de Medeiros Rodrigo Antonio, Pellizzer Eduardo Piza, Vechiato Filho Aljomar José, Dos Santos Daniela Micheline, da Silva Emily Vivianne Freitas, Goiato Marcelo Coelho
Postgraduate student, Aracatuba Dental School, São Paulo State University, São Paulo, Brazil.
Professor, Aracatuba Dental School, São Paulo State University, São Paulo, Brazil.
J Prosthet Dent. 2016 Oct;116(4):501-506.e5. doi: 10.1016/j.prosdent.2016.03.027. Epub 2016 Jul 14.
Different factors can influence marginal bone loss around dental implants, including the type of internal and external connection between the implant and the abutment. The evidence needed to evaluate these factors is unclear.
The purpose of this systematic review was to evaluate marginal bone loss by radiographic analysis around dental implants with internal or external connections.
A systematic review was conducted following the criteria defined by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Initially, a population, intervention, comparison, and outcome(s) (PICO) question was defined: does the connection type (internal or external) influence marginal bone loss in patients undergoing implantation? An electronic search of PubMed/MEDLINE and Scopus databases was performed for studies in English language published between January 2000 and December 2014 by 2 independent reviewers, who analyzed the marginal bone loss of dental implants with an internal and/or external connection.
From an initial screening yield of 595 references and after considering inclusion and exclusion criteria, 17 articles were selected for this review. Among them, 10 studies compared groups of implants with internal and external connections; 1 study evaluated external connections; and 6 studies analyzed internal connections. A total of 2708 implants were placed in 864 patients. Regarding the connection type, 2347 implants had internal connections, and 361 implants had external connections. Most studies showed lower marginal bone loss values for internal connection implants than for external connection implants.
Osseointegrated dental implants with internal connections exhibited lower marginal bone loss than implants with external connections. This finding is mainly the result of the platform switching concept, which is more frequently found in implants with internal connections.
不同因素可影响牙种植体周围的边缘骨丢失，包括种植体与基台之间的内部和外部连接类型。评估这些因素所需的证据尚不清楚。
本系统评价的目的是通过影像学分析评估具有内部或外部连接的牙种植体周围的边缘骨丢失情况。
按照系统评价和Meta分析的首选报告项目（PRISMA）所定义的标准进行系统评价。最初，定义了一个人群、干预措施、对照和结局（PICO）问题：连接类型（内部或外部）是否会影响接受种植手术患者的边缘骨丢失？由2名独立 reviewers 对PubMed/MEDLINE和Scopus数据库进行电子检索，查找2000年1月至2014年12月期间发表的英文研究，他们分析了具有内部和/或外部连接的牙种植体的边缘骨丢失情况。
从最初筛选出的595篇参考文献中，在考虑纳入和排除标准后，选择了17篇文章进行本评价。其中，10项研究比较了具有内部和外部连接的种植体组；1项研究评估了外部连接；6项研究分析了内部连接。共864例患者植入了2708颗种植体。关于连接类型，2347颗种植体为内部连接，361颗种植体为外部连接。大多数研究表明，内部连接种植体的边缘骨丢失值低于外部连接种植体。
具有内部连接的骨结合牙种植体比具有外部连接的种植体表现出更低的边缘骨丢失。这一发现主要是平台转换概念的结果，该概念在具有内部连接的种植体中更为常见。
