Is the clinical performance of dental implants influenced by different macrogeometries? A systematic review and meta-analysis.

Autor: Reis-Neta GRD; PhD student, Department of Prosthodontics and Periodontology, Piracicaba Dental School (FOP), University of Campinas (UNICAMP), Piracicaba, SP, Brazil., Cerqueira GFM; MSc student, Department of Prosthodontics and Periodontology, Piracicaba Dental School (FOP), University of Campinas (UNICAMP), Piracicaba, SP, Brazil., Ribeiro MCO; PhD student, Department of Prosthodontics and Periodontology, Piracicaba Dental School (FOP), University of Campinas (UNICAMP), Piracicaba, SP, Brazil., Magno MB; Professor, Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil., Vásquez GAM; Professor, Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry of Ribeirão Preto, University of Sao Paulo (USP), Ribeirão Preto, SP, Brazil; and Professor, Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil., Maia LC; Professor, Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil., Del Bel Cury AA; Professor, Department of Prosthodontics and Periodontology, Piracicaba Dental School (FOP), University of Campinas (UNICAMP), Piracicaba, SP, Brazil., Marcello-Machado RM; Collaborating Professor, Department of Prosthodontics and Periodontology, Piracicaba Dental School (FOP), University of Campinas (UNICAMP), Piracicaba, SP, Brazil; and Professor, Periodontology, Faculty of Dentistry, Paulista University (UNIP), São Paulo, SP, Brazil. Electronic address: raissammm@gmail.com.
Jazyk: angličtina
Zdroj: The Journal of prosthetic dentistry [J Prosthet Dent] 2024 Oct 03. Date of Electronic Publication: 2024 Oct 03.
DOI: 10.1016/j.prosdent.2024.08.019
Abstrakt: Statement of Problem: Although tapered and cylindrical implants have been widely used, a consensus on which macrogeometry offers better clinical performance is lacking.
Purpose: The purpose of this systematic review and meta-analysis was to evaluate the influence of different macrogeometries (tapered and cylindrical) on the clinical performance of dental implants.
Material and Methods: The study was registered in the international prospective register of systematic reviews (PROSPERO) database (CRD42022347436). A search for clinical studies was conducted in 6 databases to identify randomized controlled clinical trials that evaluated the effectiveness of tapered and cylindrical implants placed in the maxilla or mandible of adult patients that had at least 1 clinical performance parameter as outcome. The risk of bias was evaluated using the revised Cochrane Risk-of-Bias Tool (RoB 2) tool. Meta-analyses on implant survival and success, marginal bone loss (MBL), implant stability (ISQ), and torque insertion (TI) were performed, with the certainty of evidence evaluated using the grading of recommendations, assessment, development, and evaluations (GRADE) checklist.
Results: Of the 18 included studies, 7 had a low risk, 6 had some concerns, and 5 had a high risk of bias. Meta-analyses of survival (RR 0.99 [0.97, 1.01]; P=.38; I2=0%), implant success (RR 1.06 [0.99, 1.13] P=.08 I2=0%), 1-month MBL (MD -0.11 [-0.33, 0.10] P=.31 I2=98%), 3 months MBL (MD -0.21 [-0.27, 0.16] P=.26 I2=98%), 6 months MBL (MD -0.29 [-0.60, 0.01] P=.06 I 2 =74%), 1-year MBL (MD 0.01 [-0.07, 0.09] P=.77 I2=98%) and after 2 years MBL (MD -0.04 [-0.14, 0.07] P=.52 I2=0%), ISQ at implant installation (MD 0.35 [-0.72, 1.42] P=.52 I2=0%), %), after 2 months (MD 0.90 [-1.08, 2.87] P=.37 I2=0%) and at 1 year (MD -0.02 [-1.07, 1.03] P=.97 I2=0%), and insertion torque (MD 3.10 [-1.71, 7.92] P=.21 I2=80%) were statistically similar. However, tapered implants showed higher ISQ than cylindrical implants after 3 months (MD 1.20 [0.39, 2.01] P=.004 I2=17%). The certainty of evidence for the analyzed parameters ranged from high to very low.
Conclusions: Both macrogeometries present good clinical performance, with certainty of evidence ranging from high to very low. Tapered implants showed better secondary stability at 3 months after implant installation, but with low certainty of evidence.
(Copyright © 2024 Editorial Council for The Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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