Department of Periodontics, School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, Texas.
Department of Advanced Oral Sciences & Therapeutics, School of Dentistry, University of Maryland, Baltimore, Maryland.
Clin Oral Implants Res. 2018 Oct;29 Suppl 16:255-269. doi: 10.1111/clr.13278.
This systematic review aimed at answering the following PICO question: In patients receiving immediate (Type 1) implant placement, how does immediate compare to early or conventional loading in terms of Patient-Reported Outcome Measures (PROMs)?
Following search strategy development, the OVID, PubMed, EMBASE, and Cochrane Database of Systematic Reviews databases were search for the relevant literature. All levels of evidence including randomized controlled trials, prospective and retrospective cohort studies, and case series of at least five patients were considered for possible inclusion. An additional manual search was performed by screening the reference lists of relevant studies and systematic reviews published up to May 2017. The intervention considered was the placement of immediate implant. Study selection and data extraction were performed independently by two reviewers.
The search yielded a list of 1,102 references, of which nine were included in this systematic review. The limited number of studies included and the heterogeneity of the data identified prevented the performance of a meta-analysis. Three studies, one of which was a randomized controlled trial, allowed the extraction of comparative data specific to the aim of the present systematic review. The remaining studies allowed only data extraction for one single treatment modality and were viewed as single cohort studies. Overall, irrespective of the PROMs chosen, patients' satisfaction was overall high with little difference between the two loading protocols. Moreover, studies indicated a positive impact on oral health-related quality of life following immediate implant placement and loading.
Within the limitations of the present systematic review, immediate implant placement and loading in single tooth edentulous space seems to be a well-accepted treatment modality from the patients' perspective and is worthy of consideration in clinical practice. However, the paucity of comparative data limits any definitive conclusions as to which loading protocol; immediate or early/conventional, should be given preference based on PROMs.
本系统评价旨在回答以下 PICO 问题：在接受即刻（1 型）种植体植入的患者中，即刻与早期或传统负载在患者报告的结果测量（PROM）方面有何不同？
在制定搜索策略后，在 OVID、PubMed、EMBASE 和 Cochrane 系统评价数据库中搜索相关文献。所有证据水平，包括随机对照试验、前瞻性和回顾性队列研究以及至少 5 例的病例系列研究，都被认为可能包含在内。通过筛选相关研究和截至 2017 年 5 月发表的系统评价的参考文献列表，进行了额外的手动搜索。考虑的干预措施是即刻种植体的放置。由两名独立的审稿人进行研究选择和数据提取。
搜索结果列出了 1102 篇参考文献，其中 9 篇被纳入本系统评价。纳入的研究数量有限，数据的异质性阻止了进行荟萃分析。三项研究，其中一项为随机对照试验，允许提取特定于本系统评价目的的比较数据。其余研究仅允许提取一种单一治疗模式的数据，被视为单一队列研究。总体而言，无论选择何种 PROM，患者的满意度总体较高，两种负载方案之间差异不大。此外，研究表明即刻种植体植入和负载后对口腔健康相关生活质量有积极影响。
在本系统评价的限制范围内，单颗牙缺失空间的即刻种植体植入和负载似乎是一种从患者角度来看可接受的治疗方式，值得在临床实践中考虑。然而，比较数据的缺乏限制了任何关于即刻或早期/传统负载方案应根据 PROM 优先考虑的明确结论。
