Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
Clin Implant Dent Relat Res. 2011 Mar;13(1):19-28. doi: 10.1111/j.1708-8208.2009.00182.x.
It is important that peri-implant bone breakdown caused by, for example, undue load and/or peri-implantitis, is prevented or minimized. Some continuous loss of marginal bone is generally accepted, but the question remains as to what extent it must occur.
The purpose of this study was to compile and compare data on peri-implant marginal bone level changes from prospective studies that have registered the peri-implant marginal bone level radiographically at the time of prosthetic loading, and after 5 years of follow-up for implant systems currently available on the market.
A literature search was carried out to identify prospective studies on peri-implant marginal bone level changes around dental implants. To be included in a meta-analysis, the implant systems should have been subjected to at least two independent studies. Copycats without documentation were not accepted.
Forty prospective studies that presented with a 5-year data were identified. Three implant systems met the inclusion criteria of having at least two independent studies; Astra Tech Dental Implant System® (Astra Tech AB, Mölndal, Sweden), Brånemark System (Nobel Biocare AB, Göteborg, Sweden), and Straumann Dental Implant System (Institute Straumann AG, Basel, Switzerland). The pooled mean marginal bone level change amounted to -0.24 mm (95% CI -0.345, -0.135) for the Astra Tech Dental Implant System, 0.75 mm (95% CI -0.802, -0.693) for the Brånemark System, and 0.48 mm (95% CI -0.598, -0.360) for the Straumann Dental Implant System over 5 years, with a statistically significant difference (p < .01) between the systems.
The identified implant systems showed an annual bone loss below or much below what hitherto has been set up as a limit for success. A careful documentation of marginal bone level changes should be mandatory for all implant systems before being marketed. It is also time for revision of existing success criteria to refine the basis for clinical quality judgment of implant treatment.
例如，由于过度负载和/或种植体周围炎而导致的种植体周围骨吸收必须得到预防或最小化。人们普遍认为，种植体周围边缘骨会出现一定程度的连续丧失，但问题在于这种丧失必须控制在多大程度内。
本研究的目的是编译和比较当前市场上可获得的种植系统的前瞻性研究中有关种植体周围边缘骨水平变化的数据，这些研究在修复体加载时以及 5 年随访时对种植体周围边缘骨水平进行了影像学记录。
进行了文献检索，以确定有关种植体周围边缘骨水平变化的前瞻性研究。要进行荟萃分析，种植系统应至少有两项独立的研究。没有文件记录的复制品不被接受。
确定了 40 项具有 5 年数据的前瞻性研究。有 3 个种植系统符合至少有两项独立研究的纳入标准：AstraTech 牙种植体系统（AstraTech AB，Mölndal，瑞典）、Brånemark 系统（Nobel Biocare AB，哥德堡，瑞典）和 Straumann 牙种植体系统（Institute Straumann AG，巴塞尔，瑞士）。 AstraTech 牙种植体系统的平均边缘骨水平变化为-0.24mm（95%置信区间-0.345，-0.135），Brånemark 系统为 0.75mm（95%置信区间-0.802，-0.693），Straumann 牙种植体系统为 0.48mm（95%置信区间-0.598，-0.360），各系统之间存在统计学差异（p<0.01）。
所鉴定的种植系统在 5 年内的年骨丢失低于或远低于迄今为止设定的成功极限。在将种植系统投放市场之前，应对所有种植系统的边缘骨水平变化进行仔细记录。现在也需要对现有的成功标准进行修订，以完善对种植治疗临床质量判断的基础。
