| ObjectiveFor patients with insufficient bone mass in the missing tooth area,there is no uniform standard for selecting the ideal implant diameter and length.Therefore,this paper aims to evaluate the impact of implant length and diameter on clinical prognosis through two different angles of bone mass height and width in the missing tooth area,in order to provide a reference for clinical selection.MethodsThe literature search was performed on the three databases of PubMed,Embase,Cochrane Library and three Chinese databases(CNKI,VIP,Wanfang data)through the development of a literature search strategy.In addition,hand-searching of the included literature supplemented the electronic literature.The literature search includes two parts:(1)short implants and long implants combined bone augmentation technique,(2)narrow diameter implants and standard diameter implants.Two independent related researchers conducted literature screening based on the two-part inclusion and exclusion criteria,and finally obtained the two-part included literature.The included literatures were all randomized controlled trials.Two independent related researchers conducted data extraction and evaluated the risk of bias based on a pre-formulated data extraction table.Meta-analysis was performed on continuous variables(implant marginal bone loss)by using the Inverse Variance statistical method.Meta-analysis was performed on dichotomous variables(implant survival rate and complication)by using the Mantel-Haenszel statistical method.ResultsBased on the selection of 714 articles and the inclusion and exclusion criteria,7 studies compared the clinical effects of short implants in the maxillary posterior region with long implants after bone augmentation technique.A total of 712 implants(343 short implants and 369 long implants)were obtained from 412 patients.Three of studies also compared the clinical effects of short implants in the mandibular posterior region with long implants after bone augmentation.Overall,all included studies had low risk of bias in most areas.The results showed that the long implant group had more marginal bone loss than the short implant group in the maxillary posterior(MD combined value:0.12,95%CI:0.04-0.20,P=0.004).The long implant group had more marginal bone loss than the short implant group in the mandibular posterior(MD combined value:0.28,95%CI:0.19-0.37,P<0.00001).There was no significant difference in implant survival between two groups in the maxillary posterior region(RR combined value:1.01,95%CI:0.99-1.04,P=0.32),There was no significant difference in implant survival rate between two groups in the mandibular posterior region(RR combined value:0.97,95%CI:0.91-1.03,P=0.31).There was no statistically significant difference in the incidence of intraoperative complications between two groups in the maxillary posterior region(RR combined value:1.50,95%CI:0.47-4.77,P=0.9922).The incidence of postoperative complications in the long implant group was significantly higher than that in the short implant group(RR combined value:2.97,95%CI:1.26-7.00,P=0.01).There was no statistically significant difference in the incidence of postoperative complications between two groups in the maxillary posterior region(RR combined value:0.69,95%CI:0.40-1.18,P=0.8427).There was no statistically significant difference in the incidence of postoperative complications between two groups(RR combined value:0.40,95%CI:0.06-2.72,P=0.35).Based on the selection of 861 articles and the inclusion and exclusion criteria,3 studies compared clinical effects of standard diameter implants in the missing tooth area and narrow diameter implants when the width of the alveolar bone in the missing tooth region or the mesial-to-distal gap was insufficient.A total of 134 implants(66 standard diameter implants and 68 narrow diameter implants)were obtained from 134 patients.Overall,all included studies had low risk of bias in most areas.The results showed that there was no significant marginal bone loss in standard diameter and narrow diameter implants(MD combined value:0.00,95%CI:-0.16-0.17,P=0.95).There was no statistically significant difference in implant survival rate between two groups(RR combined value:1.00,95%CI:0.95-1.05,P=1.00).There was no significant difference in complication between two groups(RR combined value:1.52,95%CI:0.76-3.06,P=0.24).Conclusion1.Short implants have similar implant survival rate and postoperative complication rate as long implants in the posterior region,and short implants are better than long implants in the horizontal maintenance of bone around implants.2.In the maxillary posterior region,the incidence of intraoperative complications of short implants was similar to long implants,3.In the mandibular posterior region,short implants were superior to long implants after bone augmentation technique in the incidence of postoperative complications.4.Narrow diameter implants(φ 3.3mm)have similar implant marginal bone loss,implant survival rate and complication rate as standard diameter implants. |
PDF Full Text Request