Hashim Dena, Cionca Norbert, Courvoisier Delphine S, Mombelli Andrea
School of Dental Medicine, Division of Periodontology, University of Geneva, Rue Barthelemy-Menn 19, CH-1205, Geneva, Switzerland.
University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, CH-1205, Genève, Switzerland.
Clin Oral Investig. 2016 Sep;20(7):1403-17. doi: 10.1007/s00784-016-1853-9. Epub 2016 May 24.
The aim of this review was to evaluate the clinical success and survival rates of zirconia ceramic implants after at least 1 year of function and to assess if there is sufficient evidence to justify using them as alternatives to titanium implants.
An electronic search in MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Clinical Trials (CENTRAL) databases was performed in April 2015 by two independent examiners to retrieve clinical studies focusing on the survival rate of zirconia implants after at least 1 year of function. Implant survival was estimated using the overall proportion reported in the studies with a Clopper-Pearson 95 % confidence interval (random effect model with a Der-Simonian Laird estimate).
Fourteen articles were selected out of the 1519 titles initially screened. The overall survival rate of zirconia one- and two-piece implants was calculated at 92 % (95 % CI 87-95) after 1 year of function. The survival of implants at 1 year for the selected studies revealed considerable heterogeneity.
In spite of the unavailability of sufficient long-term evidence to justify using zirconia oral implants, zirconia ceramics could potentially be the alternative to titanium for a non-metallic implant solution. However, further clinical studies are required to establish long-term results, and to determine the risk of technical and biological complications. Additional randomized controlled clinical trials examining two-piece zirconia implant systems are also required to assess their survival and success rates in comparison with titanium as well as one-piece zirconia implants.
Zirconia implants provide a potential alternative to titanium ones. However, clinicians must be aware of the lack of knowledge regarding long-term outcomes and specific reasons for failure.
本综述旨在评估氧化锆陶瓷种植体在功能至少1年后的临床成功率和生存率，并评估是否有足够证据证明可将其用作钛种植体的替代品。
2015年4月，两名独立审查员在MEDLINE、EMBASE和Cochrane临床对照试验中心注册库（CENTRAL）数据库中进行了电子检索，以检索关注氧化锆种植体在功能至少1年后生存率的临床研究。使用研究中报告的总体比例及Clopper-Pearson 95%置信区间（采用Der-Simonian Laird估计的随机效应模型）来估计种植体生存率。
在最初筛选的1519篇标题中，选出了14篇文章。氧化锆单件和两件式种植体在功能1年后的总体生存率计算为92%（95%置信区间87-95）。所选研究中种植体1年时的生存率显示出相当大的异质性。
尽管缺乏足够的长期证据来证明使用氧化锆口腔种植体的合理性，但氧化锆陶瓷有可能成为钛的替代品，提供一种非金属种植体解决方案。然而，需要进一步的临床研究来确定长期结果，并确定技术和生物并发症的风险。还需要额外的随机对照临床试验来研究两件式氧化锆种植体系统，以评估其与钛以及单件式氧化锆种植体相比的生存率和成功率。
氧化锆种植体为钛种植体提供了一种潜在的替代方案。然而，临床医生必须意识到对长期结果和失败的具体原因缺乏了解。
