Department of Reconstructive Dentistry & Gerodontology, School of Dental Medicine, Faculty of Medicine, University of Bern, 3010 Bern, Switzerland; Department of Oral Surgery and Stomatology, School of Dental Medicine, Faculty of Medicine, University of Bern, 3010 Bern, Switzerland; Division of Restorative Dental Sciences, College of Dentistry, Ajman University, 346 Ajman City, UAE; Department of Restorative Dentistry, Edinburgh Dental Institute, University of Edinburgh, College of Medicine and Veterinary, Lauriston Place, Edinburgh, EH3 9HA, UK; Department of Oral Health Sciences, University of British Columbia, Vancouver, BC V6T 1Z3, Canada.
Department of Reconstructive Dentistry & Gerodontology, School of Dental Medicine, Faculty of Medicine, University of Bern, 3010 Bern, Switzerland; Department of Preventive & Restorative Sciences, University of Pennsylvania School of Dental Medicine, Philadelphia, PA 19104, USA.
J Stomatol Oral Maxillofac Surg. 2021 Jun;122(3):303-310. doi: 10.1016/j.jormas.2020.08.013. Epub 2020 Sep 28.
This review primarily evaluated the success, survival and failure rates of implants shorter than 10 mm restored with single-unit or splinted fixed dental prostheses in maxillary sinus augmented sites.
Two reviewers independently performed the systematic search of electronic databases, including MEDLINE, EMBASE and CENTRAL, up to September 2019 with no language restriction. A supplemental hand search consisted of screening 13 journals. The inclusion criteria were: primary studies reporting implant, prosthetic and patient-reported outcome measures (PROMs) of extra-short and short implants placed in conjunction with sinus floor elevation in partially dentate patients, restored with single- and splinted-crowns for direct comparison, with a minimal 1-year follow-up. Weighted arithmetic mean (WAM) of the implant survival was performed according to the type of prosthesis. This was confirmed by using Review Manager software to perform meta-analysis.
Two observational studies reporting on 106 tapered, press-fit, sintered porous-surfaced implants with a length ranging from 5 mm to 9 mm were included in this systematic review. Of these, 20 and 86 implants were restored with single and splinted prostheses, respectively. The risk ratio (RR) was 1.16 (95% CI: .31-4.30, p = .58, I² = 0%) for individually restored implants failure when compared to splinted implants, indicating that short dental implants restored with single crowns could have a 16% higher possibility of failure if compared to implants with splinted crowns. The heterogeneity value was not statistically significative (p = .58). No statistical difference in the implant survival rate of the two types of analysed prostheses was observed after WAM (p= .923). The level of evidence for the included studies ranged from low (4) to fair (2B).
Similar clinical outcomes up to a 9-year follow-up were observed in single and splinted porous-surfaced implants shorter than 10 mm located in sites with sinus lift. However, the conclusion shall be interpreted with caution due to the level of evidence and limited number of included studies included in this systematic review.
本综述主要评估上颌窦增高区植入体长度小于 10mm 的单冠或桥体固定修复体的成功率、存活率和失败率。
两位评审员独立检索电子数据库，包括 MEDLINE、EMBASE 和 CENTRAL，检索时间截至 2019 年 9 月，无语言限制。此外，还进行了补充的手工检索，筛选了 13 种期刊。纳入标准为：主要研究报告了在上颌窦提升区植入体长度小于 10mm 的短种植体，并与窦底提升相结合，在部分缺牙患者中进行种植，同时使用单冠和桥体修复，直接比较，随访时间至少 1 年。根据修复体类型，采用加权算术平均值（WAM）计算种植体存活率。使用 Review Manager 软件进行荟萃分析来确认。
本系统综述共纳入 2 项观察性研究，共报告了 106 个锥形、压配、烧结多孔表面种植体，长度为 5-9mm。其中，20 个和 86 个种植体分别用单冠和桥体修复。与桥体修复的种植体相比，单独修复的种植体失败的风险比（RR）为 1.16（95%CI：.31-4.30，p=0.58，I²=0%），这表明与桥体修复的种植体相比，用单冠修复的短种植体失败的可能性高 16%。异质性值无统计学意义（p=0.58）。经 WAM 后，两种分析修复体的种植体存活率无统计学差异（p=0.923）。纳入研究的证据水平为低（4）至中等（2B）。
在上颌窦提升区，使用单冠或桥体修复长度小于 10mm 的多孔表面种植体，9 年随访的临床效果相似。然而，由于本系统综述纳入研究的证据水平和数量有限，结论应谨慎解释。
