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氧化锆牙科种植体比钛牙科种植体的临床效果更好吗?系统评价和荟萃分析。

Do zirconia dental implants present better clinical results than titanium dental implants? A systematic review and meta-analysis.

机构信息

Post-Graduated Program in Dentistry, Department of Prothesis and Oral and Maxillofacial Surgery, Federal University of Pernambuco (UFPE), Av. Prof. Moraes Rego 1235 - Cidade Universitária, Recife, PE 50670-901, Brazil.

Post-Graduated Program in Dentistry, Department of Prothesis and Oral and Maxillofacial Surgery, Federal University of Pernambuco (UFPE), Av. Prof. Moraes Rego 1235 - Cidade Universitária, Recife, PE 50670-901, Brazil.

出版信息

J Stomatol Oral Maxillofac Surg. 2023 Feb;124(1S):101324. doi: 10.1016/j.jormas.2022.10.023. Epub 2022 Oct 29.

Abstract

INTRODUCTION

The purpose of this systematic review is to determine if the zirconia implants present better clinical results when compared to titanium implants.

METHODS

Searches were conducted in 5 databases including, until March 2022, by 2 independent reviewers, according to the inclusion and exclusion criteria established in the study and according whit this question: Do zirconia dental implants present better clinical results than titanium dental implants?

RESULTS

3235 studies were initially found in the researched databases. 03 randomized clinical trials were included in this systematic review and meta-analysis. A total of 71 patients with 192 implants (87 titanium and 105 zirconia) were evaluated, showing an effectiveness of 87,4% and 78,1% respectively and there was no statistically significant difference in terms of survival rate in the meta-analysis (P = 0.70; I = 0%). Still in the meta-analysis, there was no statistically significant difference between titanium and zirconia implants in relation to the pink esthetich score or bleeding on probing, however, a favorable difference was observed for titanium in relation to marginal bone loss (P = 0.001; I = 0%). None of the studies evaluated had a low risk of bias.

CONCLUSION

Oral rehabilitation with zirconia implants showed no advantages over titanium in this systematic review. However, the small number of studies included and the uncertain risk of bias may raise doubts in this interpretation and the results should be analyzed with caution. New studies with greater methodological rigor, follow-up time and number of interventions should be performed in order to safely determine the indication for the use of zirconia implants.

摘要

简介

本系统评价的目的是确定氧化锆种植体与钛种植体相比是否具有更好的临床效果。

方法

由 2 名独立评审员根据研究中设定的纳入和排除标准,在 5 个数据库中进行检索,截至 2022 年 3 月,根据以下问题进行检索:氧化锆牙科种植体是否比钛牙科种植体具有更好的临床效果?

结果

在研究数据库中最初发现了 3235 项研究。本系统评价和荟萃分析纳入了 03 项随机临床试验。共有 71 名患者(192 个种植体,87 个钛种植体和 105 个氧化锆种植体)接受了评估,其有效性分别为 87.4%和 78.1%,在荟萃分析中,生存率无统计学差异(P=0.70;I=0%)。尽管在荟萃分析中,钛和氧化锆种植体在粉红色美学评分或探诊出血方面没有统计学上的显著差异,但在边缘骨吸收方面,钛种植体具有有利的差异(P=0.001;I=0%)。在评估的研究中,没有研究具有低偏倚风险。

结论

在本系统评价中,氧化锆种植体的口腔修复没有优于钛种植体。然而,纳入的研究数量较少且偏倚风险不确定,这可能会对这一解释产生怀疑,因此结果应谨慎分析。为了安全确定氧化锆种植体的使用指征,应开展具有更高方法学严谨性、随访时间和干预措施数量的新研究。

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