Yu Xinbo, Lin Xinyan, Wang Feng, Wu Yiqun
Second Dental Center, National Clinical Research Center for Oral Diseases, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Second Dental Center, National Clinical Research Center for Oral Diseases, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
J Evid Based Dent Pract. 2024 Dec;24(4):102034. doi: 10.1016/j.jebdp.2024.102034. Epub 2024 Aug 24.
This systematic review and meta-analysis aimed to evaluate the diagnostic value of bleeding on probing (BOP) for peri‑implantitis detection on implant- and patient-levels, as reported in prospective and retrospective studies with at least 5 years of follow-up.
A systematic search of 3 electronic databases was conducted and supplemented with a hand-search to identify clinical studies that reported the prevalence of peri‑implantitis and BOP after at least 5 years of functional loading. Random-effects meta-analyses were conducted to combine the proportions of peri‑implantitis among BOP positive implants and patients across studies. Heterogeneity was explored with subgroup analyses.
5826 patients and 17,198 implants were included in this review. Definitions of peri‑implantitis varied between studies. Thirty studies were included for assessment. Implant-level meta-analysis was conducted in 24 studies and patient-level meta-analysis in 19 studies. Overall proportion of peri‑implantitis in BOP-positive implants was 26.5% (95% CI, 21.2 to 32.1) and 35.1% (95% CI, 27.4 to 43.1) in BOP-positive patients. Substantial heterogeneity was present, and prediction intervals were 5.2%-56% and 6.4%-71.5% at the implant- and patient-level, respectively.
Within the limitations, prevalence of peri‑implantitis was found to be around 1 third in both BOP-positive implants and patients. Prevalence varied between studies. Although a guiding clinical factor in the diagnosis of peri‑implantitis, clinicians should be aware of the significant false-positive rates of BOP.
本系统评价和荟萃分析旨在评估探诊出血（BOP）在种植体水平和患者水平上对种植体周围炎检测的诊断价值，这些研究结果来自随访至少5年的前瞻性和回顾性研究。
对3个电子数据库进行系统检索，并辅以手工检索，以确定报告了至少5年功能负载后种植体周围炎患病率和BOP情况的临床研究。进行随机效应荟萃分析，以合并各研究中BOP阳性种植体和患者中种植体周围炎的比例。通过亚组分析探讨异质性。
本评价纳入了5826例患者和17198颗种植体。各研究中种植体周围炎的定义有所不同。纳入30项研究进行评估。24项研究进行了种植体水平的荟萃分析，19项研究进行了患者水平的荟萃分析。BOP阳性种植体中种植体周围炎的总体比例为26.5%（95%CI，21.2至32.1），BOP阳性患者中为35.1%（95%CI，27.4至43.1）。存在显著异质性，种植体水平和患者水平的预测区间分别为5.2%-56%和6.4%-71.5%。
在局限性范围内，发现BOP阳性种植体和患者中种植体周围炎的患病率均约为三分之一。患病率在各研究之间有所不同。虽然BOP是种植体周围炎诊断中的一个指导性临床因素，但临床医生应意识到BOP存在显著的假阳性率。
