Chrcanovic B R, Albrektsson T, Wennerberg A
Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden.
Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden; Department of Biomaterials, Göteborg University, Göteborg, Sweden.
Int J Oral Maxillofac Surg. 2015 Apr;44(4):493-506. doi: 10.1016/j.ijom.2014.11.011. Epub 2014 Dec 23.
The purpose of the present meta-analysis was to test the null hypothesis of no difference in the implant failure rate, postoperative infection, and marginal bone loss for patients being rehabilitated with immediately loaded non-submerged dental implants or delayed loaded submerged implants, against the alternative hypothesis of a difference. An electronic search without time or language restrictions was undertaken in March 2014. Eligibility criteria included clinical human studies, either randomized or not. The search strategy resulted in 28 publications. The inverse variance method was used for a random- or fixed-effects model, depending on the heterogeneity. The estimates of an intervention were expressed as the risk ratio (RR) and mean difference (MD) in millimetres. Twenty-three studies were judged to be at high risk of bias, one at moderate risk of bias, and four studies were considered at low risk of bias. The difference between procedures (submerged vs. non-submerged implants) significantly affected the implant failure rate (P = 0.02), with a RR of 1.78 (95% confidence interval (CI) 1.12-2.83). There was no apparent significant effect of non-submerged dental implants on the occurrence of postoperative infection (P = 0.29; RR 2.13, CI 0.52-8.65) or on marginal bone loss (P = 0.77; MD -0.03, 95% CI -0.23 to 0.17).
本荟萃分析的目的是检验零假设，即对于接受即刻负重非潜入式牙种植体或延期负重潜入式种植体修复的患者，种植体失败率、术后感染和边缘骨丢失无差异，备择假设为存在差异。2014年3月进行了无时间或语言限制的电子检索。纳入标准包括临床人体研究，无论是否为随机研究。检索策略共得到28篇出版物。根据异质性，采用逆方差法进行随机效应模型或固定效应模型分析。干预措施的估计值以风险比（RR）和以毫米为单位的平均差（MD）表示。23项研究被判定为高偏倚风险，1项为中度偏倚风险，4项研究被认为是低偏倚风险。种植程序（潜入式与非潜入式种植体）之间的差异对种植体失败率有显著影响（P = 0.02），RR为1.78（95%置信区间（CI）1.12 - 2.83）。非潜入式牙种植体对术后感染的发生（P = 0.29；RR 2.13，CI 0.52 - 8.65）或边缘骨丢失（P = 0.77；MD -0.03，95% CI -0.23至0.17）没有明显的显著影响。
