A systematic review of the survival and complication rates of implant-supported fixed dental prostheses (FDPs) after a mean observation period of at least 5 years
A systematic review of the survival and complication rates of implant-supported fixed dental prostheses (FDPs) after a mean observation period of at least 5 years
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DOI：
10.1111/j.1600-0501.2012.02546.x
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发表时间：
2012-10-01
影响因子：
4.3
通讯作者：
Zembic, Anja
中科院分区：
文献类型：
--
作者：
Pjetursson, Bjarni E.;Thoma, Daniel;Zembic, Anja
目的 本次系统评价的目的是评估种植体支持的固定假牙 (FDP) 的 5 年和 10 年生存率，并描述生物和技术并发症的发生率。方法 通过电子 Medline 搜索并辅以手动搜索来识别 FDP 的前瞻性和回顾性队列研究和病例系列，平均随访时间至少为 5 年。患者必须在随访时接受临床检查。使用标准和随机效应泊松回归模型分析失败率和并发症率，以获得 5 年和 10 年生存率和并发症率的汇总估计。结果更新后的搜索提供了 979 个标题和 257 个摘要。对 90 篇文章进行了全文分析，总共有 32 项研究符合纳入标准。这些研究的荟萃分析表明，支持 FDP 的植入物 5 年后估计存活率为 95.6%，10 年后存活率为 93.1%。当机加工表面种植体被排除在分析之外而仅包括粗糙表面种植体时，5 年后存活率增加到 97.2%。种植体支持的 FDP 5 年后存活率为 95.4%，10 年后存活率为 80.1%。当专门针对金属陶瓷 FDP 进行分析时，旧的金丙烯酸 FDP 被排除在外，存活率显着增加。金属陶瓷种植体支持的 FDP 5 年后存活率为 96.4%，10 年后存活率为 93.9%。 5年后，只有66.4%的患者没有出现任何并发症。 5年观察期内最常见的并发症是饰面材料断裂（13.5%）、种植体周围炎和软组织并发症（8.5%）、通路孔修复丢失（5.4%）、基台或螺钉松动（5.3%）以及骨水泥FDP保留丢失（4.7%）。结论 可以得出结论，种植体支持的固定假牙（FDP）是一种安全、可预测的治疗方法，且存活率高。然而，生物和技术并发症很常见（33.6%）。为了最大限度地减少并发症的发生，牙科专业人员应努力为种植体支持的 FDP 选择可靠的组件和材料，并在治疗后将患者置于结构良好的维护系统中。
Objectives The objective of this systematic review was to assess the 5- and 10-year survival of implant-supported fixed dental prostheses (FDPs) and to describe the incidence of biological and technical complications. Methods An electronic Medline search complemented by manual searching was conducted to identify prospective and retrospective cohort studies and case series on FDPs with a mean follow-up time of at least 5 years. Patients had to have been examined clinically at the follow-up visit. Failure and complication rates were analyzed using standard and random-effects Poisson regression models to obtain summary estimates of 5-year and 10-year survival and complication rates. Results The updated search provided 979 titles and 257 abstracts. Full-text analysis was performed for 90 articles resulting in a total 32 studies that met the inclusion criteria. Meta-analysis of these studies indicated an estimated survival of implants supporting FDPs of 95.6% after 5 years and 93.1% after 10 years. When machined surface implants were excluded from the analysis and only rough surface implants included, the survival rate increased to 97.2% after 5 years. The survival rate of implant-supported FDPs was 95.4% after 5 years and 80.1% after 10 years of function. When the analysis was done exclusively for metalceramic FDPs, hence the old goldacrylic FDPs were excluded, the survival rate increased significantly. The survival rate of metalceramic implant-supported FDPs was 96.4% after 5 years and 93.9% after 10 years. Only 66.4% of the patients were free of any complications after 5 years. The most frequent complications over the 5-year observation period were fractures of the veneering material (13.5%), peri-implantitis and soft tissue complications (8.5%), loss of access hole restoration (5.4%), abutment or screw loosening (5.3%), and loss of retention of cemented FDPs (4.7%). Conclusion It may be concluded that implant-supported fixed dental prostheses (FDPs) are a safe and predictable treatment method with high survival rates. However, biological and technical complications were frequent (33.6%). To minimize the incidence of complications, dental professionals should make great effort in choosing reliable components and materials for implant-supported FDPs and the patients should be placed in well-structured maintenance system after treatment.