Private Practice, Brescia and Verona, Italy.
Department of Surgery, University of Verona, Verone, Italy.
Clin Implant Dent Relat Res. 2018 Aug;20(4):653-664. doi: 10.1111/cid.12620. Epub 2018 May 15.
Different implant-abutment connections are available and it has been claimed they could have an effect on marginal bone loss. The aim of this review is to establish if implant connection configuration influences peri-implant bone loss (PBL) after functional loading.
A specific question was formulated according to the Population, Intervention, Control, and Outcome (PICO): Does the type of implant-abutment connection (external, internal, or conical) have an influence on peri-implant bone loss? A PubMed/MEDLINE electronic search was conducted to identify English language publications published in international journals during the last decade (from 2006 to 2016). The search was conducted by using the Medical Subject Headings (MeSH) keywords "dental implants OR dental abutment AND external connection OR internal connection OR conical connection OR Morse Taper." Selected studies were randomized clinical trials and prospective studies; in vitro studies, case reports and retrospective studies were excluded. Titles and abstracts and, in the second phase, full texts, were evaluated autonomously and in duplicate by two reviewers.
A total of 1649 articles were found, but only 14 studies met the pre-established inclusion criteria and were considered suitable for meta-analytic analysis. The network meta-analysis (NMA) suggested a significant difference between the external and the conical connections; this was less evident for the internal and conical ones. Platform-switching (PS) seemed to positively affect bone levels, non-regarding the implant-connection it was applied to.
Within the limitations of this systematic review, it can be concluded that crestal bone levels are better maintained in the short-medium term when internal kinds of interface are adopted. In particular, conical connections seem to be more advantageous, showing lower peri-implant bone loss, but further studies are necessary to investigate the efficacy of implant-abutment connection on stability of crestal bone levels.
有不同的种植体-基台连接方式，据称它们可能会对边缘骨丧失产生影响。本综述的目的是确定种植体连接结构是否会影响功能负载后的种植体周围骨丧失（PBL）。
根据人群、干预、对照和结局（PICO）制定了一个具体问题：种植体-基台连接类型（外连接、内连接或锥形连接）是否会影响种植体周围骨丧失？使用医学主题词（MeSH）关键词“dental implants OR dental abutment AND external connection OR internal connection OR conical connection OR Morse Taper”，对过去十年（2006 年至 2016 年）在国际期刊上发表的英文文献进行了 PubMed/MEDLINE 电子检索。独立地、重复地由两名评审员评估标题和摘要，以及在第二阶段，全文。排除了体外研究、病例报告和回顾性研究。共发现 1649 篇文章，但只有 14 项研究符合预先确定的纳入标准，并被认为适合进行荟萃分析。网络荟萃分析（NMA）表明，外连接和锥形连接之间存在显著差异；而内连接和锥形连接之间的差异则不太明显。平台转换（PS）似乎对骨水平有积极影响，而不考虑它所应用的种植体连接。
在本系统评价的限制范围内，可以得出结论，在短期到中期，采用内部连接类型时，牙槽骨水平得到更好的维持。特别是锥形连接似乎更有利，显示出较低的种植体周围骨丧失，但需要进一步的研究来研究种植体-基台连接对牙槽骨水平稳定性的影响。
