Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Dental School, University of Zurich, Zurich, Switzerland.
Clin Oral Implants Res. 2018 Oct;29 Suppl 18:309-325. doi: 10.1111/clr.13291.
The aim of this systematic review was to assess clinical evidence on adverse effects of osseointegrated implants placed among natural teeth of a residual dentition.
Seven databases were searched without restrictions up to January 2018 for clinical studies on implant infraposition (IIP) or proximal contact point (PCP) loss to the adjacent teeth. After duplicate selection, data extraction, and risk of bias assessment according to the Cochrane guidelines, random-effects meta-analyses of odds ratios (OR) or mean differences (MD) and their 95% confidence intervals (CI) were performed, followed by meta-regression and sensitivity analyses.
A total of 27 nonrandomized studies with 1,572 patients (mean age 42.2 years/51.2% female) followed up to 18.5 years after implant placement were included. The pooled %prevalence of IIP was 50.5% (nine studies; 95% CI = 26.3-74.5%), and the pooled IIP extent was 0.58 mm (six studies; 95% CI = 0.33-0.83 mm), while IIP > 1 mm was seen for 20.8% of placed implants (five studies; 95% CI = 8.3-37.1%), and male patients were less prone to IIP than female patients (three studies; OR = 0.30; 95% CI = 0.10-0.88; p = 0.03). The pooled %prevalence of PCP loss was 46.3% (nine studies; 95% CI = 32.3-60.6%), with increase through observation time (two studies; OR = 1.09; 95% CI = 1.03-1.16; p = 0.004) and predilection for mesial PCPs (five studies; OR = 2.25; 95% CI = 1.06-4.77; p = 0.03). However, the quality of evidence was very low due to bias.
Patients and doctors need to be aware that long-term adverse effects of dental implants among natural teeth can be observed in terms of IIP and PCP loss to the adjacent teeth.
本系统评价的目的是评估在天然牙残留牙列中植入骨整合种植体的不良影响的临床证据。
对七个数据库进行了无限制搜索，截至 2018 年 1 月，检索有关种植体下移位（IIP）或近中接触点（PCP）损失到相邻牙齿的临床研究。根据 Cochrane 指南进行重复选择、数据提取和偏倚风险评估后，进行了优势比（OR）或均数差（MD）及其 95%置信区间（CI）的随机效应荟萃分析，随后进行了 meta 回归和敏感性分析。
共纳入 27 项非随机研究，涉及 1572 名患者（平均年龄 42.2 岁/51.2%为女性），在种植体放置后最长 18.5 年进行随访。IIP 的总患病率为 50.5%（9 项研究；95%CI=26.3-74.5%），IIP 程度为 0.58mm（6 项研究；95%CI=0.33-0.83mm），而放置的种植体中 IIP>1mm 的比例为 20.8%（5 项研究；95%CI=8.3-37.1%），男性患者发生 IIP 的可能性低于女性患者（3 项研究；OR=0.30；95%CI=0.10-0.88；p=0.03）。PCP 丧失的总患病率为 46.3%（9 项研究；95%CI=32.3-60.6%），随着观察时间的延长而增加（两项研究；OR=1.09；95%CI=1.03-1.16；p=0.004），并且偏爱近中 PCP（五项研究；OR=2.25；95%CI=1.06-4.77；p=0.03）。但是，由于存在偏倚，证据质量非常低。
患者和医生需要意识到，在天然牙中植入牙种植体的长期不良影响可能表现为 IIP 和 PCP 向相邻牙齿的损失。
