不同种植牙修复关节对边缘骨质流失的影响:贝叶斯网络 Meta 分析 (NMA) 和系统综述的新发现

F. Lorusso, I. Alla, S. Gehrke, Mariastella Di Carmine, Sergio Rexhep Tari, A. Scarano
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A series of pairwise meta-regressions for continuous variables was conducted considering the mean differences and 95% CI at two different timepoints: baseline and 1-year follow-up. The meta-analysis was performed comparing the following groups: internal conical prosthetic joint with index (IC), external hexagon bone level position (EI), internal tri-channel connection bone level position (ITC), internal hexagon 1 mm below the bone level (HI), internal hexagon bone level position (HI crest), cone morse 1 mm below the bone level (CM), cone morse bone level position (CM crest) and internal octagon bone level position (IO). The following parameters were considered for descriptive data synthesis: sample size, implant manufacturer, prosthetic joint type, prosthetic complications, marginal bone loss, study outcomes. Results: A total of 247 papers were identified by the electronic screening and 241 were submitted for the full text assessment. 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引用次数: 0

摘要

背景:评估种植牙修复关节的一个关键点是其在咀嚼负荷下的机械强度和生物反应。本系统综述旨在评估不同内/外双相种植体的边缘骨损失和修复性能。方法:随机临床试验分析时考虑了随机临床试验(RCT)。通过电子程序在 Pubmed/MEDLINE、EMBASE 和 Google Scholars 数据库中进行文章筛选。对纳入数据处理的文章进行了资格和偏倚风险评估。对连续变量进行了一系列成对元回归,考虑了两个不同时间点(基线和 1 年随访)的平均差和 95% CI。荟萃分析比较了以下组别:带指数的内锥形假体关节(IC)、外六角骨水平位置(EI)、内三通道连接骨水平位置(ITC)、低于骨水平 1 毫米的内六角(HI)、内六角骨水平位置(HI 嵴)、低于骨水平 1 毫米的锥形莫尔斯(CM)、锥形莫尔斯骨水平位置(CM 嵴)和内八角骨水平位置(IO)。描述性数据综合考虑了以下参数:样本量、种植体制造商、假体关节类型、假体并发症、边缘骨丢失、研究结果。结果:通过电子筛选共确定了 247 篇论文,其中 241 篇提交进行全文评估。在资格审查过程中,共排除了 209 篇文章,32 篇偏倚风险较低的研究被考虑用于定性综合和进一步的统计方法。与 IC、EI、ITC、内六角、锥形莫尔斯和内八角相比,CM 在基线期显示出更有效的效率并减少了边缘骨丢失(P < 0.05)。与其他关节类型相比,CM 在加载情况下的修复并发症和结构装置(包括基台和关节组件)故障率较低。结论:在本次调查的范围内,考虑到研究模型的异质性、重量以及牙科种植体特性之间的固有差异,纯 CM 在短期和中期随访中显示出更稳定的边缘骨质流失控制效果。尽管所有关节的累积并发症发生率都很低,但在早期和中期随访中,CM基台关节较少发生修复失败。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effect of Different Dental Implant Prosthetic Joints on Marginal Bone Loss: Emerging Findings from a Bayesian Network Meta-Analysis (NMA) and Systematic Review
Background: A key point in assessing dental implant prosthetic joints is their mechanical strength and biological response under the masticatory loading. The aim of the present systematic review was to evaluate the marginal bone loss and prosthetic behaviour of different internal/external bi-phasic implants. Methods: Randomized Clinical Trials (RCTs) have been considered for analytic purposes. The article screening was conducted on the Pubmed/MEDLINE, EMBASE and Google Scholars databases through an electronic process. Eligibility and risk of bias assessments were conducted for an article to be included in the data process. A series of pairwise meta-regressions for continuous variables was conducted considering the mean differences and 95% CI at two different timepoints: baseline and 1-year follow-up. The meta-analysis was performed comparing the following groups: internal conical prosthetic joint with index (IC), external hexagon bone level position (EI), internal tri-channel connection bone level position (ITC), internal hexagon 1 mm below the bone level (HI), internal hexagon bone level position (HI crest), cone morse 1 mm below the bone level (CM), cone morse bone level position (CM crest) and internal octagon bone level position (IO). The following parameters were considered for descriptive data synthesis: sample size, implant manufacturer, prosthetic joint type, prosthetic complications, marginal bone loss, study outcomes. Results: A total of 247 papers were identified by the electronic screening and 241 were submitted for the full text assessment. The eligibility process excluded 209 articles, and 32 studies with a low risk of bias were considered for the qualitative synthesis and further statistical methods. At the baseline, the CM showed a more effective efficiency and reduced marginal bone loss compared to IC, EI, ITC, internal hexagon, cone morse and internal octagon (p < 0.05). CM showed the lower rate of prosthetic complications and structural device failure including abutments and joint components under the loading compared to other joint types. Conclusion: Within the limits of the present investigation, the heterogeneity, the weight of the study model considered and the inherent differences between the dental implant properties, the pure CM showed a more consistent control of marginal bone loss at short- and medium-term follow-up. Despite the low rate of cumulative complications for all joints considered, the CM abutment joints were less prone to prosthetic failure at an early and medium-term follow-up.
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