College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
PLoS One. 2013 Aug 5;8(8):e71955. doi: 10.1371/journal.pone.0071955. Print 2013.
There are conflicting reports as to the association between smoking, radiotherapy, diabetes and osteoporosis and the risk of dental implant failure. We undertook a meta-analysis to evaluate the association between smoking, radiotherapy, diabetes and osteoporosis and the risk of dental implant failure.
A comprehensive research on MEDLINE and EMBASE, up to January 2013, was conducted to identify potential studies. References of relevant studies were also searched. Screening, data extraction and quality assessment were conducted independently and in duplicate. A random-effects meta-analysis was used to pool estimates of relative risks (RRs) with 95% confidence intervals (CIs).
A total of 51 studies were identified in this meta-analysis, with more than 40,000 dental implants placed under risk-threatening conditions. The pooled RRs showed a direct association between smoking (n = 33; RR = 1.92; 95% CI, 1.67-2.21) and radiotherapy (n = 16; RR = 2.28; 95% CI, 1.49-3.51) and the risk of dental implant failure, whereas no inverse impact of diabetes (n = 5; RR = 0.90; 95% CI, 0.62-1.32) on the risk of dental implant failure was found. The influence of osteoporosis on the risk of dental implant failure was direct but not significant (n = 4; RR = 1.09; 95% CI, 0.79-1.52). The subgroup analysis indicated no influence of study design, geographical location, length of follow-up, sample size, or mean age of recruited patients.
Smoking and radiotherapy were associated with an increased risk of dental implant failure. The relationship between diabetes and osteoporosis and the risk of implant failure warrant further study.
关于吸烟、放疗、糖尿病和骨质疏松症与牙种植体失败风险之间的关系，存在相互矛盾的报道。我们进行了一项荟萃分析，以评估吸烟、放疗、糖尿病和骨质疏松症与牙种植体失败风险之间的关系。
对 MEDLINE 和 EMBASE 进行了全面检索，检索时间截至 2013 年 1 月，以确定潜在的研究。还检索了相关研究的参考文献。筛选、数据提取和质量评估均由两人独立进行。使用随机效应荟萃分析来汇总相对风险（RR）的估计值及其 95%置信区间（CI）。
这项荟萃分析共纳入了 51 项研究，涉及 4 万多个在有风险因素的情况下植入的牙种植体。汇总 RR 显示，吸烟（n = 33；RR = 1.92；95%CI，1.67-2.21）和放疗（n = 16；RR = 2.28；95%CI，1.49-3.51）与牙种植体失败风险之间存在直接关联，而糖尿病（n = 5；RR = 0.90；95%CI，0.62-1.32）对牙种植体失败风险无反向影响。骨质疏松症对牙种植体失败风险的影响是直接的，但无统计学意义（n = 4；RR = 1.09；95%CI，0.79-1.52）。亚组分析表明，研究设计、地理位置、随访时间、样本量或纳入患者的平均年龄对结果无影响。
吸烟和放疗与牙种植体失败风险增加相关。糖尿病和骨质疏松症与种植体失败风险之间的关系需要进一步研究。
