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即刻种植与延期种植的牙种植体存留率差异:一项系统评价与Meta分析

Differences in Dental Implant Survival between Immediate vs. Delayed Placement: A Systematic Review and Meta-Analysis.

作者信息

Patel Rishi, Ucer Cemal, Wright Simon, Khan Rabia S

机构信息

ICE Postgraduate Dental Institute and Hospital, University of Salford, 24 Furness Quay, Salford M50 3XZ, UK.

Department of Medicine, University of Lancaster, Lancaster LA1 4YR, UK.

出版信息

Dent J (Basel). 2023 Sep 15;11(9):218. doi: 10.3390/dj11090218.

Abstract

OBJECTIVES

To compare the impact of immediate and delayed implant placement upon the survival of implants and to investigate the differences in implant survival between immediate and delayed placement in adults.

METHODS

A search for the relevant literature was performed using the databases of CENTRAL, MEDLINE and Scopus. The studies found were limited to publications between 2014 and 2022, written in the English language, peer-reviewed, and were randomised trials or comparative studies. The quality of the evidence was assessed using the Cochrane Risk of Bias 2.0 and Risk of Bias in Non-randomised Studies-of Interventions appraisal tools and implant survival, and the primary outcome was meta-analysed using RevMan v.5.3.

RESULTS

A total of 10 studies were eligible for inclusion, including six randomised controlled trials and four non-randomised comparative studies. Five of the six randomised trials observed a low risk of bias, while the comparative studies had a moderate-to-serious risk of bias. The search strategy resulted in 341 implants placed immediately into fresh extraction sites (332 survived, 97.4%) and 359 implants inserted into delayed sites (350 survived, 97.5%).

CONCLUSION

The meta-analysis demonstrated that there was no significant difference in the implant survival rates between immediately placed implants and implants placed using a delayed timing protocol (risk ratio 0.99; 95% CI 0.96, 1.02, Z = 0.75, = 0.45). However, the detailed analysis showed that slightly more implant failures happened in the immediate dental implant placement group, with survival rates in some studies ranging between 90 and 95%, while the delayed placement group had survival rates of more than 95%.

摘要

目的

比较即刻种植和延期种植对种植体存活的影响,并研究成人即刻种植和延期种植在种植体存活方面的差异。

方法

使用CENTRAL、MEDLINE和Scopus数据库进行相关文献检索。检索到的研究限于2014年至2022年期间发表的、英文撰写、经过同行评审的随机试验或比较研究。使用Cochrane偏倚风险2.0和非随机干预研究中的偏倚风险评估工具评估证据质量以及种植体存活情况,并使用RevMan v.5.3对主要结局进行荟萃分析。

结果

共有10项研究符合纳入标准,包括6项随机对照试验和4项非随机比较研究。6项随机试验中有5项观察到低偏倚风险,而比较研究存在中度至严重的偏倚风险。检索策略共纳入341颗即刻植入新鲜拔牙位点的种植体(332颗存活,97.4%)和359颗植入延期位点的种植体(350颗存活,97.5%)。

结论

荟萃分析表明,即刻种植的种植体与采用延期方案种植的种植体在存活率上无显著差异(风险比0.99;95%可信区间0.96,1.02,Z = 0.75,P = 0.45)。然而,详细分析显示,即刻牙种植组的种植体失败略多,一些研究中的存活率在90%至95%之间,而延期种植组的存活率超过95%。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6ca8/10528222/833f562d2ea2/dentistry-11-00218-g001.jpg

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