Institute of Odontology, Faculty of Medicine, Vilnius University, Zalgirio str. 115/117, LT- 08217, Vilnius, Lithuania.
Stomatologija. 2021;23(2):35-40.
The aim of this systematic review and meta-analysis is to evaluate the impact of abutment disconnections / reconnections on peri-implant marginal bone loss changes in partially edentulous patients.
Clinical studies were selected via electronic and hand searches in English language journals until January 1, 2020. Only randomized clinical trials (RCGTs) and prospective controlled clinical trials (CCTs) showing direct comparison between the definitive implant abutments and multiple abutment replacements in the same patient or different patient groups in the partially edentulous patients were considered. The outcome measures were (1) the type of the abutment was used, (2) the time the abutment was placed, (3) marginal bone loss changes, (4) biological complications, (5) mechanical complications.
After evaluation, 4 controlled clinical studies were included. Majority of the articles reveled protective marginal bone loss preservation for the implants with FAP (final abutment placement) at the time of implant placement compared with the implants with MAP (multiple abutment placements) in connected dental implants, in partially edentulous patients. Meta-analysis of the four studies with 280 implants reviled significantly greater bone loss in cases with multiple abutment disconnections/reconnections. The weighted mean difference in marginal bone loss was 0.4 mm (95% confidence interval, 0.16-0.63 mm), showing bone preservation in the FAP group.
Within the limitations of this meta-analysis, multiple abutments disconnections significantly affected marginal bone loss changes in partially edentulous patients. The finding suggests to overview current prosthetic and surgical treatment planning protocols to prevent greater marginal bone loss.
本系统评价和荟萃分析旨在评估基台连接/断开对部分缺牙患者种植体边缘骨丧失变化的影响。
通过电子和手工搜索英文期刊，直到 2020 年 1 月 1 日，选择临床研究。仅纳入显示在部分缺牙患者中，同一患者或不同患者组中，最终种植体基台和多个基台替换之间直接比较的随机临床试验（RCT）和前瞻性对照临床试验（CCT）。观察指标为：（1）使用的基台类型；（2）放置基台的时间；（3）边缘骨丧失变化；（4）生物并发症；（5）机械并发症。
评估后，纳入 4 项对照临床研究。大多数文章表明，与连接的种植体相比，在种植体植入时使用 FAP（最终基台放置）可更好地保护种植体的边缘骨，而在连接的种植体中，使用 MAP（多个基台放置）会导致边缘骨丧失增加。对 4 项研究共 280 个种植体进行荟萃分析表明，在多次基台断开/重新连接的情况下，骨丢失明显更多。边缘骨丢失的加权平均差异为 0.4mm（95%置信区间，0.16-0.63mm），表明 FAP 组有骨保留。
在本荟萃分析的限制范围内，多个基台的断开会显著影响部分缺牙患者的边缘骨丧失变化。这一发现表明，需要重新审视当前的修复和手术治疗计划方案，以防止更大的边缘骨丢失。
