Department of Oral Implantology, The Affiliated Stomatology Hospital of Kunming Medical University, Kunming, China.
Department of Periodontics and Dental Hygiene, The University of Texas Health Science Center at Houston School of Dentistry, Houston, Texas, USA.
Clin Implant Dent Relat Res. 2021 Dec;23(6):883-903. doi: 10.1111/cid.13051. Epub 2021 Nov 10.
To evaluate the changes in buccal bone dimensions (CBD) following immediate implant placement in the maxillary esthetic zone and to identify the factors influencing the degree of buccal bone resorption for different placement and restoration protocols.
An electronic search was conducted using the EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), and MEDLINE (PubMed) databases, combined with a manual and gray literature search, up to January 2021. Selected clinical studies had to report the changes in horizontal buccal bone dimension in maxillary immediate implantation sites (premolar to premolar) at baseline and at follow-up visits within a year of implantation. A meta-analysis was conducted to calculate the mean value of the changes in horizontal and vertical buccal bone dimensions (CHBD and CVBD) around implants. To further investigate the heterogeneity and identify factors associated with buccal bone loss after immediate implant placement, subgroup analysis and univariate meta-regression were performed.
From a total of 3498 articles, 4 randomized controlled trials and 12 nonrandomized controlled trials were included for analysis. The mean survival rate of 568 implants was 99.6%. The mean CHBD and CVBD values were 0.71 mm (95% confidence interval: [0.56, 0.86]) and 0.58 mm (95% confidence interval: [0.43, 0.72]), respectively. For possible factors that related to bone resorption, including buccal bone thickness, flap design, bone grafting, horizontal defect dimension, and restoration protocol, bone grafting was the only variable that significantly influenced CHBD.
This study demonstrated that immediate implant placement in the esthetic zone does not prevent buccal bone from resorption. Due to data heterogeneity and the small sample size of the studies included in the analysis, further well-conducted, randomized controlled trials with homogeneous samples are required to investigate the correlation of CBD with different variables.
评估上颌美学区即刻种植体植入后颊侧骨宽度（CBD）的变化，并确定不同种植体植入和修复方案影响颊侧骨吸收程度的因素。
通过电子检索 EMBASE、Cochrane 中心对照试验注册库（CENTRAL）和 MEDLINE（PubMed）数据库，结合手动检索和灰色文献检索，检索截至 2021 年 1 月的资料。选择的临床研究必须报告在种植体植入后 1 年内，基线和随访时上颌即刻种植部位（前磨牙到前磨牙）颊侧骨水平维度的变化。进行荟萃分析以计算种植体周围颊侧骨水平和垂直维度（CHBD 和 CVBD）变化的平均值。为了进一步探讨异质性和确定与即刻种植体植入后颊侧骨丢失相关的因素，进行了亚组分析和单变量荟萃回归分析。
从总共 3498 篇文章中，纳入了 4 项随机对照试验和 12 项非随机对照试验进行分析。568 个种植体的平均存活率为 99.6%。CHBD 和 CVBD 的平均数值分别为 0.71mm（95%置信区间：[0.56，0.86]）和 0.58mm（95%置信区间：[0.43，0.72]）。对于可能与骨吸收相关的因素，包括颊侧骨厚度、瓣设计、植骨、水平缺损维度和修复方案，植骨是唯一显著影响 CHBD 的变量。
本研究表明，在美学区即刻植入种植体并不能防止颊侧骨吸收。由于数据的异质性和分析中纳入研究的样本量小，需要进一步进行良好设计、同质样本的随机对照试验，以研究 CBD 与不同变量的相关性。
