Department of Prosthodontics, School of Dentistry, Medical Center - University of Freiburg, Freiburg, Germany.
Department of Prosthodontics, School of Dentistry, Medical Center - University of Freiburg, Freiburg, Germany.
J Prosthodont Res. 2018 Oct;62(4):397-406. doi: 10.1016/j.jpor.2018.04.007. Epub 2018 Jul 5.
This systematic review evaluates the clinical outcome of zirconia implant-associated survival and success rates, marginal bone loss, and implant-restoration complex integrity.
Using the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines, studies including ≥10 patients restored with zirconia implants supporting single crowns (SCs) or fixed dental prostheses (FDPs) prior to January 2017 were identified. Primary outcomes were survival rates and marginal bone loss around one and two-piece zirconia implants and the associated implant-restoration complex integrity.
1349 studies were selected; after duplicate removal and title screening, 36 remained for full-text screening. 17 studies met the inclusion criteria: 2 randomized controlled clinical studies, 11 prospective clinical studies and 4 retrospective studies. In total, 1704 implants from 1002 patients were evaluated, including 1521 one-piece and 183 two-piece zirconia implants with follow-up between 1 and 7 years. The mean survival rate was 95% (95% CI 91-97%). The overall mean marginal bone loss was 0.98mm (95% CI 0.79-1.18); the mean marginal bone loss after 1year was 0.89mm (95% CI 0.60-1.18). No meta-analysis regarding prosthetic outcomes was possible.
Survival and marginal bone loss values after one year for one-piece zirconia implants are acceptable, but long-term studies are required to support their clinical use. No particular restoration material can be recommended; this decision is apparently based on clinicians' preferences. Results from two-piece implants do not provide sufficient data to support their clinical use and no abutment or cementing materials for two-piece zirconia implants can be recommended.
本系统评价评估了氧化锆种植体相关的存活率和成功率、边缘骨丧失以及种植体-修复体复合体完整性的临床结果。
使用系统评价和荟萃分析的首选报告项目（PRISMA）指南，确定了 2017 年 1 月前纳入≥10 例接受氧化锆种植体支持单冠（SCs）或固定义齿（FDPs）修复的患者的研究。主要结果是一、二部分氧化锆种植体的存活率和边缘骨损失以及相关的种植体-修复体复合体完整性。
筛选出 1349 项研究；重复去除和标题筛选后，有 36 项研究进行了全文筛选。17 项研究符合纳入标准：2 项随机对照临床试验、11 项前瞻性临床研究和 4 项回顾性研究。共有 1002 名患者的 1704 枚种植体接受了评估，其中包括 1521 枚单部件和 183 枚双部件氧化锆种植体，随访时间为 1 至 7 年。平均存活率为 95%（95%CI 91-97%）。总体平均边缘骨损失为 0.98mm（95%CI 0.79-1.18）；1 年后的平均边缘骨损失为 0.89mm（95%CI 0.60-1.18）。不可能对修复体结果进行meta 分析。
一年后单部件氧化锆种植体的存活率和边缘骨损失值是可以接受的，但需要进行长期研究来支持其临床应用。目前没有特定的修复材料可以推荐；这一决定显然是基于临床医生的偏好。双部件种植体的结果没有提供足够的数据支持其临床应用，也不能推荐双部件氧化锆种植体的基台或粘结材料。
