prosthesis-related factors. The positive rate of bleeding on probing（BOP）（percentage of sites with BI ≥ 2）and the periodontal bone loss in relation to age（BL/Age）were calculated. These parameters were substituted into the IDRA model to assess the risk level，and improvements were made based on the assessment results. Results    The proportion of patients at high risk of peri-implant disease was 100% in both groups，and all patients had a history of periodontitis. There were statistically significant differences between the two groups in percentage of sites with BOP，number of sites with PD ≥ 5 mm，grading of the number of sites with PD ≥ 5 mm，grading of SPT frequency and implant prosthesis-related factors（all P < 0.05）；no statistically significant differences were observed in other factors between the two groups（P > 0.05）. After improving the two risk factors of PD and BI，risk level assessment was conducted based on the number of sites with PD ≥ 6 mm and the percentage of sites with BI ≥ 3. The results showed that there were statistically significant differences between the two groups in the number of sites with PD ≥ 6 mm，grading of the number of sites with PD ≥ 6 mm，full-mouth average PD，percentage of sites with BI ≥ 3，and grading of the percentage of sites with BI ≥ 3（all P < 0.05）. Conclusion    The application effect of the IDRA model may be suboptimal in Chinese implant patients with a history of periodontitis. It is recommended that the number of sites with PD ≥ 6 mm and the percentage of sites with BI ≥ 3 be used to replace the number of sites with PD ≥ 5 mm and the BOP positive rate in the original model，and further exploration of improvement methods is needed in the future.

Key words: peri-implantitis；periodontitis；implant disease risk assessment, IDRA

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