Kotsakis Georgios A, Ioannou Andreas L, Hinrichs James E, Romanos Georgios E
Advanced Education Program in Periodontology, University of Minnesota, Minneapolis, MN, USA.
School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA.
Clin Implant Dent Relat Res. 2015 Jun;17(3):598-609. doi: 10.1111/cid.12240. Epub 2014 May 30.
Even though the efficacy of implant treatment and the excellent success rates that modern implant surfaces yield remain unchallenged, there is limited information available on implant success rates in medically compromised patients.
The aim of this systematic review was to evaluate the survival of implants placed in the maxillary jaws of medically compromised patients.
Two reviewers using predefined selection criteria performed an electronic search complemented by a manual search, independently and in duplicate.
After the final selection, 11 studies reporting on four distinct medical conditions were included out of 405 potentially eligible titles. In detail, three studies reported on implants placed in diabetic patients, six on implants placed in patients with a history of oral cancer, one on implants in patients with a history of epilepsy, and one on implants in patients with autoimmune rheumatoid arthritis.
Placement of maxillary implants in medically compromised patients seems to yield acceptable survival rates. Implant survival in well-controlled diabetic patients, patients diagnosed with rheumatoid arthritis, and patients treated for severe epilepsy is comparable to that in healthy patients. Implants placed in the maxillae of patients treated for oral cancer may attain osseointegration less predictably than in the mandible.
尽管种植治疗的疗效以及现代种植体表面所带来的极高成功率无可争议，但关于医学上存在缺陷的患者的种植成功率的信息却十分有限。
本系统评价的目的是评估在医学上存在缺陷的患者上颌骨中植入种植体的存留情况。
两名评价者按照预先确定的选择标准，独立且重复地进行了电子检索，并辅以手工检索。
经过最终筛选，在405个可能符合条件的标题中，纳入了11项报告4种不同医学状况的研究。具体而言，3项研究报告了在糖尿病患者中植入种植体的情况，6项报告了有口腔癌病史患者中植入种植体的情况，1项报告了有癫痫病史患者中植入种植体的情况，1项报告了自身免疫性类风湿关节炎患者中植入种植体的情况。
在医学上存在缺陷的患者中植入上颌种植体似乎能获得可接受的存留率。血糖控制良好的糖尿病患者、被诊断为类风湿关节炎的患者以及接受严重癫痫治疗的患者的种植体存留情况与健康患者相当。在接受口腔癌治疗的患者上颌骨中植入种植体实现骨结合的可预测性可能低于下颌骨。
