Engelhardt Sebastian, Papacosta Petros, Rathe Florian, Özen Jülide, Jansen John A, Junker Rüdiger
Section Parodontologie, C1 Centre Médico-Dentaire, Geneva, Switzerland.
Clin Oral Implants Res. 2015 Jun;26(6):671-87. doi: 10.1111/clr.12363. Epub 2014 Mar 15.
Immediate loading of dental implants appears to be a successful option. Questions still remain whether annual failure rates (AFRs) as well as annual marginal bone-level changes are comparable with conventionally loaded implants.
Immediately loaded implants (≤24 h after implantation) do not show different annual survival rates or peri-implant bone-level changes as compared to conventionally loaded implants (≥3 months after implantation).
An electronic search in the National Library of Medicine and in Cochrane Central Register of Controlled Trials was performed for articles published up to November 2013. Only publications in English were considered. Additionally, the bibliographies of the full-text papers were searched. Primary outcome variable was percentage AFR; secondary outcome variable was annual radiographic bone-level change.
Electronic search yielded 154 full-text articles; ten randomized controlled clinical trials were eventually meta-analyzed. Annual failure rates were 2.3% and 3.4% for conventionally and immediately loaded implants, respectively. No difference in implant failure rates was found (RR: 0.82). Regarding marginal bone-level changes, the weighted mean difference (WMD) between immediate and conventional loading amounted to 0.02 mm at 1 year (P > 0.05), to 0.08 mm at 2 years (P > 0.05), -0.10 mm at 3 years (P > 0.05) and -0.3 mm at 5 years (P < 0.05). The total WMD for the combined follow-up was 0.01 mm (P > 0.05).
No clinically relevant differences regarding annual failure rates or radiographic bone-level changes between conventionally and immediately loaded implants can be found for up to 5 years of follow-up.
牙种植体即刻负重似乎是一种成功的选择。然而，其年失败率（AFR）以及每年边缘骨水平变化是否与传统负重种植体相当，仍存在疑问。
与传统负重种植体（种植后≥3个月）相比，即刻负重种植体（种植后≤24小时）的年生存率或种植体周围骨水平变化并无差异。
对美国国立医学图书馆及考克兰系统评价数据库中截至2013年11月发表的文章进行电子检索。仅纳入英文出版物。此外，还检索了全文论文的参考文献。主要结局变量为AFR百分比；次要结局变量为每年影像学骨水平变化。
电子检索得到154篇全文文章；最终对10项随机对照临床试验进行了荟萃分析。传统负重和即刻负重种植体的年失败率分别为2.3%和3.4%。未发现种植体失败率存在差异（RR：0.82）。关于边缘骨水平变化，即刻负重与传统负重之间的加权平均差（WMD）在1年时为0.02mm（P>0.05），2年时为0.08mm（P>0.05），3年时为-0.10mm（P>0.05），5年时为-0.3mm（P<0.05）。联合随访的总WMD为0.01mm（P>0.05）。
在长达5年的随访中，未发现传统负重和即刻负重种植体在年失败率或影像学骨水平变化方面存在临床相关差异。
