Altaib Fouad Hassan, Alqutaibi Ahmed Yaseen, Al-Fahd Adnan, Eid Sherif
Quintessence Int. 2019;50(8):636-650. doi: 10.3290/j.qi.a42948.
To evaluate if short implants without augmentation can be considered a successful alternative treatment modality in the rehabilitation of posterior atrophic ridges when compared to standard-length implants with augmentation.
Electronic searches were performed in the PubMed and Cochrane Central Register of Controlled Trials (CENTRAL) databases. Randomized controlled trials (RCTs) that compared short implants and standard implants with augmentation were the only articles included. Titles and abstracts were screened, data were extracted, and articles were assessed for risk of bias. Meta-analyses were performed for 13 of the included RCTs that had similar outcome measures.
Of the total 17 relevant studies identified, 13 RCTs fulfilled the inclusion criteria. The meta-analysis showed no significant differences regarding the implant failure rate at 1 year (I2 = 67%, P = .13; risk difference [RD]: -0.05, 95% confidence interval [CI]: -0.11, 0.01), at 3 years (I2 = 58%, P = .17; RD: -0.04, 95% CI: -0.01, 0.02), and at 5 to 10 years (I2 = 0%, P = .47; RD: -0.05, 95% CI: -0.19, 0.09). However, the meta-analyses of 10 trials regarding the postoperative complications of short- and standard-length dental implants showed a significantly higher rate of postoperative complications in the standard-length dental implant group at 1 year (I2 = 93%, P = .02; RD: -0.21, 95% CI: -0.39, -0.04).
Short dental implants seem to be an effective alternative treatment for the atrophic posterior ridge. The pooled data revealed that short dental implants have statistically less marginal bone loss and fewer postoperative complications when compared to standard-length dental implants with augmentation. However, there are no statistically significant differences in regard to implant failure.
评估与采用植骨术的标准长度种植体相比,未进行植骨术的短种植体在修复后牙区萎缩性牙槽嵴时是否可被视为一种成功的替代治疗方式。
在PubMed和Cochrane对照试验中央注册库(CENTRAL)数据库中进行电子检索。仅纳入比较短种植体和采用植骨术的标准种植体的随机对照试验(RCT)。对标题和摘要进行筛选,提取数据,并评估文章的偏倚风险。对13项具有相似结局指标的纳入RCT进行荟萃分析。
在总共识别出的17项相关研究中,13项RCT符合纳入标准。荟萃分析显示,1年时种植体失败率无显著差异(I² = 67%,P = 0.13;风险差异[RD]:-0.05,95%置信区间[CI]:-0.11,0.01),3年时(I² = 58%,P = 0.17;RD:-0.04,95% CI:-0.01,0.02),以及5至10年时(I² = 0%,P = 0.47;RD:-0.05,95% CI:-0.19,0.09)。然而,10项关于短长度和标准长度牙种植体术后并发症的试验的荟萃分析显示,标准长度牙种植体组在1年时术后并发症发生率显著更高(I² = 93%,P = 0.02;RD:-0.21,95% CI:-0.39,-0.04)。
短牙种植体似乎是萎缩后牙区的一种有效替代治疗方法。汇总数据显示,与采用植骨术的标准长度牙种植体相比,短牙种植体在统计学上边缘骨丢失更少,术后并发症更少。然而,在种植体失败方面无统计学显著差异。