| Abstract | Kao alternativa klasičnoj protetskoj terapiji, predstavljeni su dentalni
oseointegrirajući implantati. Uspješenost terapije uvelike ovisi o funkciji i estetici
koja može biti narušena periimplantatnim bolestima. Periimplantatni mukozitis
smatra se reverzibilnom promjenom, a periimplantitis ireverzibilnom promjenom.
Periimplantitis je definiran kao upala potpornog tkiva (kosti) oko implantata i
rezultira gubitkom implantata. Često se uspoređuje s parodontitisom, ali
periimplantitis se, za razliku od parodontitisa, puno brže širi i teže liječi. Loša oralna
higijena, pušenje, sistemske bolesti i ranije dijagnosticirani parodontitis rizični su
faktori za njegov razvoj. Očituje se kliničkom slikom krvarenja nakon sondiranja,
prisutnošću gnoja, stvaranjem džepova, upalom mekih tkiva i oteklinama, gubitkom
kosti vidljivome na RTG-u i, u konačnici, pomičnošću implantata.
Glavna tema novijih istraživanja je izbjegnuće gubitka implantata. Ovisno o defektu
oko implantata, provodi se nekirurška, odnosno kirurška terapija. Mehaničko
čišćenje supra i subgingivnog plaka i kamenca, ispiranje džepova antisepticima uz
antibiotsku potporu spadaju u nekiruršku terapiju. Kirurška terapija je indicirana kod
opsežnijih defekata koji zahtjevaju odizanje mukoperiostalnog režnja kako bi se što
bolje uklonilo upalno i granulacijsko tkivo, remodelirala kost i ispunio defekt
koštanim nadomjesnim materijalom. Liječenje laserom te PRF-om novije su metode
liječenja periimplantitisa.
Još uvijek se traga za metodom liječenja koja će u potpunosti dovesti do
izliječenja periimplantitisa. |
| Abstract (english) | As an alternative to traditional prosthetic therapy, osseointegrated implants have
been presented. The success of dental implant therapy depends largely on function
and aesthetics, which may be spoiled by following peri-implant diseases. Periimplant
mucositis is considered to be reversibile condition while peri-implantitis is
seen as irreversibile condition.
Peri-implantitis is defined as inflammation of supporting tissue (bone) in periimplant
area and results in the loss of an implant. It is often compared to
periodontitis but unlike periodontitis, it expands faster and is more difficult to treat.
Poor oral hygiene, smoking, systemic diseases and early diagnosis of periodontal
disease are risk factors for its development. It is manifested by clinical signs like
bleeding after probing, pus formation and formation of pockets, swelling and
inflammation of soft tisues, bone loss visible on X-ray, and ultimately implant
mobility.
The main topic of recent reserches is how to avoid implant loss. Depending on a
defect around the implant, non surgical or surgical treatment is carried out.
Mechanical cleaning of supra and subgingival plaque as well as antiseptic and
antibiotic pocket rinse include non surgical treatment. Surgical treatment is indicated
in extensive defects requiring mucoperiostal flap to remove inflammatory and
granulation tissue, remodeling of the bone and filling defect with bone substitutes.
Laser therapy and PRF are new methods of peri-implantitis treatment.
We are still searching for a method of treatment that would enable complete
healing of peri-implatitis. |
