Professor, Prosthodontics, Faculty of Dentistry, Cairo University and Member of Evidence Based Dentistry Centre, Cairo University, Egypt.
Lecturer, Faculty of Dentistry, Delta University for Science and Technology, Egypt.
J Prosthet Dent. 2018 Nov;120(5):668-677. doi: 10.1016/j.prosdent.2018.01.019. Epub 2018 Jul 11.
Osteoporosis is a risk factor for implant success. Evidence for the prognosis of dental implants in patients with osteoporosis is still unclear.
The purpose of this systematic review was to compare implant success in patients with low versus normal bone density and to evaluate special techniques used to enhance implant success in these patients.
Searches were performed electronically in 4 databases (PubMed, LILACS, Cochrane, and Grey Literature) through July 2017 and manually to identify studies addressing the subject. Randomized and nonrandomized clinical trials and cohort studies were included.
Eleven studies met the eligibility criteria, with a total of 1071 participants. Seven studies compared implant success in low and normal bone density, and 4 compared implant success in special and conventional techniques of implant placement. The risk of bias in the assessment of cohort studies was critical; of nonrandomized clinical trials, serious; and of randomized clinical trials, high. The meta-analysis showed no significant difference between implant survival in patients with low and normal bone density 5 years after implant placement.
Implant survival in patients with low bone density seems to be feasible with special precautions. Implant placement using special adopted techniques might provide equivalent implant stability, survival, and marginal bone loss to normal bone. The quality of evidence is still unclear.
骨质疏松症是种植体成功的一个风险因素。骨质疏松症患者的牙种植预后证据仍不清楚。
本系统评价的目的是比较低骨密度和正常骨密度患者的种植体成功率，并评估用于提高这些患者种植体成功率的特殊技术。
通过 2017 年 7 月在 4 个数据库（PubMed、LILACS、Cochrane 和灰色文献）进行电子搜索，并手动搜索以确定涉及该主题的研究。纳入随机和非随机临床试验和队列研究。
符合纳入标准的研究共有 11 项，共 1071 名参与者。7 项研究比较了低骨密度和正常骨密度患者的种植体成功率，4 项研究比较了特殊和常规种植技术的种植体成功率。队列研究评估的偏倚风险为关键；非随机临床试验为严重；随机临床试验为高。荟萃分析显示，种植体放置后 5 年，低骨密度患者与正常骨密度患者的种植体存活率无显著差异。
在特殊预防措施下，低骨密度患者的种植体存活似乎是可行的。采用特殊采用的技术进行种植体放置可能提供与正常骨相同的种植体稳定性、存活率和边缘骨丢失。证据质量仍不清楚。
