Stafford Gary L
Department of General Dental Sciences, Marquette University School of Dentistry, Milwaukee, Wisconsin USA.
Evid Based Dent. 2014 Sep;15(3):87-8. doi: 10.1038/sj.ebd.6401047.
Medline, Embase, the Cochrane Oral Health Group's Trials Register and OpenGREY databases were searched together with the reference lists of identified articles.
Randomised controlled trials (RCTs) and prospective cohort studies of at least six month duration were included. Studies/case series in which there was only one implant surface (SLA or SLActive) and one loading protocol (immediate or early) were also considered.
Two reviewers screened, selected and abstracted data, independently. RCTs were assessed for quality using the Cochrane risk of bias approach and observational studies using the Newcastle-Ottawa scale (NOS). The primary outcomes were changes from baseline to follow-up of clinical attachment level (CAL), probing depth (PD) and radiographic changes in the peri-implant bone level and number of implants lost. Cumulative survival rates (%) of each included study were calculated.
Twenty-three articles reporting 19 studies (seven RCTs; 12 prospective observational studies) were included. The seven RCTs included 407 patients with 853 implants (8% titanium plasma-sprayed, 41.5% SLA and 50.5% SLActive). Only one RCT was considered to be at low risk of bias, the others were considered to be at unclear risk. The 12 observational studies included 1394 SLA and 145 SLActive implants and were considered to be of medium methodological quality based on the NOS. A narrative summary of the studies was undertaken owing to marked heterogeneity of the loading periods, types of implants described and lack of occurrence of the outcome of interest. There were no significant differences reported in the studies in relation to implant loss or clinical parameters between the immediate/early loading and delayed loading protocols. Overall, 95% of SLA and 97% of SLActive implants still survive at the end of follow-up.
Despite the positive findings achieved by the included studies, few RCTs were available for analysis for SLActive implants. Study heterogeneity, scarcity of data and the lack of pooled estimates represent a limitation between studies' comparisons and should be considered when interpreting the present findings.
对Medline、Embase、Cochrane口腔健康组试验注册库和OpenGREY数据库进行了检索，并查阅了已识别文章的参考文献列表。
纳入至少为期6个月的随机对照试验（RCT）和前瞻性队列研究。仅有一种种植体表面（SLA或SLActive）和一种加载方案（即刻或早期）的研究/病例系列也在考虑范围内。
两名评审员独立筛选、选择并提取数据。使用Cochrane偏倚风险方法评估RCT的质量，并使用纽卡斯尔-渥太华量表（NOS）评估观察性研究。主要结局为从基线到随访时临床附着水平（CAL）、探诊深度（PD）的变化，以及种植体周围骨水平的影像学变化和种植体丢失数量。计算每项纳入研究的累积生存率（%）。
纳入了23篇报告19项研究的文章（7项RCT；12项前瞻性观察性研究）。7项RCT纳入了407例患者，共853枚种植体（8%为钛等离子喷涂，41.5%为SLA，50.5%为SLActive）。只有1项RCT被认为偏倚风险较低，其他被认为风险不明。12项观察性研究包括1394枚SLA种植体和145枚SLActive种植体，根据NOS，其方法学质量被认为中等。由于加载期、所描述的种植体类型存在显著异质性且缺乏感兴趣的结局，因此对研究进行了叙述性总结。在即刻/早期加载方案与延迟加载方案之间，研究中未报告种植体丢失或临床参数方面的显著差异。总体而言，在随访结束时，95%的SLA种植体和97%的SLActive种植体仍然留存。
尽管纳入研究取得了阳性结果，但可供分析SLActive种植体的RCT很少。研究异质性、数据稀缺以及缺乏汇总估计值是研究间比较的一个局限性，在解释当前结果时应予以考虑。
