Int J Oral Implantol (Berl). 2024 Mar 19;17(1):13-42.
To assess the implant failure rate and clinical and radiographic outcomes of implants affected by peri-implantitis that received surgical treatment.
A systematic search was conducted of three databases (PubMed, Embase and Cochrane Library) to identify studies that examined implant failure and biological outcomes after surgical peri-implantitis treatment, including ≥ 10 patients and reporting on a follow-up period of at least 12 months. Data and risk of bias were assessed qualitatively and quantitively. Surgical modalities were subdivided into reconstructive, non-reconstructive and combined. Meta-analyses were performed for implant failure, marginal bone level and probing pocket depth at 12 and 36 months with the respective subset of available data for each time and endpoint.
A total of 45 studies with 3,463 treated implants were included in the quantitative evaluation. Meta-analyses revealed low implant failure rates of 1.2% (95% confidence interval 0.4%, -2.1%) and 4.2% (95% confidence interval 1.0%, -8.8%) at 12 and 36 months, respectively. No significant difference between the subgroups was observed at 12 months. At 36 months, reconstructive modalities showed a significantly lower implant failure rate (1.0%; 95% confidence interval 0.0%, 5.0%; P = 0.04, χ2(1) = 4.1) compared to non-reconstructive modalities (8.0%; 95% confidence interval 2.0%, 18.0%). The mean probing pocket depth was 3.71 mm (95% confidence interval 3.48, 3.94 mm) at 12 months and 3.63 mm (95% confidence interval 3.02, 4.24 mm) at 36 months. The mean marginal bone loss was 3.31 mm (95% confidence interval 2.89, 3.74 mm) at 12 months and 2.38 mm (95% confidence interval 1.01, 3.74 mm) at 36 months. No significant differences between the modalities were observed for bleeding on probing after either of these time points. Cumulative interventions during supportive therapy were reported in 9% of the studies.
Surgical treatment of peri-implantitis results in a low implant failure rate in the short and medium term. No differences were noted between the different interventions with regard to failure rate. Surrogate therapeutic endpoints were improved after treatment, without significant differences between the different modalities. Therapeutic success and/or disease resolution and cumulative interventions during supportive therapy are seldom reported in the literature, but limited long-term outcomes are documented consistently.
评估受种植体周围炎影响的种植体的种植体失败率以及临床和影像学结果，并接受手术治疗。
系统检索了三个数据库（PubMed、Embase 和 Cochrane Library），以确定研究种植体周围炎治疗后种植体失败和生物学结果的研究，包括至少 10 例患者，并报告至少 12 个月的随访期。定性和定量评估数据和偏倚风险。手术方式分为重建、非重建和联合。对 12 个月和 36 个月时的种植体失败、边缘骨水平和探诊袋深度进行了荟萃分析，每个时间点和终点都有相应的可用数据子集。
共有 45 项研究，涉及 3463 例治疗种植体，纳入定量评估。荟萃分析显示，12 个月和 36 个月时的种植体失败率分别为 1.2%（95%置信区间 0.4%，-2.1%）和 4.2%（95%置信区间 1.0%，-8.8%），差异无统计学意义。12 个月时，各亚组之间无显著差异。36 个月时，重建方式的种植体失败率明显低于非重建方式（1.0%；95%置信区间 0.0%，5.0%；P=0.04，χ2（1）=4.1）。12 个月时的平均探诊袋深度为 3.71mm（95%置信区间 3.48，3.94mm），36 个月时为 3.63mm（95%置信区间 3.02，4.24mm）。12 个月时的平均边缘骨丧失为 3.31mm（95%置信区间 2.89，3.74mm），36 个月时为 2.38mm（95%置信区间 1.01，3.74mm）。这两个时间点的探诊出血均未观察到各手术方式之间的差异。在 9%的研究中报告了支持性治疗期间的累积干预措施。
种植体周围炎的手术治疗在短期和中期可获得较低的种植体失败率。不同干预措施之间在失败率方面没有差异。治疗后替代治疗终点得到改善，不同方式之间没有显著差异。文献中很少报道治疗的成功和/或疾病缓解以及支持性治疗期间的累积干预措施，但一致记录了有限的长期结果。
