Peri-implant Doku Hastalıkları ve Tedavisi

Yıl 2017, Cilt: 7 Sayı: 2, 64 - 70, 15.06.2017

Eser Elemek Ömer Birkan Ağralı , Hatice Selin Yıldırım Leyla Kuru

Öz

Peri-implant hastalık, implantın kemik ile başarılı bir şekilde osseoentegrasyonunu takiben bakteriler ile konak cevabı arasındaki dengenin bozulması sonucu oluşur. Peri-implant hastalıklardan biri olan peri-implant mukozitis, iltihabi reaksiyonların sadece mukozada olduğu durumlarda görülürken, peri-implantitis peri-implant mukozadaki iltihaba kemik kaybının eşlik ettiği durumda görülür. Peri-implant hastalıkların teşhisinde klinik değerlendirmede sondalama derinliği, sondalamada kanama ve süpürasyon göz önüne alınır. Buna ilave olarak radyografik değerlendirmede destek kemik seviyeleri incelenir. Peri-implant hastalıkların gelişmesinde sigara, kötü ağız hijyeni, periodontal hastalık geçmişi, diyabet mellitus, kardiyovasküler hastalıklar ve implant yüzey özellikleri birer risk faktörü olarak kabul edilmektedir. Peri-implant mukozitisin tedavisinde mekanik tedavi ile birlikte antimikrobiyal tedavi uygulanırken, peri-implantitis olgularında bu yöntemler yeterli sonuç vermemektedir. Peri-implantitisin tedavisinde mekanik işlemlere ilave, rezektif ve/veya rejeneratif cerrahi ile periodontal tedaviler uygulanmaktadır. Diş hekimlerinin peri-implant hastalıkların oluşması ve mevcut bir hastalığın ilerlemesini önlemeye yönelik bilgilerinin arttırılması gerekmektedir. Bununla birlikte hastaların da destekleyici periodontal/peri-implant tedavi kapsamında düzenli diş hekimi kontrollerine gitmeleri ve ağız hijyen seviyelerini maksimum düzeyde idame etmeleri sağlanmalıdır.

Anahtar Kelimeler

Peri-implant mukozitis, peri-implantitis, peri-implant risk faktörleri, peri-implant tedavi

Peri-implant Tissues and Diseases

Öz

Peri-implant diseases occur due to imbalance between host response and biofilm after successful osseointegration of an implant with the bone. Among peri-implant diseases, peri-implant mucositis is used to describe the presence of inflammation only within the mucosa, whereas peri-implantitis is characterized by loss of supporting bone in addition to the inflammation within the mucosa. For the diagnosis of peri-implant diseases, probing depth, bleeding on probing, and suppuration are clinically assessed. Additionally, supporting bone levels are radiographically evaluated. Smoking, lack of oral hygiene, history of periodontal disease, diabetes mellitus, cardiovascular diseases, and implant surface characteristics are the known risk factors for the development of peri-implant diseases. For the treatment of peri-implant mucositis, antimicrobial treatment is performed together with mechanical debridement. However, these treatment approaches are not sufficient for peri-implantitis cases. For the treatment of peri-implantitis, resective and/or regenerative surgical interventions are used in addition to mechanical debridement. It is crucial to improve the knowledge among dentists about the prevention and progression of peri-implant diseases. On the other hand, patients should be advised regular dental visits and to maintain the highest level of oral hygiene.

Anahtar Kelimeler

Peri-implant mucositis, peri-implantitis, peri-implant risk factors, peri-implant treatment

Kaynakça

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