Grünbauer, S.J.J. (2022) De ontwikkeling van een nieuwe uitkomstmaat voor het kwantificeren van de ontstekingslast ten gevolge van peri-implantaire infecties; een patiëntgebonden retrospectief observationeel onderzoek. thesis, Dentistry.
Full text available on request.Abstract
Peri-implant infections are a “port e d’entrée” for microorganisms and cause increased activity of the immune system through an inflammatory response. This increased activity is associated with the disease course of several systemic diseases and it is therefore important to estimate the correct overall inflammatory burden. Nowadays, various outcome measures are used in diagnosis of peri-implant infections, such as: pocket depth, bleeding on probing, pus flow, gingival index, specific bacteria etc. All these outcome measures relate to individual implants and therefore cannot be used to quantify the total inflammatory burden in the entire mouth. In order to quantify the inflammatory burden due to periodontitis in natural elements, the PISA measurement method is used. The PISA is capable of quantifying the total inflammatory burden in the entire mouth by combining the above outcomes. However, the PISA is also used for mouths where implants are present. The disadvantage of the PISA method is that a formula is applied on the position where there is an implant by using a formula that is composed for a natural element at that position. Thus, this method does not take the shape of implants into account, which may differ from the radices of natural elements. In this study a new method is introduced for a mouth with implants by adding a new formula to the existing PISA method. This modifies it to include implants. By using this modified-PISA it is expected that the inflammation around implants will be calculated with a significantly higher accuracy. The study was split into ‘implant level’ and ‘patient level’ where single implants and the whole mouth were analyzed respectively. Because data from a previous study was used this study is a patient-centered observational retrospective cohort study. With the variables ‘pocket depth’ and ‘bleeding on probing’, the PISA and modified-PISA were calculated using the respective formulas. First, the raw data was made visual by means of bar chart. Then the results of these formulas were compared by a mixed design two-way ANOVA test. The statistical analysis showed no significant difference at the level of individual implants between the PISA or modified-PISA measurement method in the front region (p > 0.05). However, with a p-value < ,001, there was a significant difference between the use of the PISA or modified-PISA for implants in the premolar and molar region. At patient level there appeared to be a significant difference between the use of the PISA and modified-PISA for any number of implants in the mouth (p-value < ,05). The literature also shows the clinical relevancy to make the most accurate calculation of the total inflammatory burden in the mouth for a number of systemic diseases, treatments and use of medication. It can be concluded that the modified PISA, for a mouth with implants, has added value to the diagnostics of the total inflammatory burden in the mouth.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | de Waal, dr. Y.C.M. |
| Faculty: | Medical Sciences |
| Date Deposited: | 27 Mar 2023 11:44 |
| Last Modified: | 27 Mar 2023 11:44 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3459 |
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