Levin Liran, Halperin-Sternfeld Michal
Dr. Levin is an assistant professor, Faculty of Medicine, Technion, Israel Institute of Technology, Haifa; Harvard School of Dental Medicine, Boston; Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus, Haifa, P.O. Box 9602, Haifa 31096, Israel,
J Am Dent Assoc. 2013;144(10):1119-33. doi: 10.14219/jada.archive.2013.0030.
For the past few decades, dental implants have served as reliable replacements for missing teeth. However, there is an increasing trend toward replacing diseased teeth with dental implants.
The authors conducted a systematic review of long-term survival rates of teeth and implants. They searched the MEDLINE database for relevant publications up to March 2013. They considered studies in which investigators assessed the long-term effectiveness of dental implants or that of tooth preservation. They included only studies that had follow-up periods of 15 years or longer.
The authors selected 19 articles for inclusion. Investigators in nine studies assessed the tooth survival rate, whereas investigators in 10 studies assessed the implant survival rate. When comparing the overall long-term (that is, 15 years or more) tooth loss rate with that of implants, the authors observed rates ranging between 3.6 and 13.4 percent and 0 and 33 percent for teeth and implants, respectively. They could not perform a meta-analysis because of the substantial differences between the studies.
The results of this systematic review show that implant survival rates do not exceed those of compromised but adequately treated and maintained teeth, supporting the notion that the decision to extract a tooth and place a dental implant should be made cautiously. Even when a tooth seems to be compromised and requires treatment to be maintained, implant treatment also might require additional surgical procedures that might pose some risks as well. Furthermore, a tooth can be extracted and replaced at any time; however, extraction is a definitive and irreversible treatment.
在过去几十年里，牙种植体一直是可靠的缺牙替代物。然而，用牙种植体替代患牙的趋势正在增加。
作者对牙齿和种植体的长期生存率进行了系统综述。他们在MEDLINE数据库中检索截至2013年3月的相关出版物。他们纳入了研究者评估牙种植体长期有效性或牙齿保留长期有效性的研究。他们仅纳入随访期为15年或更长时间的研究。
作者选择了19篇文章纳入。9项研究中的研究者评估了牙齿生存率，而10项研究中的研究者评估了种植体生存率。在比较牙齿和种植体的总体长期（即15年或更长时间）失牙率时，作者观察到牙齿和种植体的失牙率分别在3.6%至13.4%和0至33%之间。由于研究之间存在重大差异，他们无法进行荟萃分析。
该系统综述的结果表明，种植体生存率不超过经过适当治疗和维护的患牙，这支持了拔牙和植入牙种植体的决定应谨慎做出的观点。即使一颗牙齿似乎受损且需要治疗以维持其功能，种植体治疗也可能需要额外的外科手术，这也可能带来一些风险。此外，牙齿可以在任何时候拔除并替换；然而，拔牙是一种确定性的、不可逆转的治疗方法。
