种植体表面特性和/或种植体材料对种植体周围炎的发生和进展有何影响？系统文献回顾。

What is the influence of implant surface characteristics and/or implant material on the incidence and progression of peri-implantitis? A systematic literature review.

机构信息

Division of Regenerative Dental Medicine and Periodontology, University Clinics of Dental Medicine (CUMD), University of Geneva, Geneva, Switzerland.

Department of Periodontology, Faculty of Odontology, University of Malmö, Malmö, Sweden.

出版信息

Clin Oral Implants Res. 2021 Oct;32 Suppl 21:203-229. doi: 10.1111/clr.13859.

DOI:10.1111/clr.13859

PMID:34642989

Abstract

OBJECTIVES

To answer the focused question, 'In animals or patients with dental implants, does implant surface characteristics and/or implant material have an effect on incidence and progression of peri-implantitis?'

MATERIAL AND METHODS

Pre-clinical in vivo experiments on experimental peri-implantitis and clinical trials with any aim and design, and ≥5 years follow-up, where the effect of ≥2 different type of implant material and/or surface characteristics on peri-implantitis incidence or severity, and/or progression, implant survival or losses due to peri-implantitis, and/or marginal bone levels/loss was assessed.

RESULTS

Meta-analyses based on data of pre-clinical experiments, using the ligature induced peri-implantitis model in the dog, indicated that after the spontaneous progression phase implants with a modified surface showed significantly greater radiographic bone loss (effect size 0.44 mm; 95%CI 0.10-0.79; p = .012; 8 publications) and area of infiltrated connective tissue (effect size 0.75 mm ; 95%CI 0.15-1.34; p = .014; 5 publications) compared to non-modified surfaces. However, in 9 out of the 18 included experiments, reported in 25 publications, no significant differences were shown among the different implant surface types assessed. Clinical and/or radiographic data from 7605 patients with 26,188 implants, reported in 31 publications (20 RCTs, 3 CTs, 4 prospective cohort, and 4 retrospective studies; 12 with follow-up ≥10 years), overall did not show significant differences in the incidence of peri-implantitis, when this was reported or could be inferred, among the various implant surfaces. In general, high survival rates (90-100%) up to 30 years and no clinically relevant differences in marginal bone loss/levels, merely compatible with crestal remodelling, were presented for the various implant types.

CONCLUSION

Pre-clinical in vivo experiments indicate that surface characteristics of modified implants may have a significant negative impact on peri-implantitis progression, while clinical studies do not support the notion that there is a difference in peri-implantitis incidence among the various types of implant surfaces. No assumptions can be made regarding the possible impact of implant material on incidence and/or peri-implantitis progression due to limited information.

摘要

目的

回答聚焦问题，“在动物或植入物患者中，种植体表面特性和/或种植体材料对种植体周围炎的发生和进展有影响吗？”

材料和方法

针对实验性种植体周围炎的临床前体内实验和任何目的及设计的临床试验，随访时间≥5 年，评估≥2 种不同类型的种植体材料和/或表面特性对种植体周围炎发生率或严重程度、进展、种植体存活率或因种植体周围炎导致的损失、以及边缘骨水平/损失的影响。

结果

基于临床前实验数据的荟萃分析，使用犬结扎诱导的种植体周围炎模型，表明在自发进展阶段后，具有改良表面的种植体显示出明显更大的放射影像学骨丧失（效应大小 0.44mm；95%CI 0.10-0.79；p=0.012；8 项研究）和浸润性结缔组织面积（效应大小 0.75mm；95%CI 0.15-1.34；p=0.014；5 项研究），与非改良表面相比。然而，在 18 项实验中的 9 项中，在 25 项研究报告中，未显示评估的不同种植体表面类型之间存在显著差异。31 项研究（20 项 RCT、3 项 CT、4 项前瞻性队列研究和 4 项回顾性研究）报告了 7605 名患者 26188 个种植体的临床和/或放射影像学数据（12 项研究的随访时间≥10 年），总体而言，在报告或可以推断的种植体周围炎发生率方面，各种种植体表面之间没有显著差异。一般来说，各种种植体类型的存活率高达 90-100%（长达 30 年），边缘骨损失/水平无明显差异，仅与牙骨质重塑相兼容。