Gharpure Amit S, Bhatavadekar Neel B
1 Periodontics, University of Washington School of Dentistry, Seattle, Wa.
2 Clarus Dental Specialities, Pune, India; University of North Carolina at Chapel Hill, NC.
J Oral Implantol. 2017 Oct;43(5):395-403. doi: 10.1563/aaid-joi-D-17-00118. Epub 2017 Jun 12.
The recently popularized socket-shield technique involves intentional retention of a section of the remnant root at the time of immediate implant placement, thereby preserving the buccal/proximal bone from resorption. The objective of this systematic review was to assess the literature available on the socket-shield technique and weigh its biological plausibility and long-term clinical prognosis. A systematic search was performed on PubMed-Medline, Embase, Web of Knowledge, Google Scholar, and Cochrane Central for clinical/animal studies from January 1970 to April 2017. Twenty-three studies were assessed: 1 clinical case-control study, 4 animal histological reports, 1 clinical abstract, and 17+2* case reports. Eighteen out of the 23 studies had a duration of ≤12 months. A quality assessment of 5 studies (4 animal histologic and 1 clinical case-control) performed using the modified Animal Research: Reporting of In Vivo Experiments guidelines revealed that 4/5 studies had low scores. Fifty-eight out of 70 (82.86%) implants from 4 animal histological studies had complications; buccal/crestal bone loss (54.55%) and failure of osseointegration (27.27%) were the most common. Thirty-three out of 136 (24.26%) implants from 19+2 (2 studies had both histologic and clinical components, which are assessed separately) clinical studies had complications; buccal/crestal bone loss (78.78%) and shield exposure/failure (12.12%) were the most common. Other complications recorded were periodontal ligament and cementum formation on implant surfaces, pocket formation, inflammation, mucositis, and peri-implantitis. However, some clinical reports indicated stable results at 12 months. It would be difficult to predict the long-term success of this technique until high-quality evidence becomes available. A video abstract is available for viewing at https://youtu.be/lNMeUxj2XPA?list=PLvRxNhB9EJqbqjcYMbwKbwi8Xpbb0YuHI .
最近普及的牙槽窝保护技术包括在即刻种植体植入时有意保留一段残余牙根，从而防止颊侧/邻面骨吸收。本系统评价的目的是评估有关牙槽窝保护技术的现有文献，并权衡其生物学合理性和长期临床预后。对PubMed-Medline、Embase、Web of Knowledge、谷歌学术和Cochrane中心进行了系统检索，以查找1970年1月至2017年4月期间的临床/动物研究。共评估了23项研究：1项临床病例对照研究、4项动物组织学报告、1篇临床摘要以及17 + 2篇病例报告。23项研究中有18项的观察期≤12个月。使用改良的《动物研究：体内实验报告》指南对5项研究（4项动物组织学研究和1项临床病例对照研究）进行质量评估，结果显示4/5的研究得分较低。4项动物组织学研究中的70枚种植体中有58枚（82.86%）出现并发症；最常见的是颊侧/牙槽嵴顶骨吸收（54.55%）和骨结合失败（27.27%）。19 + 2项临床研究（2项研究同时包含组织学和临床部分，分别进行评估）中的136枚种植体中有33枚（24.26%）出现并发症；最常见的是颊侧/牙槽嵴顶骨吸收（78.78%）和保护罩暴露/失败（12.12%）。记录的其他并发症包括种植体表面形成牙周膜和牙骨质、形成牙周袋、炎症、黏膜炎和种植体周围炎。然而，一些临床报告表明在12个月时结果稳定。在获得高质量证据之前，很难预测该技术的长期成功率。可在https://youtu.be/lNMeUxj2XPA?list=PLvRxNhB9EJqbqjcYMbwKbwi8Xpbb0YuHI观看视频摘要。
