Carbajal Mejía Jeison B, Wakabayashi Kazumichi, Nakano Tamaki, Yatani Hirofumi
Int J Oral Maxillofac Implants. 2016 Jul-Aug;31(4):761-75. doi: 10.11607/jomi.4727.
The radiologic outcomes of implants placed using static computer-guided surgery have not yet been systematically investigated. The purpose of this study was to evaluate the marginal bone loss (MBL) around dental implants inserted with static computer assistance in healed sites.
An electronic search of publications in English from three databases (from 2000 to March 2015), including PubMed, Web of Science, and Cochrane Oral Health Group Trials Register, and a hand search of peerreviewed journals for relevant articles were performed. Only clinical human studies, either randomized or nonrandomized, with at least 10 cases and a minimum follow-up time of 12 months, reporting on MBL were included.
The search strategy resulted in 18 publications, with 2,675 implants inserted with static computer assistance in healed sites. The pooled mean MBL at 1-year follow-up was 1.06 mm (95% CI: 0.83 to 1.30 mm; heterogeneity: random-effects model, I² = 99.38%; P < .01). Moreover, when considering studies with a 3-year follow-up only (n = 5; 748 implants), the pooled MBL was 1.48 mm (95% CI: 0.81 to 2.15 mm; heterogeneity: random-effects model, I² = 99%; P < .01).
Within the limitations of this review, the MBL around dental implants placed in healed sites with computer-guided surgery seems to be a well-functioning one-stage alternative to extended two-stage conventional procedures if patients are appropriately selected and an appropriate width of bone is available for implant placement. However, current evidence is limited by the quality of available studies and the lack of comparative long-term clinical trials.
使用静态计算机引导手术植入种植体的放射学结果尚未得到系统研究。本研究的目的是评估在愈合部位通过静态计算机辅助植入的牙种植体周围的边缘骨丢失(MBL)情况。
对三个数据库(2000年至2015年3月)中的英文出版物进行电子检索,包括PubMed、科学网和Cochrane口腔健康组试验注册库,并对手检同行评审期刊以查找相关文章。仅纳入至少10例病例、最短随访时间为12个月且报告了MBL的临床人体研究,包括随机或非随机研究。
检索策略共得到18篇出版物,其中有2675颗种植体在愈合部位通过静态计算机辅助植入。1年随访时合并的平均MBL为1.06mm(95%可信区间:0.83至1.30mm;异质性:随机效应模型,I² = 99.38%;P <.01)。此外,仅考虑3年随访的研究(n = 5;748颗种植体)时,合并的MBL为1.48mm(95%可信区间:0.81至2.15mm;异质性:随机效应模型,I² = 99%;P <.01)。
在本综述的局限性范围内,如果患者选择得当且有合适宽度的骨用于种植体植入,在愈合部位通过计算机引导手术植入牙种植体周围的MBL似乎是一种功能良好的一期替代延长的二期传统手术的方法。然而,目前的证据受到现有研究质量和缺乏比较性长期临床试验的限制。