Jung Ronald E, Pjetursson Bjarni E, Glauser Roland, Zembic Anja, Zwahlen Marcel, Lang Niklaus P
Department of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland.
Clin Oral Implants Res. 2008 Feb;19(2):119-30. doi: 10.1111/j.1600-0501.2007.01453.x. Epub 2007 Dec 7.
The objective of this systematic review was to assess the 5-year survival of implant-supported single crowns (SCs) and to describe the incidence of biological and technical complications.
An electronic MEDLINE search complemented by manual searching was conducted to identify prospective and retrospective cohort studies on SCs with a mean follow-up time of at least 5 years. Failure and complication rates were analyzed using random-effects Poisson's regression models to obtain summary estimates of 5-year proportions.
Twenty-six studies from an initial yield of 3601 titles were finally selected and data were extracted. In a meta-analysis of these studies, survival of implants supporting SCs was 96.8% [95% confidence interval (CI): 95.9-97.6%] after 5 years. The survival rate of SCs supported by implants was 94.5% (95% CI: 92.5-95.9%) after 5 years of function. The survival rate of metal-ceramic crowns, 95.4% (95% CI: 93.6-96.7%), was significantly (P=0.005) higher than the survival rate, 91.2% (95% CI: 86.8-94.2%), of all-ceramic crowns. Peri-implantitis and soft tissue complications occurred adjacent to 9.7% of the SCs and 6.3% of the implants had bone loss exceeding 2 mm over the 5-year observation period. The cumulative incidence of implant fractures after 5 years was 0.14%. After 5 years, the cumulative incidence of screw or abutment loosening was 12.7% and 0.35% for screw or abutment fracture. For supra-structure-related complications, the cumulative incidence of ceramic or veneer fractures was 4.5%.
It can be concluded that after an observation period of 5 years, high survival rates for implants and implant-supported SCs can be expected. However, biological and particularly technical complications are frequent.
本系统评价的目的是评估种植体支持的单冠（SCs）的5年生存率，并描述生物学和技术并发症的发生率。
通过电子检索MEDLINE并辅以手工检索，以识别关于SCs的前瞻性和回顾性队列研究，平均随访时间至少为5年。使用随机效应泊松回归模型分析失败率和并发症发生率，以获得5年比例的汇总估计值。
从最初的3601篇标题中最终筛选出26项研究并提取数据。在对这些研究的荟萃分析中，支持SCs的种植体5年后的生存率为96.8%[95%置信区间（CI）：95.9 - 97.6%]。种植体支持的SCs在功能5年后的生存率为94.5%（95% CI：92.5 - 95.9%）。金属烤瓷冠的生存率为95.4%（95% CI：93.6 - 96.7%），显著高于全瓷冠的生存率91.2%（95% CI：86.8 - 94.2%）（P = 0.005）。在5年观察期内，9.7%的SCs邻近部位发生种植体周围炎和软组织并发症，6.3%的种植体骨吸收超过2 mm。5年后种植体骨折的累积发生率为0.14%。5年后，螺钉或基台松动的累积发生率为12.7%，螺钉或基台骨折的累积发生率为0.35%。对于上部结构相关并发症，陶瓷或贴面骨折的累积发生率为4.5%。
可以得出结论，经过5年的观察期，种植体和种植体支持的SCs有望获得较高的生存率。然而，生物学并发症尤其是技术并发症很常见。
