Dept. of Implantology, School of Stomatology, Lanzhou University, Lanzhou 730000, China.
Dept. of Stomatology, The 940th Hospital of Joint Logistics Support Force of People's Liberation Army, Lanzhou 730050, China.
Hua Xi Kou Qiang Yi Xue Za Zhi. 2023 Feb 1;41(1):80-87. doi: 10.7518/hxkq.2023.01.011.
This study aimed to systematically evaluate the safety and clinical efficacy of 4 mm-extra-short implant (ESI) placement in severely atrophic posterior areas.
Databases of PubMed, Embase, Cochrane Library, Web of Science, CNKI, and Wanfang from January 1, 2010, until August 31, 2022, were searched to identify randomized controlled trials or controlled clinical trials related to ESI and standard implants (SI). An additional hand search of the references of included articles was also conducted. Meta-analyses were carried out with RevMan 5.4 software.
A total of 11 studies were included, involving six randomized controlled trials and five controlled clinical trials. The meta-analyses indicated that when implants were placed in the posterior area, the implant survival rate between ESI and SI did not significantly differ [RR=1.23, 95%CI (0.66, 2.27), =0.52]. ESI resulted in significantly stable marginal bone level [MD=-0.16, 95%CI (-0.25,-0.07), =0.000 7] and less biological complications [RR=0.34, 95%CI (0.19, 0.62), =0.000 4] but more mechanical complications [RR=2.89, 95%CI (1.05, 7.92), =0.04].
Based on the limited evidence, ESI could achieve clinical outcomes similar to those of SI when the height of the posterior alveolar bone is less than 5 mm, with lower technical sensitivity and fewer postoperative clinical complications than SI. Due to insufficient evidence and limited sample size, further clinical trials are needed to verify the long-term efficacy of ESI.
本研究旨在系统评估在严重萎缩的后部区域中放置 4mm-超短种植体(ESI)的安全性和临床疗效。
检索PubMed、Embase、Cochrane 图书馆、Web of Science、CNKI 和万方数据库,时间范围为 2010 年 1 月 1 日至 2022 年 8 月 31 日,以确定与 ESI 和标准种植体(SI)相关的随机对照试验或对照临床试验。还对纳入文章的参考文献进行了额外的手工检索。使用 RevMan 5.4 软件进行荟萃分析。
共纳入 11 项研究,包括 6 项随机对照试验和 5 项对照临床试验。荟萃分析结果表明,在后牙区植入种植体时,ESI 和 SI 之间的种植体存活率无显著差异[RR=1.23,95%CI(0.66,2.27),=0.52]。ESI 可显著稳定边缘骨水平[MD=-0.16,95%CI(-0.25,-0.07),=0.0007],减少生物学并发症[RR=0.34,95%CI(0.19,0.62),=0.0004],但增加机械并发症[RR=2.89,95%CI(1.05,7.92),=0.04]。
基于有限的证据,当后牙槽骨高度小于 5mm 时,ESI 可获得与 SI 相似的临床效果,且技术敏感性较低,术后临床并发症较少。由于证据不足且样本量有限,需要进一步的临床试验来验证 ESI 的长期疗效。