AbstractDesignThis multi-center, randomized clinical trial compared the long-term outcomes of guided bone regeneration (GBR) with open flap debridement (OFD) in treating peri-implantitis-related bony defects with ≥3 osseous walls over 36 months. The study aimed to evaluate the healing potential of GBR using a deproteinized bovine bone mineral (DBBM) graft and native bilayer collagen membrane (NBCM) compared to OFD without the use of graft materials.Case selectionSixty-six individuals diagnosed with peri-implantitis were randomly assigned to either GBR (34 patients) or OFD (32 patients).

摘要设计这项多中心随机临床试验比较了引导骨再生（GBR）与开放皮瓣清创（OFD）治疗36个月内≥3个骨壁的种植体周围炎相关骨缺损的长期疗效。该研究旨在评估使用脱蛋白牛骨矿物质（DBBM）移植物和天然双层胶原膜（NBCM）与不使用移植材料的OFD相比GBR的愈合潜力。病例选择66名被诊断患有种植体周围炎的个体被随机分配到GBR（34名患者）或OFD（32名患者）。

The OFD group served as the control, where inflamed tissue was removed and the implant surface decontaminated using 3% hydrogen peroxide, but no bone graft was placed. The GBR group received DBBM and NBCM for defect reconstruction. Radiographic defect fill (RDF), probing pocket depth (PPD), bleeding on probing (BOP), suppuration (SUP), mucosal recession (MREC), and patient-reported outcomes (PROs) were assessed over the study duration.

OFD组作为对照，去除发炎组织，并使用3%过氧化氢净化植入物表面，但不放置骨移植物。GBR组接受DBBM和NBCM进行缺损重建。在研究期间评估了射线照相缺陷填充（RDF），探测袋深度（PPD），探测出血（BOP），化脓（SUP），粘膜退缩（MREC）和患者报告的结果（PRO）。

Post-surgical care included azithromycin, ibuprofen, and chlorhexidine rinses.Study timelineThe study involved baseline assessments, surgical interventions, and follow-ups at 6, 12, and 36 months. Supportive peri-implant therapy was provided every 3 months during the additional 24-month follow-up.Data analysisPrimary outcome was RDF at 36 months.

手术后护理包括阿奇霉素，布洛芬和洗必泰冲洗液。研究时间表该研究涉及基线评估，手术干预和6,12和36个月的随访。在额外的24个月随访期间，每3个月提供一次支持性种植体周围治疗。数据分析主要结果是36个月时的RDF。

Secondary outcomes included PPD, BOP, SUP, MREC, and PROs. Descriptive statistics and ANCOVA models were used for analysis.ResultsAt 36 months, GBR resulted in a mean RDF of 2.13  ±  1.26 mm, compared to 1.64  ±  1.54 mm with OFD (p  =  .18). No significant differences were found in PPD, BOP, SUP, REC, or PROs between the groups.

次要结果包括PPD，BOP，SUP，MREC和PROs。描述性统计和ANCOVA模型用于分析。结果在36个月时，GBR的平均RDF为2.13±1.26 mm，而OFD为1.64±1.54 mm（p=0.18）。两组之间的PPD，BOP，SUP，REC或PRO没有显着差异。

Treatment success (defined as no additional bone loss, PPD ≤ 5 mm, no BOP, and no SUP.

治疗成功（定义为无额外骨质流失，PPD≤5 mm，无BOP，无SUP。

A Commentary onRenvert S, Giovannoli J-L, Rinke SThe efficacy of reconstructive therapy in the surgical management of peri-implantitis: a 3-year follow-up of a randomized clinical trial. J Clin Periodontol 2024; https://doi.org/10.1111/jcpe.14049GRADE Rating: CommentaryPeri-implantitis is a significant inflammatory condition that causes progressive bone loss around dental implants, often requiring surgical intervention when non-surgical approaches fail to restore health1.

Renvert S，Giovannoli J-L，Rinke的评论重建疗法在种植体周围炎手术治疗中的疗效：一项随机临床试验的3年随访。J临床牙周病2024；https://doi.org/10.1111/jcpe.14049GRADE评级：评论种植体周围炎是一种严重的炎症性疾病，会导致牙种植体周围进行性骨质流失，当非手术方法无法恢复健康时，通常需要手术干预1。

Among the available surgical options, guided bone regeneration (GBR) and open flap debridement (OFD) are two commonly utilized techniques. The randomized clinical trial (RCT) by Renvert et al. (2024) compared these approaches in treating peri-implantitis-related three-wall bony defects over a 36-month period2.

在可用的手术选择中，引导骨再生（GBR）和开放式皮瓣清创（OFD）是两种常用的技术。Renvert等人（2024）的随机临床试验（RCT）比较了这些方法在36个月内治疗种植体周围炎相关的三壁骨缺损2。

The study evaluates the long-term efficacy of GBR and OFD, focusing on radiographic defect fill (RDF) and composite treatment success.The inclusion criteria in this study, requiring three osseous walls and defects of ≥3 mm depth, aligned with the European Federation of Periodontology (EFP) guidelines3.

该研究评估了GBR和OFD的长期疗效，重点是射线照相缺陷填充（RDF）和复合治疗的成功。。

This methodological decision allowed for a consistent comparison of treatment efficacy, minimizing variability due to defect characteristics. The study’s multicentre design, with calibration across centers, further contributed to the robustness of the collected data. RDF was used as the primary outcome, with GBR showing a mean RDF of 2.13 mm compared to 1.64 mm for OFD, though the difference was not statistically significant (p = 0.18)2.

这种方法上的决定允许对治疗效果进行一致的比较，从而最大程度地减少由于缺陷特征引起的变异性。该研究的多中心设计，跨中心校准，进一步提高了收集数据的稳健性。RDF被用作主要结果，GBR显示平均RDF为2.13 mm，而OFD为1.64 mm，尽管差异无统计学意义（p=0.18）2。

These findings align with previous studies, such as Isler et al.4, which also demonstrated the potential for GBR to improve defect fill in peri-implantitis cases.While both GBR and OFD successfully reduced probing pocket depth (PPD) and maintained stable clinical p.

这些发现与先前的研究一致，例如Isler等[4]，这些研究也证明了GBR在种植体周围炎病例中改善缺陷填充的潜力。而GBR和OFD均成功降低了探测袋深度（PPD），并保持了稳定的临床p。

GBR with DBBM and NBCM resulted in higher average defect fill and treatment success than OFD after 3 years, though the difference was not statistically significant.

使用DBBM和NBCM的GBR在3年后比OFD导致更高的平均缺陷填充和治疗成功率，尽管差异无统计学意义。

Ongoing supportive peri-implant therapy is key for maintaining the benefits of reconstructive treatments in peri-implantitis.

持续的支持性种植体周围治疗是维持种植体周围炎重建治疗益处的关键。

No significant difference in patient-reported outcomes between GBR and OFD indicates similar patient satisfaction with both treatment methods.

GBR和OFD之间患者报告的结果没有显着差异，表明两种治疗方法的患者满意度相似。

ReferencesBerglundh T, Armitage G, Araujo MG, Avila-Ortiz G, Blanco J, Camargo PM, et al. Peri-implant diseases and conditions: Consensus report of workgroup 4 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Clin Periodontol. 2018;45. Suppl 20.

参考文献Berglundh T，Armitage G，Araujo MG，Avila Ortiz G，Blanco J，Camargo PM等。种植体周围疾病和条件：2017年世界牙周和种植体周围疾病和条件分类研讨会第4工作组的共识报告。J临床牙周病。2018年；45、补充20。

https://doi.org/10.1111/jcpe.12957.Renvert S, Giovannoli JL, Rinke S. The efficacy of reconstructive therapy in the surgical management of peri-implantitis: a 3-year follow-up of a randomized clinical trial. J Clin Periodontol. 2024. https://doi.org/10.1111/jcpe.14049.Herrera H, Berglundh T, Schwarz F, Chapple I, Jepsen S, Sculean A.

https://doi.org/10.1111/jcpe.12957.RenvertS，Giovannoli JL，Rinke S.重建疗法在种植体周围炎手术治疗中的疗效：一项随机临床试验的3年随访。J临床牙周病。2024https://doi.org/10.1111/jcpe.14049.HerreraH，Berglundh T，Schwarz F，Chapple I，Jepsen S，Sculean A。

et al. Prevention and treatment of peri-implant diseases—The EFP S3 level clinical practice guideline. J Clin Periodontol. 2023;50. Suppl 26:4–76. https://doi.org/10.1111/jcpe.13823.Article .

等。种植体周围疾病的预防和治疗EFP S3级临床实践指南。J临床牙周病。2023年；补充26:4-76。https://doi.org/10.1111/jcpe.13823.Article。

PubMed

PubMed

Google Scholar

谷歌学者

Isler SC, Soysal F, Ceyhanlı T, Bakırarar B, Unsal B. Efficacy of concentrated growth factor versus collagen membrane in reconstructive surgical therapy of peri-implantitis: 3-year results of a randomized clinical trial. Clin Oral Investig. 2022;26:5247–60. https://doi.org/10.1007/s00784-022-04493-y.Article .

Isler SC，Soysal F，CeyhanlıT，Bakırarar B，Unsal B.浓缩生长因子与胶原膜在种植体周围炎重建手术治疗中的疗效：一项随机临床试验的3年结果。临床口腔调查。2022年；26:5247-60。https://doi.org/10.1007/s00784-022-04493-y.Article。

PubMed

PubMed

PubMed Central

公共医学中心

Google Scholar

谷歌学者

Aghazadeh A, Persson RG, Renvert S. Impact of bone defect morphology on the outcome of reconstructive treatment of peri-implantitis. Int J Implant Dent. 2020;6:33. https://doi.org/10.1186/s40729-020-00219-5.Article

Aghazadeh A，Persson RG，Renvert S.骨缺损形态对种植体周围炎重建治疗结果的影响。Int J植入凹痕。2020年；6： 33页。https://doi.org/10.1186/s40729-020-00219-5.Article

PubMed

PubMed

PubMed Central

公共医学中心

Google Scholar

谷歌学者

Schwarz F, Schmucker A, Becker J. Efficacy of alternative or adjunctive measures to conventional treatment of peri-implant mucositis and peri-implantitis: a systematic review and meta-analysis. Int J Implant Dent. 2015;1:22. https://doi.org/10.1186/s40729-015-0023-1.Article

Schwarz F，Schmucker A，Becker J.替代或辅助措施对种植体周围粘膜炎和种植体周围炎常规治疗的疗效：系统评价和荟萃分析。Int J植入凹痕。2015年；1： 二十二。https://doi.org/10.1186/s40729-015-0023-1.Article

PubMed

PubMed

PubMed Central

公共医学中心

Google Scholar

谷歌学者

Afrashtehfar KI, Jurado CA, Abu Fanas SH, Del Fabbro M. Short-term data suggests cognitive benefits in the elderly with single-implant overdentures. Evid Based Dent. 2024;25:71–72. https://doi.org/10.1038/s41432-024-00999-4.Article

Afrashtehfar KI，Jurado CA，Abu Fanas SH，Del Fabbro M.短期数据表明单种植覆盖义齿对老年人的认知有益。基于Evid的Dent。2024年；25:71-72。https://doi.org/10.1038/s41432-024-00999-4.Article

PubMed

PubMed

PubMed Central

公共医学中心

Google Scholar

谷歌学者

Derks J, Ortiz-Vigón A, Guerrero A, Donati M, Bressan E, Ghensi P, et al. Reconstructive surgical therapy of peri-implantitis: a multicenter randomized controlled clinical trial. Clin Oral Implants Res. 2022;33:921–44. https://doi.org/10.1111/clr.13972. Erratum in: Clin Oral Implants Res.

Derks J，Ortiz Vigón A，Guerrero A，Donati M，Bressan E，Ghensi P等。种植体周围炎的重建手术治疗：一项多中心随机对照临床试验。Clin Oral Implants Res.2022；33:921-44。https://doi.org/10.1111/clr.13972.勘误表：Clin Oral Implants Res。

2023;34:78-79.Article .

2023年；34:78-79。第条。

PubMed

PubMed

PubMed Central

公共医学中心

Google Scholar

谷歌学者

Lundh A, Lexchin J, Mintzes B, Schroll JB, Bero L. Industry sponsorship and research outcome. Cochrane Database Syst Rev. 2017;2:MR000033. https://doi.org/10.1002/14651858.MR000033.pub3.Article

Lundh A，Lexchin J，Mintzes B，Schroll JB，Bero L.行业赞助和研究成果。；2： MR000033。https://doi.org/10.1002/14651858.MR000033.pub3.Article

PubMed

PubMed

Google Scholar

谷歌学者

Download referencesAcknowledgementsWe sincerely thank Dr. Edward E. Putnins, Professor in Periodontology in the Department of Oral Biological & Medical Sciences at the University of British Columbia (UBC), for his valuable comments that greatly improved this manuscript.FundingOpen access funding provided by University of Bern.Author informationAuthors and AffiliationsDepartment of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, SwitzerlandKelvin I.

下载参考文献致谢我们衷心感谢不列颠哥伦比亚大学（UBC）口腔生物与医学系牙周病学教授Edward E.Putnins博士的宝贵意见，这些意见极大地改进了这份手稿。。作者信息作者和附属机构瑞士伯尔尼大学牙科医学院重建牙科和老年医学系。

AfrashtehfarPrivate Practice, Abu Dhabi City, UAEKelvin I. AfrashtehfarDepartment of Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi ArabiaHayam A. AlfallajKing Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi ArabiaHayam A.

Afrashtehfar私人诊所，阿布扎比市，UAEKelvin I.Afrashtehfar沙特利雅得沙特国王本·阿卜杜勒阿齐兹健康科学大学牙科学院修复与修复牙科科学系，沙特阿拉伯利雅得A.AlfallajKing Abdullah国际医学研究中心（KAIMRC），沙特阿拉伯利雅得A。

AlfallajRestorative Dentistry Department, University of Chile, Santiago, ChileEduardo FernandezInstituto de Ciencias Biomédicas, Universidad Autónoma de Chile, Santiago, ChileEduardo FernandezOral Implantology Research Institute, Dubai, UAESouheil HussainiPrivate Practice, Dubai, UAESouheil HussainiAuthorsKelvin I.

智利大学圣地亚哥分校AlfallajRestorative牙科系，智利自治大学圣地亚哥分校ChileEduardo FernandezInstituto de Ciencias Biomédicas，ChileEduardo FernandezOral Implantology Research Institute，迪拜，UAESouheil HussainiPrivate Practice，迪拜，UAESouheil HussainiAuthorsKelvin I。

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Reprints and permissionsAbout this articleCite this articleAfrashtehfar, K.I., Alfallaj, H.A., Fernandez, E. et al. Guided bone regeneration improves defect fill and reconstructive outcomes in 3-wall peri-implantitis defects.

转载和许可本文引用本文Afrashtehfar，K.I.，Alfallaj，H.A.，Fernandez，E。等人。引导骨再生可改善3壁种植体周围炎缺陷的缺陷填充和重建结果。

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