Periodontology Unit, Faculty of Odontology and Medicine, University of Santiago de Compostela and Medical-Surgical Dentistry Research Group, Health Research Institute of Santiago de Compostela, Santiago de Compostela, Spain.
Department of Prosthodontics, University Hospital Erlangen of Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany.
J Clin Periodontol. 2023 Feb;50(2):158-169. doi: 10.1111/jcpe.13733. Epub 2022 Oct 22.
The aim was to systematically evaluate the effect of low insertion torque values on the survival rate of immediately loaded dental implants.
The protocol was registered with PROSPERO (ID CRD42020189499). An electronic search was performed in PubMed, Embase, Web of Science, and Cochrane Central Register of Controlled Trials until June 2022 in English and Spanish. Studies analysing the failure or survival rate of immediately loaded dental implants according to different insertion torque values were included.
Five-hundred seventy-three articles were assessed for eligibility, of which seven articles, four randomized clinical trials (RCTs), one controlled clinical trial, and two prospective case series studies were included in the qualitative analysis. The RCTs were classified as having low risk of bias and the non-RCTs as having moderate and serious risk of bias. The mean survival rate for implants with low insertion toque (≤35 Ncm) was 96% (p > .001, 95% confidence interval [CI]: 0.91-0.98) and that for implants with medium or high insertion torque (>35 Ncm) was 92% (p > .001, 95% CI: 0.86-0.96) (incidence rate ratio [IRR] = 1.05, 95% CI: 0.79-1.39, p = .175, I = 0.0%). Splinted implants with insertion torque >20 Ncm and single implants with insertion torque >35 Ncm had a higher survival rate than implants with lower insertion torque values (IRR = 1.05, 95% CI: 0.78-1.43, p = .956, I = 0.0%, and RR = 0.92, 95% CI: 0.48-1.75, p = .799, I = 0.0%, respectively). Different insertion torque values achieved equivalent outcomes. The mean follow-up was 24 months.
Low insertion torque values have no significant effect on survival rates of immediate loading implants at a mean follow-up of 24 months.
系统评估低植入扭矩值对即刻负载种植体存活率的影响。
本研究方案已在 PROSPERO（注册号：CRD42020189499）注册。我们对 PubMed、Embase、Web of Science 和 Cochrane 中央对照试验注册库进行了电子检索，检索时间截至 2022 年 6 月，语言为英语和西班牙语。我们纳入了分析不同植入扭矩值对即刻负载种植体失败或存活率影响的研究。
对 573 篇文章进行了资格评估，其中 7 篇文章（4 项随机临床试验、1 项对照临床试验和 2 项前瞻性病例系列研究）被纳入定性分析。这些 RCT 被归类为低偏倚风险，而非 RCT 则为中偏倚和高偏倚风险。低植入扭矩（≤35 Ncm）的种植体平均存活率为 96%（p>.001，95%置信区间 [CI]：0.91-0.98），而中高植入扭矩（>35 Ncm）的种植体平均存活率为 92%（p>.001，95% CI：0.86-0.96）（发生率比 [IRR] = 1.05，95% CI：0.79-1.39，p = 0.175，I = 0.0%）。扭矩大于 20 Ncm 的夹板种植体和扭矩大于 35 Ncm 的单牙种植体的存活率高于低扭矩值的种植体（IRR = 1.05，95% CI：0.78-1.43，p = 0.956，I = 0.0%；RR = 0.92，95% CI：0.48-1.75，p = 0.799，I = 0.0%）。不同的植入扭矩值产生了等效的结果。平均随访时间为 24 个月。
在平均 24 个月的随访中，低植入扭矩值对即刻负载种植体的存活率没有显著影响。
