目的:根据植入物-基台连接类型的配置随时间的变化,量化累积的口腔植入物存活率和影像学骨水平的变化。材料和方法:在四个数据库(PubMed/MEDLINE,科克伦图书馆,WebofScience,和Embase),和记录由两名独立评审员根据纳入标准进行评审。根据种植体-基牙连接类型将纳入的文章的数据分为四类([1]外六角;[2]骨水平,内部,窄锥<45度;[3]骨水平,内部宽锥体≥45度或平坦;和[4]组织水平)和随访持续时间(短期1至2年,中期2到5年,和长期>5年)。从基线(负荷)到上次报告的随访,对累积生存率(CSR)和边缘骨水平(ΔMBL)的变化进行了荟萃分析。基于研究和试验设计中的植入物和随访持续时间,适当地分割或合并研究。该研究是根据PRISMA2020指南编制的,并在PROSPERO数据库中注册。结果:共筛选3082篇文献。全文回顾465篇文章,共包括270篇文章(代表16,448名受试者,45,347个植入物),用于定量合成和分析。平均ΔMBL(95%CI)如下:短期外六角=0.68mm(0.57,0.79);短期骨水平,内部,窄锥<45度=0.34毫米(0.25,0.43);短期骨水平,内部宽锥体≥45度=0.63毫米(0.52,0.74);短期组织水平=0.42毫米(0.27,0.56);中期外六角=1.03毫米(0.72,1.34);中期骨水平,内部,窄锥<45度=0.45毫米(0.34,0.56);中期骨水平,内部宽锥体≥45度=0.73毫米(0.58,0.88);中期组织水平=0.4毫米(0.21,0.61);长期外部六角=0.98毫米,0.70,1.25);长期骨水平,内部,窄锥<45度=0.44毫米(0.31,0.57);长期骨水平,内部宽锥体≥45度=0.95mm(0.68,1.22);长期组织水平=0.43mm(0.24,0.61)。CSR(95%CI)为:短期外部十六进制=97%(96%,98%);短期骨水平,内部,窄锥<45度=99%(99%,99%);短期骨水平,内部宽锥体≥45度=98%(98%,99%);短期组织水平=99%(98%,100%);中期外部十六进制=97%(96%,98%);中期骨水平,内部,窄锥<45度=98%(98%,99%);中期骨水平,内部宽锥体≥45度=99%(98%,99%);中期组织水平=98%(97%,99%);长期外部十六进制=96%(95%,98%);长期骨水平,内部,窄锥<45度=98%(98%,99%);长期骨水平,内部宽锥体≥45度=99%(98%,100%);长期组织水平=99%(98%,100%)。结论:随着时间的推移,种植体-基台界面的构型对ΔMBL具有可测量的影响。这些变化可以在至少3至5年的时间内观察到。在所有测量的时间间隔,对于外部六角和内部宽锥≥45度连接,注意到类似的ΔMBL,就像内部一样,窄锥<45度和组织水平的连接。
Purpose: To quantify the cumulative oral implant survival rates and changes in radiographic bone levels based on the configuration of the implant-abutment connection type over time. Materials and Methods: An electronic literature search was conducted in four databases (PubMed/MEDLINE, Cochrane Library, Web of Science, and Embase), and records were refereed by two independent reviewers based on the inclusion criteria. Data from included articles were grouped by implant-abutment connection type into four categories ([1] external hex; [2] bone level, internal, narrow cone < 45 degrees; [3] bone level, internal wide cone ≥ 45 degrees or flat; and [4] tissue level) and duration of follow-up (short-term 1 to 2 years, mid-term 2 to 5 years, and long-term > 5 years). Meta-analyses were performed for cumulative survival rate (CSR) and changes in marginal bone level (ΔMBL) from baseline (loading) to last reported follow-up. Studies were split or merged as appropriate based on the implants and follow-up duration in the study and trial design. The study was compiled under PRISMA 2020 guidelines and registered in the PROSPERO database. Results: A total of 3,082 articles were screened. Full-text
review of 465 articles resulted in a total of 270 articles (representing 16,448 subjects with 45,347 implants) included for quantitative synthesis and analysis. Mean ΔMBL (95% CI) was as follows: short-term external hex = 0.68 mm (0.57, 0.79); short-term bone level, internal, narrow cone < 45 degrees = 0.34 mm (0.25, 0.43); short-term bone level, internal wide cone ≥ 45 degrees = 0.63 mm (0.52, 0.74); short-term tissue level = 0.42 mm (0.27, 0.56); mid-term external hex = 1.03 mm (0.72, 1.34); mid-term bone level, internal, narrow cone < 45 degrees = 0.45 mm (0.34, 0.56); mid-term bone level, internal wide cone ≥ 45 degrees = 0.73 mm (0.58, 0.88); mid-term tissue level = 0.4 mm (0.21, 0.61); long-term external hex = 0.98 mm, 0.70, 1.25); long-term bone level, internal, narrow cone < 45 degrees = 0.44 mm (0.31, 0.57); long-term bone level, internal wide cone ≥ 45 degrees = 0.95 mm (0.68, 1.22); and long-term tissue level = 0.43 mm (0.24, 0.61). CSRs (95% CI) were: short-term external hex = 97% (96%, 98%); short-term bone level, internal, narrow cone < 45 degrees = 99% (99%, 99%); short-term bone level, internal wide cone ≥ 45 degrees = 98% (98%, 99%); short-term tissue level = 99% (98%, 100%); mid-term external hex = 97% (96%, 98%); mid-term bone level, internal, narrow cone < 45 degrees = 98% (98%, 99%); mid-term bone level, internal wide cone ≥ 45 degrees = 99% (98%, 99%); mid-term tissue level = 98% (97%, 99%); long-term external hex = 96% (95%, 98%); long-term bone level, internal, narrow cone < 45 degrees = 98% (98%, 99%); long-term bone level, internal wide cone ≥ 45 degrees = 99% (98%, 100%); and long-term tissue level = 99% (98%, 100%). Conclusion: The configuration of the implant-abutment interface has a measurable effect on the ΔMBL over time. These changes can be observed over a period of at least 3 to 5 years. At all measured time intervals, similar ΔMBL was noted for external hex and internal wide cone ≥ 45-degree connections, as were internal, narrow cone < 45-degree and tissue-level connections.