Helmy M H E-D, Alqutaibi A Y, El-Ella A A, Shawky A F
Department of Prosthodontics, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt; Department Prosthodontics, Faculty of Dentistry, Assuit University, Assuit, Egypt.
Faculty of Oral and Dental Medicine, Ibb University, Ibb, Yemen; Department of Prosthodontics, Faculty of Dentistry, Ahram Canadian University, Cairo, Egypt.
Int J Oral Maxillofac Surg. 2018 May;47(5):642-650. doi: 10.1016/j.ijom.2017.10.018. Epub 2017 Nov 13.
The aim of this study was to compare implant failure and radiographic bone level changes with different loading protocols for unsplinted two-implant-supported mandibular overdentures. An electronic search of two databases (PubMed, Cochrane Library) was performed, without language restriction, to identify randomized controlled trials (RCTs) comparing immediate or early versus conventional dental implant loading protocols for unsplinted two-implant-supported mandibular overdentures. Data were extracted independently by two reviewers. The Cochrane tool was used to assess the quality of included studies. A meta-analysis was performed. Eight RCTs were identified, seven of which were included; one trial was excluded because related outcomes were not measured. Four of the seven studies were considered to have a high risk of bias and three an unclear risk. Meta-analysis revealed no difference between immediate versus conventional or early versus conventional implant loading protocols regarding implant failure (risk difference (RD) -0.02, 95% confidence interval (CI) -0.13 to 0.10; RD 0.09, 95% CI -0.03 to 0.20) or marginal bone loss (mean difference (MD) 0.09, 95% CI -0.10 to 0.28; MD -0.05, 95% CI -0.12 to 0.02) for implants supporting mandibular overdentures. These findings should be interpreted with great caution given the serious numerical limitations of the studies included.
本研究的目的是比较无夹板双种植体支持的下颌覆盖义齿采用不同加载方案时的种植体失败率和影像学骨水平变化。对两个数据库（PubMed、Cochrane图书馆）进行了电子检索，不受语言限制，以识别比较无夹板双种植体支持的下颌覆盖义齿即刻或早期与传统牙种植体加载方案的随机对照试验（RCT）。由两名 reviewers 独立提取数据。采用Cochrane工具评估纳入研究的质量。进行了荟萃分析。共识别出8项RCT，其中7项被纳入；1项试验被排除，因为未测量相关结果。7项研究中有4项被认为存在高偏倚风险，3项存在不明确风险。荟萃分析显示，在支持下颌覆盖义齿的种植体的种植体失败率（风险差（RD）-0.02，95%置信区间（CI）-0.13至0.10；RD 0.09，95%CI -0.03至0.20）或边缘骨丢失（平均差（MD）0.09，95%CI -0.10至0.28；MD -0.05，95%CI -0.12至0.02）方面，即刻与传统或早期与传统种植体加载方案之间没有差异。鉴于纳入研究存在严重的数值限制，这些发现应谨慎解读。
