Department of Biomaterials, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
Clin Oral Implants Res. 2013 Apr;24(4):355-62. doi: 10.1111/clr.12063. Epub 2012 Nov 5.
Calcium phosphate ceramic coatings have the potential to compensate for challenging bone conditions such as delayed or impaired bone healing and low bone quantity or density. Thus, the increasing universal prevalence of subjects with such challenging bone conditions might be paralleled by an enhanced global use of calcium phosphate ceramic-coated dental implants. However, it is speculated that the long-term clinical survival of calcium phosphate-coated dental implants might be adversely affected by coating delamination.
The aims of the current review were (1) to systematically appraise and (2) to meta-analyse long-term survival data of calcium phosphate-coated dental implants in clinical trials.
An extensive search in the electronic databases of the National Library of Medicine (http://www.ncbi.nlm.nih.gov), The Cochrane Central Register of Controlled Trials and the ISI Web of Knowledge, was carried out for articles published between January 2000 and November 2011 to identify randomized controlled clinical trials, prospective clinical trials as well as retrospective analysis of cases (RA) presenting survival data on the topic of calcium phosphate-coated dental implants. Only publications in English were considered, and the search was narrowed to studies in humans with a follow-up of at least 5 years only. Furthermore, the reference lists of related review articles and publications selected for inclusion in this review were systematically screened. The primary outcome variable was percentage annual failure rate (AFR), and the secondary outcome variable was percentage cumulative survival rate (CSR).
The electronic search in the database of the National Library of Medicine, The Cochrane Central Register of Controlled Trials and the ISI Web of Knowledge, resulted in the identification of 385 titles. These titles were initially screened by the two independent reviewers for possible inclusion, resulting in 29 publications suitable for further consideration. Screening the abstracts led to 20 full-text articles. From these articles, 15 reports were excluded. Finally, five of these original research reports could be selected for evaluation. No additional publications were identified by manual search. Thus, a total of five articles were included for analysis. Meta-analysis revealed that neither AFRs of calcium phosphate-coated dental implants increased progressively nor that long-term CSRs for calcium phosphate-coated dental implants were inferior to survival rates of noncoated implants.
We conclude that (1) published long-term survival data for calcium phosphate-coated dental implants are very limited, (2) AFRs of calcium phosphate-coated dental implants do not increase progressively, and (3) long-term CSRs for calcium phosphate-coated dental implants are comparable to survival rates of noncoated implants.
钙磷陶瓷涂层具有补偿挑战性骨条件的潜力，例如延迟或受损的骨愈合以及低骨量或密度。因此，具有挑战性骨条件的受试者的普遍增加可能与钙磷陶瓷涂层牙科植入物的全球使用增加相平行。但是，有人推测，钙磷陶瓷涂层牙科植入物的长期临床存活率可能会受到涂层分层的不利影响。
本综述的目的是（1）系统评估和（2）对临床试验中钙磷陶瓷涂层牙科植入物的长期存活率数据进行荟萃分析。
在国家医学图书馆（http://www.ncbi.nlm.nih.gov）的电子数据库中进行了广泛的搜索，包括 Cochrane 对照试验中央登记册和 ISI Web of Knowledge，以查找 2000 年 1 月至 2011 年 11 月期间发表的关于钙磷陶瓷涂层牙科植入物主题的随机对照临床试验、前瞻性临床试验以及病例的回顾性分析（RA）的文章，以获取生存数据。仅考虑英文出版物，并将搜索范围缩小到仅随访至少 5 年的人类研究。此外，还系统地筛选了相关综述文章和选定纳入本综述的出版物的参考文献列表。主要结局变量为年失败率（AFR）的百分比，次要结局变量为累积存活率（CSR）的百分比。
在国家医学图书馆数据库、Cochrane 对照试验中央登记册和 ISI Web of Knowledge 中的电子搜索，共确定了 385 个标题。这两个独立的审稿人最初对这些标题进行了筛选，以确定可能纳入的标题，从而确定了 29 篇适合进一步考虑的出版物。对摘要进行筛选导致了 20 篇全文文章。从这些文章中，排除了 15 篇报告。最后，选择了其中的 5 篇原始研究报告进行评估。通过手动搜索未发现其他出版物。因此，共有 5 篇文章被纳入分析。荟萃分析表明，钙磷涂层牙科植入物的 AFR 没有逐渐增加，而且钙磷涂层牙科植入物的长期 CSR 并不劣于非涂层植入物的存活率。
我们的结论是（1）发表的钙磷涂层牙科植入物的长期生存数据非常有限，（2）钙磷涂层牙科植入物的 AFR 没有逐渐增加，（3）钙磷涂层牙科植入物的长期 CSR 与非涂层植入物的存活率相当。
