Department of Oral Implantology, Jinhua Stomatological Hospital, 277 Silian Rd, Jinhua, 321000, Zhejiang Province, People's Republic of China.
Department of Stomatology, Yingtan Shangpin Dental Clinic, Yingtan, 335000, Jiangxi Province, People's Republic of China.
Int J Implant Dent. 2021 Apr 30;7(1):61. doi: 10.1186/s40729-021-00311-4.
Several authors have suggested that implants can be placed simultaneously with onlay bone grafts without affecting outcomes. Therefore, the purpose of this study was to answer the following clinical questions: (1) What are the outcomes of implants placed simultaneously with autogenous onlay bone grafts? And (2) is there a difference in outcomes between simultaneous vs delayed placement of implants with autogenous onlay bone grafts? Databases of PubMed, Embase, and Google Scholar were searched up to 15 November 2020. Data on implant survival was extracted from all the included studies (single arm and comparative) to calculate point estimates with 95% confidence intervals (CI) and pooled using the DerSimonian-Laird meta-analysis model. We also compared implant survival rates between the simultaneous and delayed placement of implants with data from comparative studies. Nineteen studies were included. Five of them compared simultaneous and delayed placement of implants. Dividing the studies based on follow-up duration, the pooled survival of implant placed simultaneously with onlay grafts after <2.5 years of follow-up was 93.1% (95% CI 82.6 to 97.4%) and after 2.5-5 years was 86% (95% CI 78.6 to 91.1%). Implant survival was found to be 85.8% (95% CI 79.6 to 90.3%) with iliac crest grafts and 95.7% (95% CI 83.9 to 93.0%) with intra-oral grafts. Our results indicated no statistically significant difference in implant survival between simultaneous and delayed placement (OR 0.43, 95% 0.07, 2.49, I=59.04%). Data on implant success and bone loss were limited. Data indicates that implants placed simultaneously with autogenous onlay grafts have a survival rate of 93.1% and 86% after a follow-up of <2.5 years and 2.5-5years respectively. A limited number of studies indicate no significant difference in implant survival between the simultaneous and delayed placement of implants with onlay bone grafts. There is a need for randomized controlled trials comparing simultaneous and delayed implant placement to provide robust evidence.
一些作者认为，在不影响结果的情况下，可以同时将种植体放置于骨移植术中。因此，本研究的目的是回答以下临床问题：（1）同时进行自体骨移植术的种植体的结果如何？（2）与自体骨移植术的延迟种植体相比，同时放置种植体的结果是否存在差异？研究人员检索了 PubMed、Embase 和 Google Scholar 数据库，截至 2020 年 11 月 15 日。从所有纳入的研究（单臂和对照研究）中提取种植体存活率数据，使用 DerSimonian-Laird 荟萃分析模型计算点估计值和 95%置信区间（CI），并进行合并。我们还比较了来自对照研究的数据，比较了同时和延迟放置种植体的存活率。共纳入 19 项研究。其中 5 项研究比较了同时和延迟放置种植体。根据随访时间将研究分组，2.5 年以下随访时同时放置骨移植术中种植体的累积存活率为 93.1%（95%CI 82.6%至 97.4%），2.5-5 年时为 86%（95%CI 78.6%至 91.1%）。髂嵴移植时的种植体存活率为 85.8%（95%CI 79.6%至 90.3%），口腔内移植时为 95.7%（95%CI 83.9%至 93.0%）。我们的结果表明，同时和延迟放置种植体的存活率之间无统计学显著差异（OR 0.43，95%CI 0.07，2.49，I=59.04%）。关于种植体成功和骨吸收的数据有限。数据表明，在 2.5 年以下和 2.5-5 年的随访中，同时将自体骨移植术中种植体放置的存活率分别为 93.1%和 86%。少数研究表明，在同时和延迟放置骨移植术中种植体的存活率之间没有显著差异。需要进行随机对照试验来比较同时和延迟放置种植体，以提供可靠的证据。
