在后牙区应用4 mm超短种植体临床效果的Meta分析  

Clinical efficacy of extra-short implant (4 mm) placed in posterior areas: a Meta-analysis

作　　者：张启航 龚佳明 余佳颖 赵瑞敏 苟萍 余占海[1] Zhang Qihang;Gong Jiaming;Yu Jiaying;Zhao Ruimin;Gou Ping;Yu Zhanhai(Dept.of Implantology,School of Stomatology,Lanzhou University,Lanzhou 730000,China;Dept.of Stomatology,The 940th Hospital of Joint Logistics Support Force of People’s Liberation Army,Lanzhou 730050,China)

机构地区：[1]兰州大学口腔医学院/口腔医院种植科,兰州730000 [2]解放军联勤保障部队第940医院口腔科,兰州730050

出　　处：《华西口腔医学杂志》2023年第1期80-87,共8页West China Journal of Stomatology

基　　金：兰州大学口腔医院科研基金(lzukqky-2020-t07,lzukqky-2022-t04)。

摘　　要：目的 通过系统评价及Meta分析的方法评估在后牙区骨量不足植入4 mm超短种植体(ESI)的安全性和效用。方法 电子检索2010年1月1日—2022年8月31日PubMed、Embase、Cochrane Library、Web of Science、CNKI、万方数据库有关ESI与标准种植体(SI)(≥8 mm)的随机对照试验或临床对照试验,并进行引文检索。应用RevMan 5.4版软件进行Meta分析。结果 共11篇研究符合纳入标准,其中随机对照试验6篇,临床对照试验5篇。Meta分析结果:在后牙区种植时,ESI与SI的存留率差异无统计学意义[RR=1.23,95%CI(0.66,2.27),P=0.52];ESI表现出更稳定的边缘骨水平[MD=-0.16,95%CI (-0.25,-0.07),P=0.000 7],更少的生物并发症[RR=0.34,95%CI (0.19,0.62),P=0.000 4],然而机械并发症更多[RR=2.89,95%CI (1.05,7.92),P=0.04]。结论 基于有限的证据,在后牙牙槽嵴高度低于5 mm时应用ESI可以获得媲美SI的临床效果,且具备技术敏感性低、术后生物并发症少等优势。由于ESI长期随访证据不足、样本量有限,仍需要更多临床试验评估ESI的长期效用。Objective This study aimed to systematically evaluate the safety and clinical efficacy of 4 mm-extrashort implant(ESI) placement in severely atrophic posterior areas. Methods Databases of PubMed, Embase, Cochrane Library, Web of Science, CNKI, and Wanfang from January 1, 2010, until August 31, 2022, were searched to identify randomized controlled trials or controlled clinical trials related to ESI and standard implants(SI). An additional hand search of the references of included articles was also conducted. Meta-analyses were carried out with RevMan 5.4 software. Results A total of 11 studies were included, involving six randomized controlled trials and five controlled clinical trials.The meta-analyses indicated that when implants were placed in the posterior area, the implant survival rate between ESI and SI did not significantly differ [RR=1.23, 95%CI(0.66, 2.27), P=0.52]. ESI resulted in significantly stable marginal bone level [MD=-0.16, 95%CI(-0.25,-0.07), P=0.000 7] and less biological complications [RR=0.34, 95%CI(0.19, 0.62), P=0.000 4] but more mechanical complications [RR=2.89, 95%CI(1.05, 7.92), P=0.04]. Conclusion Based on the limited evidence, ESI could achieve clinical outcomes similar to those of SI when the height of the posterior alveolar bone is less than 5 mm, with lower technical sensitivity and fewer postoperative clinical complications than SI. Due to insufficient evidence and limited sample size, further clinical trials are needed to verify the long-term efficacy of ESI.

关 键 词：超短种植体 标准种植体 存留率 边缘骨吸收 并发症 META分析 

分 类 号：R783.1[医药卫生—口腔医学]