Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Research Area: Oral Surgery, Section for Oral Biology and Immunopathology, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Dent Traumatol. 2022 Apr;38(2):105-116. doi: 10.1111/edt.12730. Epub 2022 Jan 8.
BACKGROUND/AIMS: Treatment after traumatic tooth loss is challenging and is currently guided by expert opinion and the individual patient situation. The aim of this study was to provide an overview on the outcome of dental implant treatment in the anterior maxilla after traumatic tooth loss, based on a systematic review of the existing evidence.
A systematic search of the literature was performed on PubMed, Cochran Library and Web of Science following the PRISMA guidelines based on a structured research question (PICO). All clinical studies of five patients or more with follow-up of at least 1 year after implant loading were included. Patients were at least 18 years of age. Cohen's Kappa-coefficient was calculated. The Newcastle-Ottawa Scale was applied to assess the quality of the included studies. Descriptive statistical methods were applied.
Nine hundred and ninety-nine articles were identified through the systematic search. Finally, six articles were eligible for inclusion. The studies comprised prospective and retrospective cohort studies and case series. From these, 96 patients with 120 implants were included. The age ranged from 18 to 59 years. The survival rates of implants and superstructures were 97% and 95%, respectively, after a mean follow-up of 3.5 years. Mean marginal bone resorption was 0.56 mm (range 0.21-1.30 mm). Complication rates were 7% and 11% on implant and superstructure level, respectively. Patient-reported outcome measures and objective evaluations showed a high level of satisfaction with the aesthetic outcome. Bone augmentation was performed in 60 implant sites. Three patients underwent pre-surgical orthodontic treatment. The maxillary central incisor was the most frequently replaced tooth (70%).
This systematic review revealed a low level of evidence on the outcome of dental implant treatment after traumatic tooth loss. Systematic reporting of treatment outcomes of tooth replacements after dental trauma is highly encouraged to further guide dentists for the benefit of these challenging patients.
背景/目的：外伤性牙齿缺失后的治疗具有挑战性，目前主要依据专家意见和患者个体情况来指导。本研究旨在通过系统回顾现有证据，概述外伤性上颌前牙缺失后牙种植治疗的结果。
根据结构化研究问题（PICO），按照 PRISMA 指南，在 PubMed、Cochrane 图书馆和 Web of Science 上进行了系统的文献检索。纳入了至少有 5 名患者且在种植体负荷后至少随访 1 年的所有临床研究。患者年龄至少 18 岁。计算 Cohen's Kappa 系数。应用纽卡斯尔-渥太华量表评估纳入研究的质量。应用描述性统计方法。
通过系统检索共确定了 999 篇文章。最终，有 6 篇文章符合纳入标准。这些研究包括前瞻性和回顾性队列研究以及病例系列研究。其中纳入了 96 名患者的 120 个种植体。患者年龄为 18-59 岁。平均随访 3.5 年后，种植体和上部结构的存活率分别为 97%和 95%。平均边缘骨吸收量为 0.56mm（范围为 0.21-1.30mm）。种植体和上部结构的并发症发生率分别为 7%和 11%。患者报告的结果测量和客观评估显示对美学结果的满意度较高。在 60 个种植部位进行了骨增量，3 名患者接受了术前正畸治疗。上颌中切牙是最常被替换的牙齿（70%）。
本系统综述显示外伤性牙齿缺失后牙种植治疗结果的证据水平较低。强烈鼓励系统报告牙外伤后牙齿替换的治疗结果，以进一步为这些具有挑战性的患者指导牙医。
