Palacios-Garzón Natalia, Mauri-Obradors Elisabeth, Roselló-LLabrés Xavier, Estrugo-Devesa Albert, Jané-Salas Enric, López-López José
Int J Oral Maxillofac Implants. 2018 May/Jun;33(3):580-589. doi: 10.11607/jomi.6190.
The objective of this systematic review was to compare the loss of marginal bone between implants with internal and external connections by analyzing results reported in studies published after 2010.
A literature search in MEDLINE with the keywords "dental implant connections, external internal implant connection, bone loss implant designs, internal and external connection implant studies in humans" was conducted. Clinical trials on human beings, comparing both connections and published in English, from 2010 to 2016 were selected. Their methodologic quality was assessed using the Jadad scale.
From the initial search, 415 articles were obtained; 32 were chosen as potentially relevant based on their titles and abstracts. Among them, only 10 finally met the inclusion criteria. A total of 1,523 patients with 3,965 implants were analyzed. Six out of 10 studies observed that internal connections showed significantly less bone loss compared with external connections. The remaining four articles did not find statistically significant differences between the two connections.
According to this systematic review and considering its limitation due to the degree of heterogeneity between the included studies, both internal and external connections present high survival rates. To assess whether marginal bone loss differs significantly between the two connections, more homogenous clinical studies are needed with identical implant characteristics, larger samples, and longer follow-up periods. Studies included in this review and characterized by long-term follow-ups showed that the external connection is a reliable connection on a long-term basis.
本系统评价的目的是通过分析2010年后发表的研究报告结果，比较内连接种植体和外连接种植体之间的边缘骨丧失情况。
在MEDLINE中进行文献检索，关键词为“牙种植体连接、种植体内外连接、种植体设计的骨丧失、人类内连接和外连接种植体研究”。选择2010年至2016年发表的、比较两种连接方式且为英文的人体临床试验。使用Jadad量表评估其方法学质量。
从初始检索中获得415篇文章；根据标题和摘要，32篇被选为可能相关的文章。其中，最终只有10篇符合纳入标准。共分析了1523例患者的3965颗种植体。10项研究中有6项观察到，与外连接相比，内连接的骨丧失明显更少。其余4篇文章未发现两种连接方式之间存在统计学显著差异。
根据本系统评价，并考虑到纳入研究之间的异质性程度所带来的局限性，内连接和外连接的生存率都很高。为了评估两种连接方式之间的边缘骨丧失是否存在显著差异，需要进行更多具有相同种植体特征、更大样本量和更长随访期的同类临床研究。本评价中纳入的具有长期随访特点的研究表明，外连接在长期来看是一种可靠的连接方式。
