Article type
Year
Abstract
Background: New treatment interventions in Implant Dentistry are often commercially marketed and clinicians’ decisions are usually based on experience rather than scientific evidence. The Otago model presents a 5 year venture to implement evidence-based implant practice in Otago by conducting a number of systematic reviews and meta-analyses in areas of controversy in Implant Dentistry.
Objectives: Four systematic reviews were completed to study the survival of immediately placed and/or loaded single implants in the aesthetic and molar regions, and to explore the advantages of platform-switched implants in preserving peri-implant marginal bone levels.
Methods: A literature and manual search of the main electronic databases including the Cochrane Oral Health Group’s Trials Register was conducted. The systematic reviews were prepared in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and Cochrane guidelines. Descriptive and outcome data were extracted using specially designed data extraction forms. Quality assessment of the included studies followed the Cochrane Handbook of Systematic Reviews. MIX software for meta-analysis, RevMan 5.0 software, and R statistical software (version 2.7.1) were used to analyze the data.
Results: Immediate placement and loading of single implant crowns in the aesthetic zone were associated with a significantly higher risk of implant failure. Although there were no statistically significant differences between immediate and delayed placement or loading in the molar sites, the included studies were not of sufficient quality to draw reliable conclusions. Conversely, peri-implant marginal bone loss around platform-switched implantswas significantly less compared with platform-matched implants.
Conclusions: The systematic reviews and meta-analyses indicated a higher risk with the immediate placement and loading approaches when compared with conventional placement and loading of single implants but showed an aesthetic advantage in the use of platform-switched implant. The need for further long-term, well-conducted, randomized controlled studies was suggested.
Objectives: Four systematic reviews were completed to study the survival of immediately placed and/or loaded single implants in the aesthetic and molar regions, and to explore the advantages of platform-switched implants in preserving peri-implant marginal bone levels.
Methods: A literature and manual search of the main electronic databases including the Cochrane Oral Health Group’s Trials Register was conducted. The systematic reviews were prepared in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and Cochrane guidelines. Descriptive and outcome data were extracted using specially designed data extraction forms. Quality assessment of the included studies followed the Cochrane Handbook of Systematic Reviews. MIX software for meta-analysis, RevMan 5.0 software, and R statistical software (version 2.7.1) were used to analyze the data.
Results: Immediate placement and loading of single implant crowns in the aesthetic zone were associated with a significantly higher risk of implant failure. Although there were no statistically significant differences between immediate and delayed placement or loading in the molar sites, the included studies were not of sufficient quality to draw reliable conclusions. Conversely, peri-implant marginal bone loss around platform-switched implantswas significantly less compared with platform-matched implants.
Conclusions: The systematic reviews and meta-analyses indicated a higher risk with the immediate placement and loading approaches when compared with conventional placement and loading of single implants but showed an aesthetic advantage in the use of platform-switched implant. The need for further long-term, well-conducted, randomized controlled studies was suggested.