Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK; The School of Dentistry, University of Liverpool, Pembroke Place, Liverpool, UK; Broadway Dental Care, Broadway, Worcestershire, UK.
Aberdeen Dental School and Hospital Cornhill Road Aberdeen UK.
J Dent. 2019 May;84:9-21. doi: 10.1016/j.jdent.2019.03.008. Epub 2019 Mar 20.
To identify and appraise the most recent studies reporting dental implant survival in adults (≥18 years) using contemporary implant systems (solid screw, roughened surface) for a period of 10 years; and explore new predictors of implant survival.
MEDLINE, Scopus, and the Cochrane Central Register of Controlled trials were searched from 1997 to January 2018 to focus on contemporary implant systems.
Only prospective observational studies with at least 10 participants and 35 implants were included. The unit of study was the 'absolute survival' rate of dental implants after 10 years in the oral cavity. Study quality was assessed utilising a modified Hoy risk of bias tool for prevalence studies. A sensitivity meta-analysis was undertaken utilising a plausibly imputed model for missing data.
18 studies met the inclusion criteria. The summary estimate for 10-year survival at the implant level was 96.4% (95% CI 95.2%-97.5%) and the prediction interval was 91.5%-99.4%. The sensitivity meta-analysis summary estimate of survival was 93.2% (95% CI 90.1% to 95.8%)p = 0.041 with a prediction interval of 76.6%-100%. Older age (≥ 65 years) was a significant predictor at 91.5%, p = 0.038 in the sensitivity meta-analysis.
A traditional analysis produced similar 10-year survival estimates to previous systematic reviews. A more realistic sensitivity meta-analysis accounting for loss to follow-up data and the calculation of prediction intervals demonstrated a possible doubling of the risk of implant loss in the older age groups.
Improved analysis provides the clinician with better estimation of the real-world risk of implant failures so helping the clinician communicate the potential risk to patients.
确定并评价最近的研究报告，这些研究报告使用现代种植体系统（实心螺钉，粗糙表面）对成年人（≥18 岁）进行了 10 年的种植体存活情况，并探讨了种植体存活的新预测因子。
从 1997 年到 2018 年 1 月，在 MEDLINE、Scopus 和 Cochrane 对照试验中心注册库中进行了搜索，重点关注现代种植体系统。
仅纳入了至少有 10 名参与者和 35 枚种植体的前瞻性观察研究。研究单位是口腔内种植体 10 年后的“绝对存活率”。使用改良的 Hoy 偏倚风险工具评估研究质量，用于流行率研究。对于缺失数据，采用似然推断模型进行敏感性荟萃分析。
18 项研究符合纳入标准。10 年种植体存活率的汇总估计值为 96.4%（95%CI 95.2%-97.5%），预测区间为 91.5%-99.4%。敏感性荟萃分析的生存汇总估计值为 93.2%（95%CI 90.1%至 95.8%），p=0.041，预测区间为 76.6%-100%。年龄较大（≥65 岁）是敏感性荟萃分析中具有显著意义的预测因子，其 91.5%的概率为 p=0.038。
传统分析产生的 10 年生存率估计与以前的系统评价相似。更现实的敏感性荟萃分析考虑了失访数据，并计算了预测区间，结果表明，年龄较大的人群中种植体丢失的风险可能增加一倍。
改进后的分析为临床医生提供了对种植体失败实际风险的更好估计，从而帮助临床医生向患者传达潜在风险。
