Section of Graduate Periodontology, University Complutense, Madrid, Spain.
ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain.
Clin Oral Implants Res. 2018 Oct;29 Suppl 18:124-144. doi: 10.1111/clr.13293. Epub 2018 Jun 15.
The primary aim of this systematic review was to evaluate the available evidence on the effect of the abutment material on the stability and health of the peri-implant hard tissues.
A protocol was developed to answer the following focused question: "Which is the effect of the abutment material on stability and health of the peri-implant hard tissues?" Randomized controlled trials (RCTs), controlled clinical trials (CCTs) or prospective case series (CS) with at least 6 months of follow-up were included, and meta-analyses were performed to compare abutment materials vs. titanium and to evaluate the impact of various abutment materials on bone changes (primary outcome), probing depth, plaque levels and peri-implant mucosal inflammation.
Twenty-nine publications from 33 investigations were included. Results from the meta-analyses demonstrated no significant differences between the different abutment materials when compared to titanium, in regard to the changes in marginal bone levels (MBLs) (n = 15; WMD = 0.034; 95% CI [-0.04, 0.10]; p < 0.339). The meta-analysis reported a significantly greater increase in bleeding on probing for titanium compared to zirconia abutments (n = 3; WMD = -26.96%; 95% CI [-45.00%, -8.92%]; p = 0.003). When evaluating the behaviour of each material different to titanium, there was a significant bone loss over time (n = 31; WMD = 0.261; 95% CI [0.18, 0.35]; p < 0.001) for all the individual materials except for titanium nitride.
This systematic review has shown that the abutment material had minimal impact on marginal bone levels when compared to the standard titanium.
本系统评价的主要目的是评估基台材料对种植体周围硬组织稳定性和健康的影响。
制定了一个方案来回答以下聚焦问题：“基台材料对种植体周围硬组织的稳定性和健康有何影响？” 纳入了随机对照试验（RCT）、对照临床试验（CCT）或前瞻性病例系列（CS），随访时间至少为 6 个月，并进行荟萃分析以比较基台材料与钛的差异，并评估各种基台材料对骨变化（主要结局）、探诊深度、菌斑水平和种植体周围黏膜炎症的影响。
纳入了 33 项研究中的 29 篇文献。荟萃分析结果表明，不同基台材料与钛相比，在边缘骨水平（MBL）变化方面无显著差异（n = 15；WMD = 0.034；95%CI [-0.04, 0.10]；p < 0.339）。荟萃分析报告称，与钛基台相比，氧化锆基台的探诊出血显著增加（n = 3；WMD = -26.96%；95%CI [-45.00%, -8.92%]；p = 0.003）。当评估每种与钛不同的材料的行为时，所有单独的材料除了氮化钛外，随着时间的推移均出现明显的骨丢失（n = 31；WMD = 0.261；95%CI [0.18, 0.35]；p < 0.001）。
本系统评价表明，与标准钛相比，基台材料对边缘骨水平的影响较小。
