背景:通常表明,ZI植入物(ZI)可以替代主要的骨重建来恢复患有广泛萎缩的患者。它可以安装在上颌窦内,被称为骨种植体(IZI)或上颌窦外(EZI),取决于手术技术。
目的:评估纵向研究中ZI与常规植入物(CI)的生存率和并发症发生率。
方法:在五个数据库和灰色文献中进行了电子搜索,以查找直到4月为止的文章,2022年。资格标准包括观察性队列研究(前瞻性或回顾性)和至少5年随访的随机临床试验(RCT)。报告ZIversusCI的生存率。对18项研究进行了荟萃分析。
结果:共分析了1709例患者的5434个植入物(2972ZI和2462CI)。ZI和CI的平均生存率分别为96.5%±5.02和95.8%±6.36(平均随访时间78个月)。在前瞻性研究中,ZI和CI之间没有统计学意义(风险比[RR]为1.21;95%置信区间[CI]:0.28至5.28;卡方[Chi2]=11.37;I2=56%;自由度[df]=5;z评分=0.25;P=0.80),回顾性研究IZI(RR为1.29;95%CIs:0.52~3.23;Chi2=4.07;I2=2%;df=4;z评分=0.55;P=0.58)和回顾性研究EZI(RR为0.72;95%CIs:0.31~1.66;Chi2=1.99;I2=0%;df=3;z评分=0.78;P=0.44).与ZI最相关的生物并发症是鼻窦炎,其次是感染和口腔沟通。
结论:ZI具有较高的长期生存率(96.5%,平均随访91.5个月),与CI相比没有显着差异。最常见的生物并发症是鼻窦炎,最常见的是IZI技术。本系统评价(SR)在INPLASY中注册,编号为INPLASY202280025。
BACKGROUND: Zygomatic implants (ZI) have been frequently indicated to rehabilitate patients with extensive atrophies in alternatives to major bone reconstructions. It can be installed inside the maxillary sinus, called instrasinus zygomatic implant (IZI) or outside the maxillary sinus (EZI), depending on the surgery technique.
OBJECTIVE: To evaluate the survival and complication rates of ZI in longitudinal studies when compared with conventional implants (CI).
METHODS: An electronic search was performed in five databases and in Gray literature for articles published until April, 2022. The eligibility criteria comprised observational cohort studies (prospective or retrospective) and randomized clinical trials (RCTs) with at least 5 years of follow-up, reporting survival rate of ZI versus CI. A meta-analysis was conduct with 18 studies.
RESULTS: A total of 5434 implants (2972 ZI and 2462 CI) were analyzed in 1709 patients. The mean survival rate was 96.5% ± 5.02 and 95.8% ± 6.36 for ZI and CI, respectively (mean follow-up time of 78 months). There were observed no statistically significant between ZI and CI in prospective studies (risk ratio [RR] of 1.21; 95% confidence intervals [CIs]: 0.28 to 5.28; chi-squared [Chi2 ] = 11.37; I2 = 56%; degrees of freedom [df] = 5; z-score = 0.25; P = 0.80), retrospective studies IZI (RR of 1.29; 95% CIs: 0.52 to 3.23; Chi2 = 4.07; I2 = 2%; df = 4; z-score = 0.55; P = 0.58) and retrospective studies EZI (RR of 0.72; 95% CIs: 0.31 to 1.66; Chi2 = 1.99; I2 = 0%; df = 3; z-score = 0.78; P = 0.44). The biological complications most related to ZI was sinusitis, followed by infection and oroantral communication.
CONCLUSIONS: ZI have a high long-term survival rate (96.5% with a mean of 91.5 months of follow-up), showing no significant difference when compared with CI. The most prevalent biological complication is sinusitis, being most commonly to the IZI technique. This systematic
review (SR) was registered in INPLASY under number INPLASY202280025.