Veitz-Keenan Analia, Keenan James R
New York College of Dentistry, New York, USA.
Evid Based Dent. 2017 Mar;18(1):5. doi: 10.1038/sj.ebd.6401214.
Data sourcesMedline and Embase databases and bibliographies of all included articles and relevant review articles were screened for possible inclusion.Study selectionLongitudinal studies were included reporting on implant survival, success, incidence of peri-implantitis, bone loss and periodontal status and on partially dentate patients with a history of treatment for periodontitis. There were no language restrictions for the included studies.Data extraction and synthesisAuthors independently and in duplicate assessed the studies for eligibility and data extraction. Disagreements were resolved by discussion and consensus. The methodological quality assessment of the included studies was done using an adapted Newcastle-Ottawa Scale (NOS). Confounding factors such as smoking, systemic disease influencing osseointegration, chemotherapy and radiation were assessed and adjusted in the analysis. Data were organised into tables and grouped in accordance with the study design.ResultsTwenty-four studies reported in 27 publications were included. Implant survival and success rate were higher in periodontally healthy patients.Twelve prospective cohort studies, five case series with a control group, four retrospective cohort studies and three studies with a sub group comparison were included.Bone loss and peri-implantitis were increased in patients with a history of treated periodontitis. More complications were reported in patients presenting with more severe forms of periodontitis. High heterogeneity among the studies in terms of study design, population, therapy, unit of analysis, inconsistent definitions of baseline and outcomes, inadequate reporting and confounding factors meant a meta-analysis could not be performed.Most of the studies showed better implant survival rates for the non-periodontitis group ranging from 91.67% to 100% compared to the treated periodontitis group 79.22% to 100% over a 1.2 to 16 year follow-up.ConclusionsImplants placed in patients treated for periodontal disease are associated with higher incidence of biological complications and lower success and survival rates than those placed in periodontally healthy patients. Severe forms of periodontal disease are associated with higher rates of implant loss. The conclusion of the review is limited by the strength of the evidence.
数据来源
检索了Medline和Embase数据库以及所有纳入文章和相关综述文章的参考文献，以筛选可能纳入的文献。
研究选择
纳入纵向研究，这些研究报告种植体的存留率、成功率、种植体周围炎的发生率、骨吸收和牙周状况，以及有牙周炎治疗史的部分牙列缺损患者的情况。纳入的研究没有语言限制。
数据提取与综合
作者独立且重复地评估研究的纳入资格并进行数据提取。分歧通过讨论和达成共识来解决。使用经过改编的纽卡斯尔-渥太华量表（NOS）对纳入研究进行方法学质量评估。在分析中评估并调整了吸烟、影响骨结合的全身疾病、化疗和放疗等混杂因素。数据整理成表格，并根据研究设计进行分组。
结果
纳入了27篇出版物中报道的24项研究。牙周健康患者的种植体存留率和成功率更高。
纳入了12项前瞻性队列研究、5项有对照组的病例系列研究、4项回顾性队列研究和3项有亚组比较的研究。
有牙周炎治疗史的患者骨吸收和种植体周围炎增加。牙周炎病情越严重的患者报告的并发症越多。研究在研究设计、人群、治疗、分析单位、基线和结局的定义不一致、报告不充分以及混杂因素等方面存在高度异质性，这意味着无法进行荟萃分析。
大多数研究显示，在1.2至16年的随访中，非牙周炎组的种植体存留率更好，范围为91.67%至100%，而牙周炎治疗组为79.22%至100%。
结论
与牙周健康患者相比，牙周疾病治疗患者植入种植体后生物并发症发生率更高，成功率和存留率更低。严重的牙周疾病形式与更高的种植体丢失率相关。本综述的结论受到证据强度的限制。
