Int J Prosthodont. 2020 May/Jun;33(3):297-306. doi: 10.11607/ijp.6577.
To evaluate the effect of different abutment morphologies on peri-implant hard and soft tissue behavior.
The focus question for this literature search was: What are the effects of different abutment morphology (concave vs convex) on peri-implant hard and soft tissue behavior? Randomized clinical trials (RCTs) with a minimum sample size of 20 implants (10 per group) and a follow-up period of at least 3 months after implant loading were considered eligible for this study. This review excluded studies comparing different abutment heights or surfaces and different implant shapes. Two different meta-analyses were performed: one for marginal bone loss (MBL) to evaluate hard tissue changes, and one for Pink Esthetic Score (PES) as an indicator of soft tissue modifications.
Four publications from 12 full texts analyzed were included. The meta-analysis (data from 117 patients and 173 abutments) indicated that a statistically significant difference (P < .00001) was detected from the data regarding MBL between the two groups (mean difference = -0.21 [95% CI: -0.25, -0.16]), but not considering the PES (mean difference = -0.69 [95% CI: -2.08, 0.70]) after a minimum period of 3 months after implant loading. All such evidence was confirmed by the trial sequential analysis on both MBL and PES.
The results demonstrate that abutment design may have an influence on MBL but no impact on soft tissues. However, the existing evidence is moderate, as few RCTs were conducted and follow-up periods were short.
评估不同基台形态对种植体周围软硬组织的影响。
本次文献检索的焦点问题是：不同基台形态（凹面与凸面）对种植体周围软硬组织的影响有何不同？符合条件的研究为至少 20 个种植体（每组 10 个），且在种植体负载后至少有 3 个月的随访期的随机临床试验（RCT）。本综述排除了比较不同基台高度或表面以及不同种植体形状的研究。进行了两次不同的荟萃分析：一次用于评估硬组织变化的边缘骨丧失（MBL），另一次用于评估软组织变化的 Pink 美学评分（PES）。
从 12 篇全文分析中纳入了 4 篇文献。荟萃分析（来自 117 名患者和 173 个基台的数据）表明，两组之间 MBL 的数据存在统计学显著差异（P <.00001）（平均差异= -0.21 [95%CI：-0.25，-0.16]），但不考虑 PES（平均差异= -0.69 [95%CI：-2.08，0.70]），在种植体负载后至少 3 个月。基于 MBL 和 PES 的试验序贯分析均证实了所有这些证据。
结果表明，基台设计可能对 MBL 有影响，但对软组织没有影响。然而，由于进行的 RCT 较少且随访期较短，因此现有证据为中等强度。
