种植体植入深度对周围硬组织影响的系统回顾及Meta分析

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摘要目的系统评价种植体的植入深度对周围硬组织水平变化的影响，从而获得理想的植入深度，为临床应用提供理论基础和实践指导。方法在PubMed、Medline、Embase、The Cochrane Library、CBM、CNKI、万方等数据库中检索2006年1月1日～2016年6月1日发表的文献，语言为英文和中文，对入选文献进行全文阅读、数据提取、质量评价，采用Revman 5.3软件进行Meta分析及绘制森林图，效应指标是平均数和95%置信区间。结果检索文献105篇，初步纳入28篇，全文阅读后最终纳入5篇。不考虑是否使用平台转移情况下，早期阶段平骨水平组骨吸收量少于骨下水平组[MD=0.30，95%CI（0.20，0.39），P＜0.000 01]。亚组分析时，2项研究与平台转移相关，但未能得出有意义结果（P=0.99）。4项研究与非平台转移相关，分别在3～6个月，平骨水平组骨吸收量少于骨下水平组[MD=0.26，95%CI（0.15，0.38），P＜0.000 01]；＞12个月时间段，骨上水平组骨吸收量少于平骨水平组 [MD=-0.59，95%CI（-0.72，-0.46），P＜0.000 01]。结论骨水平种植体植入骨下水平时，在骨重建过程中的边缘骨吸收量可能大于平骨水平或骨上水平。

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	陈世玉
	李昀生
	邵健
	江燕军

关键词 ：种植体, 植入深度, 边缘骨吸收, 平台转移, Meta分析

Abstract：Objective To review the change of marginal bone level around dental implants while inserted different depths.Achieving an ideal insertion depth to provide an theoretical basis and practical activity for clinical application. Methods A literature search of electronic databeses(PubMed,Medline,Embase,The Cochrane Library,CBM,CNKI,Wan-Fang)were performed up,and works published in the English and Chinese languge from January 1st,2006 to June 1st, 2016.Full-text analysis was performed in relevant publications,and to make data extraction,the quality evaluation. Revman 5.3 software was used for Meta analysis and forest plot drawing.The effect indexes were mean differences(MD) and 95%confidence intervals(CI).Results 105 studies were searched and 28 articles were preliminary chosen.After the full-text reading,5 articles were eventually included.Irrespective of platform switching,the marginal bone loss around implants in the crestal level was significantly less than the implants in the subcrestal level among the early stage after placements[MD=0.30,95%CI(0.20,0.39),P＜0.000 01].Subgroup analyses,2 articles were regarding of platform switching im plants,but no statistically significant difference was detected(P=0.99).4 articles were regarding of non-switched platform implants,Subgroup analyses showed thatthe marginalbone loss around cretalbone levelimplants was significantly less than the subcrestal bone levelimplants,respectively during the period of 3-6 months[MD=0.26,95%CI(0.15，0.38),P＜0.000 01]. And less bone lossin the above bone levelimplants than the crestalbone levelimplants in more than 1 year after prosthetic loading[MD=-0.59,95%CI(-0.72，-0.46),P＜0.000 01].Conclusion Implants in a subcrestal position may be associated with a higher amount of bone loss during the remodeling process than implants placed in an epior supracrestal position.

Key words： Dental implants Insertion depth Marginal bone loss Platform switching Meta analysis

引用本文:

陈世玉;李昀生;邵健;江燕军. 种植体植入深度对周围硬组织影响的系统回顾及Meta分析[J]. 中国当代医药, 2017, 24(8): 14-18.
CHEN Shi-yu;LI Yun-sheng;SHAO Jian;JIANG Yan-jun. Systematic review and Meta analysis of the influence of insertion depth on marginal hard tissue of dental implants. 中国当代医药, 2017, 24(8): 14-18.

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