Charité-Universitaetsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt- Universitaet zu Berlin, Dental Materials and Biomaterial Research, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Aßmannshauser Str. 4-6, 14197, Berlin, Germany.
Department of Oral Implantology, The Affiliated Stomatology Hospital of Kunming Medical University, Block C, No. 1088, Haiyuan Middle Road, High-Tech Zone, Kunming, Yunnan, China.
Int J Implant Dent. 2023 Sep 21;9(1):34. doi: 10.1186/s40729-023-00494-y.
This systematic review aimed to evaluate the incidence of microleakage events (IME) and to identify the potential factors influencing the sealing ability of the implant-abutment interface (IAI) under in vitro investigation.
An electronic search of MEDLINE (PubMed), EMBASE, and Web of Science databases, combined with a manual literature search was conducted up to September 2022. In vitro studies that reported the degree of microleakage at IAI under dynamic loading conditions were included. A meta-analysis was performed to calculate the mean values of the incidence of microleakage events. Subgroup analysis and meta-regression were conducted to further investigate the effect of different variables.
675 studies were identified following the search process and 17 in vitro studies were selected according to the eligibility criteria. The weighted mean incidence of microleakage events was 47% (95% confidence interval: [0.33, 0.60]), indicating that contamination was observed in nearly half of the samples. Concerning possible factors that may influence microleakage (e.g., loading condition, assessment method, implant-abutment connection design, types of abutment material, the use of sealing agents), loading condition (p = 0.016) was the only variable that significantly influenced IME in the meta-regression analysis.
The results demonstrated that dynamic loading significantly increases the potential of bacterial penetration at the implant-abutment junction. The results should be interpreted carefully due to the data heterogeneity and further well-conducted in vitro studies with homogeneous samples are needed to standardize the methodologies.
本系统评价旨在评估微渗漏事件（IME）的发生率，并确定在体外研究中影响种植体-基台界面（IAI）密封能力的潜在因素。
对 MEDLINE（PubMed）、EMBASE 和 Web of Science 数据库进行电子检索，并结合手工文献检索，检索截止日期为 2022 年 9 月。纳入报告在动态加载条件下 IAI 微渗漏程度的体外研究。进行荟萃分析以计算微渗漏事件发生率的平均值。进行亚组分析和荟萃回归分析，以进一步探讨不同变量的影响。
经过搜索过程，共确定了 675 项研究，根据纳入标准选择了 17 项体外研究。微渗漏事件的加权平均发生率为 47%（95%置信区间：[0.33, 0.60]），这表明近一半的样本观察到了污染。关于可能影响微渗漏的因素（例如，加载条件、评估方法、种植体-基台连接设计、基台材料类型、密封剂的使用），加载条件（p=0.016）是荟萃回归分析中唯一显著影响 IME 的变量。
结果表明，动态加载显著增加了细菌在种植体-基台交界处渗透的可能性。由于数据异质性，结果应谨慎解释，需要进一步进行设计良好的、具有同质样本的体外研究，以标准化方法。
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