Di Fiore Adolfo, Montagner Mattia, Sivolella Stefano, Stellini Edoardo, Yilmaz Burak, Brunello Giulia
Department of Neurosciences, School of Dentistry, University of Padova, 35128 Padova, Italy.
Private Practice, 35121 Padova, Italy.
J Clin Med. 2022 Aug 17;11(16):4812. doi: 10.3390/jcm11164812.
The present review aimed to assess the possible relationship between occlusal overload and peri-implant bone loss. In accordance with the PRISMA guidelines, the MEDLINE, Scopus, and Cochrane databases were searched from January 1985 up to and including December 2021. The search strategy applied was: (dental OR oral) AND implants AND (overload OR excessive load OR occlusal wear) AND (bone loss OR peri-implantitis OR failure). Clinical studies that reported quantitative analysis of occlusal loads through digital contacts and/or occlusal wear were included. The studies were screened for eligibility by two independent reviewers. The quality of the included studies was assessed using the Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool. In total, 492 studies were identified in the search during the initial screening. Of those, 84 were subjected to full-text evaluation, and 7 fulfilled the inclusion criteria (4 cohort studies, 2 cross-sectional, and 1 case-control). Only one study used a digital device to assess excessive occlusal forces. Four out of seven studies reported a positive correlation between the overload and the crestal bone loss. All of the included studies had moderate to serious overall risk of bias, according to the ROBINS-I tool. In conclusion, the reported data relating the occlusal analysis to the peri-implant bone level seem to reveal an association, which must be further investigated using new digital tools that can help to standardize the methodology.
本综述旨在评估咬合负荷过重与种植体周围骨丢失之间可能存在的关系。根据PRISMA指南，检索了1985年1月至2021年12月的MEDLINE、Scopus和Cochrane数据库。应用的检索策略为：（牙科或口腔）与种植体与（负荷过重或过度负荷或咬合磨损）与（骨丢失或种植体周围炎或失败）。纳入了通过数字接触和/或咬合磨损报告咬合负荷定量分析的临床研究。由两名独立评审员对研究进行合格性筛选。使用干预性非随机研究中的偏倚风险（ROBINS-I）工具评估纳入研究的质量。在初步筛选过程中，检索共识别出492项研究。其中，84项接受了全文评估，7项符合纳入标准（4项队列研究、2项横断面研究和1项病例对照研究）。只有一项研究使用数字设备评估过大的咬合力。七项研究中有四项报告负荷过重与牙槽嵴骨丢失之间存在正相关。根据ROBINS-I工具，所有纳入研究的总体偏倚风险为中度至重度。总之，所报告的将咬合分析与种植体周围骨水平相关的数据似乎揭示了一种关联，必须使用有助于规范方法的新数字工具进一步研究。
