School of Dentistry, International Medical University, Kuala Lumpur, Wilayah Persekutuan, Malaysia.
School of Pharmacy, Department of Pharmacy Practice, College of pharmacy, International Medical University, Kuala Lumpur, Wilayah Persekutuan, Malaysia; School of Medicine, Taylor's University, Subang Jaya, Selangor, Malaysia.
J Dent. 2024 Jul;146:105065. doi: 10.1016/j.jdent.2024.105065. Epub 2024 May 16.
To perform a comprehensive quantitative and qualitative analysis of the findings from previously published meta-analyses and to assess existing biases.
DATA/SOURCES: A search was conducted for meta-analyses of observational studies investigating the association between any risk factor and peri‑implantitis in PubMed, Scopus, Cochrane Database of Systematic Reviews, and Epistemonikos, from inception until October 2023 (PROSPERO: CRD42024512408).
From a total of 5002 publications, 51 full-text articles were evaluated for eligibility, and 12 articles that described 41 unique meta-analyses evaluating the association between risk factors and periimplantitis were selected. Among 41 associations, 24 associations were significant. None of the associations were graded as convincing evidence. Two associations, presence of periodontitis (OR = 3.84 [95 % CI 2.58,5.72]) and cigarette smoking (RR=2.07 [95 % CI 1.41,3.04]) were graded as highly suggestive. Eight associations, diabetes mellitus, hyperglycaemia, lack of prophylaxis, history of chronic periodontal disease, ongoing or history of periodontal disease, implants located in the anterior region of the jaw (maxillary and mandibular), osteoprotegerin (OPG) gene polymorphisms, and lack of keratinized mucosal width were graded as suggestive evidence.
Periodontitis and cigarette smoking are highly suggestive risk factors for peri‑implantitis. The remaining risk factors which are suggestive require more high-quality studies to be performed to upgrade the level of evidence.
The highly suggestive and suggestive risk factors for peri‑implantitis summarized in this umbrella review should be rigorously assessed, monitored and managed by clinicians to reduce the risk peri‑implantitis, as well as to form part of the preoperative consent process.
对先前发表的荟萃分析结果进行全面的定量和定性分析，并评估现有偏倚。
在 PubMed、Scopus、Cochrane 系统评价数据库和 Epistemonikos 中，对研究任何风险因素与种植体周围炎之间关联的观察性研究进行了荟萃分析的检索，检索时间为从建库至 2023 年 10 月（PROSPERO：CRD42024512408）。
在总共 5002 篇文献中，评估了 51 篇全文文章的纳入资格，选择了 12 篇描述了 41 项评估风险因素与种植体周围炎之间关联的独特荟萃分析的文章。在 41 项关联中，有 24 项具有统计学意义。没有任何关联被评为有说服力的证据。有两项关联被评为高度提示性，分别为牙周炎（OR=3.84 [95%CI 2.58,5.72]）和吸烟（RR=2.07 [95%CI 1.41,3.04]）。有八项关联被评为提示性证据，分别为糖尿病、高血糖、缺乏预防措施、慢性牙周病史、正在发生或有牙周病史、位于下颌前牙区（上颌和下颌）的种植体、护骨素（OPG）基因多态性和缺乏角化黏膜宽度。
牙周炎和吸烟是种植体周围炎的高度提示性危险因素。其余提示性危险因素需要更多高质量的研究来提高证据水平。
本综述总结的种植体周围炎高度提示性和提示性危险因素应由临床医生严格评估、监测和管理，以降低种植体周围炎的风险，并作为术前同意过程的一部分。
