Alqutaibi Ahmed Yaseen, Elawady Dina Mohamed Ahmed
Quintessence Int. 2020;51(4):294-302. doi: 10.3290/j.qi.a44144.
To evaluate the influence of implant splinting on peri-implant marginal bone level and implant failures in completely edentulous patients who have been rehabilitated with mandibular implant overdentures.
A literature search of electronic databases (PubMed and Cochrane Central Register of Controlled Trials [CENTRAL]) was performed, with the last search conducted in July 2019. Randomized controlled trials with at least a 12-month follow-up period were selected. The review and meta-analysis were performed in accordance with PRISMA guidelines. Two comparisons were included in the meta-analysis: (1) Two-implant supported ball versus two-implant supported bar mandibular overdenture; (2): Two- versus four-implant supported bar mandibular overdenture.
Six randomized controlled trials fulfilled the inclusion criteria and were included in a quality assessment and meta-analysis. Pooled data revealed a nonsignificant difference in marginal bone level (I2 = 0%; P = 1; mean difference = 0.00; 95% CI -0.37 to 0.37) and implant failures (P = .24; risk ratio = 6.07; 95% CI 0.30 to 121.33) when two-implant ball overdentures were compared to two-implant bar overdentures. Similarly, there was no significant difference in marginal bone level (I2 = 59%; P = .59; mean difference = -0.16; 95% CI -0.73 to 0.41) or implant failures (I2 = 0%; P = .36; risk ratio = 2.03; 95% CI 0.45 to 9.16) when two- versus four-implant bar overdentures were compared.
Based on the findings of the meta-analysis, there is no influence of implant splinting on peri-implant marginal bone level and implant failures for completely edentulous patients rehabilitated with mandibular implant overdentures. However, this result should be interpreted with caution due to the limited number of analyzed studies, most of them considered at unclear risk of bias. Well-designed randomized controlled trials with follow-up periods of at least 5 years are highly recommended to establish evidence with regard to the influence of implant splinting on mandibular overdentures.
评估种植体夹板固定对采用下颌种植覆盖义齿修复的全口无牙患者种植体周围边缘骨水平及种植体失败情况的影响。
对电子数据库（PubMed和Cochrane对照试验中心注册库[CENTRAL]）进行文献检索，最后一次检索于2019年7月进行。选取随访期至少为12个月的随机对照试验。根据PRISMA指南进行综述和荟萃分析。荟萃分析纳入两项比较：（1）两颗种植体支持的球状附着体与两颗种植体支持的杆式下颌覆盖义齿；（2）两颗种植体支持的杆式下颌覆盖义齿与四颗种植体支持的杆式下颌覆盖义齿。
六项随机对照试验符合纳入标准，被纳入质量评估和荟萃分析。汇总数据显示，在比较两颗种植体球状附着体覆盖义齿与两颗种植体杆式覆盖义齿时，边缘骨水平（I² = 0%；P = 1；平均差 = 0.00；95%可信区间 -0.37至0.37）和种植体失败情况（P = 0.24；风险比 = 6.07；95%可信区间0.30至121.33）无显著差异。同样，在比较两颗种植体杆式覆盖义齿与四颗种植体杆式覆盖义齿时，边缘骨水平（I² = 59%；P = 0.59；平均差 = -0.16；95%可信区间 -0.73至0.41）或种植体失败情况（I² = 0%；P = 0.36；风险比 = 2.03；95%可信区间0.45至9.16）也无显著差异。
基于荟萃分析结果，对于采用下颌种植覆盖义齿修复的全口无牙患者，种植体夹板固定对种植体周围边缘骨水平及种植体失败情况没有影响。然而，由于分析的研究数量有限，且其中大多数研究的偏倚风险不明确，因此对这一结果的解读应谨慎。强烈建议开展设计良好、随访期至少为5年的随机对照试验，以确定种植体夹板固定对下颌覆盖义齿影响的证据。
