임플란트 주위질환의 효과적 진단
The effective diagnosis of peri-implant diseases
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상실된 치아의 수복방법으로서 임플란트는 지난 90년대부터 본격화되어 현재까지 매우 보편화된 술식으로자리매김 하였다. 최근 병원에 내원하는 환자의 구강및 파노라마 초진 사진에서 매식된 임플란트는 쉽게관찰할 수 있으며, 임플란트 주위질환 역시 과거에 비해 빈번히 관찰되고 있다. 임플란트 주위염(Peri-implantitis, Fig. 1)은만성 치주염과 유사한 양상을 보이는 부위특이적 감염으로 1987년 Mombelli 등에 의해 처음으로 용어가 소개되었다1). 1994년 제1회 EuropeanWorkshop on periodontology(EWOP) 에서임플란트 주위질환(Peri-implant disease)은 임플란트 주위조직에 발생하는 질환으로 정의하였고,임플란트 주위의 연조직에 발생한 가역적인 염증과정을 보이는 임플란트 주위점막염(peri-implantmucositis)과 부가적으로 임플란트 주위 지지골의상실 및 5㎜ 이상의 치주낭 깊이, 탐침시 출혈 또는화농이 있는 임플란트 주위염(Peri-implantitis)으로 분류하였다.
Abstract
Peri-implant diseases are inflammatory lesions, which include peri-implant mucositis and peri-implantitis. Peri-implant mucositís is described as the presence of inflammation in the mucosa around implants without any bone loss. By contrast, in periimplantitis, besides the inflammation in the peri-implant mucosa, loss of supporting bone is also seen. Diagnosis of peri-implant diseases require the use of gentle probing(0.2 ~ 0.3N) to identify the presence of bleeding on probing, probing depth and suppuration, both signs of clinical inflammation. Radiographs are required to detect loss of supporting bone. Baseline probing measurements and high quality, long cone periapical radiographs should be obtained once the restoration of the implant is completed to make possible longitudinal monitoring of peri-implant tissue.
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