Shi Jun-Yu, Gu Ying-Xin, Zhuang Long-Fei, Lai Hong-Chang
Int J Oral Maxillofac Implants. 2016 Sep-Oct;31(5):1077-88. doi: 10.11607/jomi.4321.
The aim of this review was to systematically appraise survival rates of implants placed using the osteotome technique with and without grafting in the published literature.
An electronic search was conducted to identify prospective and retrospective studies on osteotome sinus floor elevation published between January 1, 2000 and October 30, 2015. Studies were included that (1) involved use of the osteotome technique with or without grafting; (2) provided data regarding the implant survival rates, residual bone height (RBH), and grafting materials; and (3) reported mean follow-up of at least 1 year after functional loading and included a minimum of 10 patients. The mean weighted cumulative implant survival rates were used to compare the two treatment strategies-grafted or nongrafted. The influence of RBH and implant length on weighted cumulative implant survival was also evaluated.
After search and evaluation of the literature according to the inclusion criteria, 34 studies involving 1,977 patients and 3,119 implants were included. Eighty-four out of 102 implant failures documented in the studies occurred within 1 year of functional loading. Statistically significant differences in the cumulative survival rates were found in the graft and nongraft groups (95.89% and 97.30%, respectively; P = .05). In the nongraft group, no statistically significant difference in the cumulative survival rate was found when implants were placed at RBH < 5 mm or ≥ 5 mm (95.04% and 97.63%, respectively; P = .12). In the graft group, however, a statistically significant difference was found when implants were placed at RBH < 5 mm or ≥ 5 mm (92.19% and 97.59%, respectively; P < .01). Significantly lower weighted mean cumulative implant survival rates were found in the shorter (< 8 mm) implant group than in the longer (≥ 8 mm) implant group (83.33% and 96.28%, respectively; P < .01).
The cumulative survival rates were significantly higher in the nongraft group than in the graft group. Early failures (< 1 year functional loading) accounted for the vast majority of the implant failures. The cumulative survival rates in the graft group were significantly lower when the RBH was < 5 mm, while the cumulative survival rates in the nongraft group demonstrated no statistically significant difference based on RBH. Shorter (< 8 mm) implants demonstrated significantly lower cumulative survival rates than longer implants.
本综述的目的是系统评估在已发表文献中，使用骨凿技术且有无植骨情况下种植体的存活率。
进行电子检索，以识别2000年1月1日至2015年10月30日期间发表的关于骨凿上颌窦底提升的前瞻性和回顾性研究。纳入的研究需满足以下条件：（1）涉及使用骨凿技术且有无植骨；（2）提供有关种植体存活率、剩余骨高度（RBH）和植骨材料的数据；（3）报告功能加载后至少1年的平均随访情况，且纳入至少10名患者。使用平均加权累积种植体存活率来比较两种治疗策略——植骨或未植骨。还评估了RBH和种植体长度对加权累积种植体存活率的影响。
根据纳入标准对文献进行检索和评估后，纳入了34项研究，涉及1977名患者和3119颗种植体。研究中记录的102例种植体失败中有84例发生在功能加载后1年内。在植骨组和未植骨组中，累积存活率存在统计学显著差异（分别为95.89%和97.30%；P = 0.05）。在未植骨组中，当种植体植入RBH < 5 mm或≥ 5 mm时，累积存活率无统计学显著差异（分别为95.04%和97.63%；P = 0.12）。然而，在植骨组中，当种植体植入RBH < 5 mm或≥ 5 mm时，发现有统计学显著差异（分别为92.19%和97.59%；P < 0.01）。较短（< 8 mm）种植体组的加权平均累积种植体存活率显著低于较长（≥ 8 mm）种植体组（分别为83.33%和96.28%；P < 0.01）。
未植骨组的累积存活率显著高于植骨组。早期失败（功能加载< 1年）占种植体失败的绝大多数。当RBH < 5 mm时，植骨组的累积存活率显著较低，而未植骨组的累积存活率根据RBH无统计学显著差异。较短（< 8 mm）种植体的累积存活率显著低于较长种植体。
