Gonçalves Thais Marques Simek Vega, Bortolini Sergio, Martinolli Matteo, Alfenas Bruna Fernandes Moreira, Peruzzo Daiane Cristina, Natali Alfredo, Berzaghi Andrea, Garcia Renata Cunha Matheus Rodrigues
Department of Dentistry, Universidade Federal de Santa Catarina, Florianópolis, SC, BR.
Department of Dental Materials, University of Modena and Reggio Emilia, Modena, IT.
Braz Dent J. 2015 Jul-Aug;26(4):325-36. doi: 10.1590/0103-6440201300265.
Lack of standard criteria in the outcome assessment makes it difficult to draw conclusions on the clinical performance of short implants and, under these circumstances, determine the reasons for implant failure. This study evaluated, through a systematic review of the literature and meta-analysis, the essential parameters required to assess the long-term clinical performance of short and extra-short implants. Electronic databases (Pubmed-MEDLINE, Cochrane Library Database, Embase, and Lilacs) were searched by two independent reviewers, without language limitation, to identify eligible papers. References from the selected articles were also reviewed. The review included clinical trials involving short dental implants placed in humans, published between January 2000 and March 2014, which described the parameters applied for outcome's measurements and provided data on survival rates. Thirteen methodologically acceptable studies were selected and 24 parameters were identified. The most frequent parameters assessed were the marginal bone loss and the cumulative implant survival rate, followed by implant failure rate and biological complications such as bleeding on probing and probing pocket depths. Only cumulative implant survival rate data allows meta-analysis revealing a positive effect size (from 0.052 (fixed) to 0.042 (random)), which means that short implant appears to be a successful treatment option. Mechanical complications and crown-to-implant (C/I) ratio measurement were also commonly described, however, considering the available evidence; no strong conclusions could be drawn since different methods were used to assess each parameter. By means of this literature review, a standard evaluation scheme is proposed, being helpful to regiment further investigations and comparisons on future studies.
在结果评估中缺乏标准准则,使得难以就短种植体的临床性能得出结论,在此种情况下,也难以确定种植体失败的原因。本研究通过对文献的系统回顾和荟萃分析,评估了评估短种植体和超短种植体长期临床性能所需的关键参数。两名独立评审员对电子数据库(PubMed-MEDLINE、Cochrane图书馆数据库、Embase和Lilacs)进行检索,无语言限制,以识别符合条件的论文。还对所选文章的参考文献进行了审查。该综述纳入了2000年1月至2014年3月期间发表的涉及人类短牙种植体的临床试验,这些试验描述了用于结果测量的参数并提供了生存率数据。选择了13项方法学上可接受的研究,并确定了24个参数。评估最频繁的参数是边缘骨丢失和种植体累积生存率,其次是种植体失败率和生物学并发症,如探诊出血和探诊袋深度。只有种植体累积生存率数据允许进行荟萃分析,显示出正效应量(从0.052(固定效应)到0.042(随机效应)),这意味着短种植体似乎是一种成功的治疗选择。机械并发症和冠根比(C/I)测量也经常被描述,然而,考虑到现有证据,由于评估每个参数使用的方法不同,无法得出强有力的结论。通过本文献综述,提出了一个标准评估方案,有助于规范未来研究的进一步调查和比较。