Impact of platform switching on marginal peri-implant bone-level changes. A systematic review and meta-analysis.
Impact of platform switching on marginal peri-implant bone-level changes. A systematic review and meta-analysis.
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DOI：
10.1111/clr.12339
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发表时间：
2015-03
影响因子：
4.3
通讯作者：
Hertel M
中科院分区：
文献类型：
--
作者：
Strietzel FP;Neumann K;Hertel M
为了解决焦点问题，与平台匹配（PM）种植体-基台配置的种植体相比，平台切换（PS）是否会影响内腔种植体周围的边缘骨水平（MBL）变化？使用PubMed、Web of Science、Journals@Ovid全文和Embase等电子数据库进行系统的文献检索，手动检索2005年至2013年6月发表的人类随机临床试验（rct）和前瞻性临床对照队列研究（PCCS），这些研究报告了PS-种植体与pm -种植体-基台连接时MBL的变化。22篇出版物符合系统评价的条件。对15项随机对照试验和7项PCCS的定性分析显示，更多的研究（13项随机对照试验和3项PCCS）显示，与pm -种植体-基台连接相比，PS-种植体周围的平均边缘骨损失显著减少，这表明PS技术有明显的发展趋势。一项包含13项随机对照试验的荟萃分析显示，PS种植体的平均MBL变化（0.49 mm [CI95% 0.38; 0.60]）显著低于PM种植体(1.01 mm [CI95% 0.62; 1.40] （P < 0.0001）。荟萃分析显示，与pm -种植体-基台配置相比，PS种植体的平均MBL变化明显更少。本文纳入的研究大多显示偏倚风险不明确且较高，随访期相对较短。定性分析显示，与PM技术相比，PS技术更倾向于预防或减少种植体周围边缘骨丢失。由于纳入研究的异质性，其结果需要谨慎解释。
To address the focused question, is there an impact of platform switching (PS) on marginal bone level (MBL) changes around endosseous implants compared to implants with platform matching (PM) implant-abutment configurations? A systematic literature search was conducted using electronic databases PubMed, Web of Science, Journals@Ovid Full Text and Embase, manual search for human randomized clinical trials (RCTs) and prospective clinical controlled cohort studies (PCCS) reporting on MBL changes at implants with PS-, compared with PM-implant-abutment connections, published between 2005 and June 2013. Twenty-two publications were eligible for the systematic review. The qualitative analysis of 15 RCTs and seven PCCS revealed more studies (13 RCTs and three PCCS) showing a significantly less mean marginal bone loss around implants with PS- compared to PM-implant-abutment connections, indicating a clear tendency favoring the PS technique. A meta-analysis including 13 RCTs revealed a significantly less mean MBL change (0.49 mm [CI95% 0.38; 0.60]) at PS implants, compared with PM implants (1.01 mm [CI95% 0.62; 1.40] (P < 0.0001). The meta-analysis revealed a significantly less mean MBL change at implants with a PS compared to PM-implant-abutment configuration. Studies included herein showed an unclear as well as high risk of bias mostly, and relatively short follow-up periods. The qualitative analysis revealed a tendency favoring the PS technique to prevent or minimize peri-implant marginal bone loss compared with PM technique. Due to heterogeneity of the included studies, their results require cautious interpretation.
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