种植体支持的单端悬臂修复体的临床疗效:系统回顾和meta分析

Marginal bone loss of implant-supported prostheses with and without cantilever-a systematic review and meta analysis

目的:评估种植体支持的单端悬臂修复的留存率、成功率(无并发症)和边缘骨吸收,并评价悬臂长度对种植体支持的单端悬臂修复效果影响。方法:检索截止2016年5月1日在Pubmed和Cochrane Central Register of Controlled Trials数据库收录的相关英文临床研究文献,从符合纳入标准的文献中提取种植体留存率、种植修复成功率和边缘骨吸收等数据并进行meta分析。结果:检索到相关的题目和摘要263条,最终纳入16篇文献。6篇文献报道了种植体支持的局部固定义齿,meta分析显示是否带有单端悬臂梁对其成功率、种植体留存率和边缘骨吸收均无显著影响。10篇文献报道了种植体支持的全口义齿,其种植体留存率为97%~100%,种植修复成功率为52%~98%,平均边缘骨吸收为0.23~1.73 mm。没有文献报道悬臂长度对种植修复有不良影响。结论:种植体支持的单端悬臂修复体是一个可预期的治疗选择。当种植体支持的局部固定义齿悬臂梁<9 mm,种植体支持的全口义齿悬臂梁<15.6 mm时,可以获得较好的临床疗效。

PURPOSE： The aim of the present review was to evaluate the clinical parameters and marginal bone loss of implant-supported prostheses with cantilever; and to assess the influence of cantilever length on the clinical parameters and marginal bone loss of implant-supported prostheses with cantilever. METHODS： PubMed and Cochrane Central Register of Controlled Trials were searched up to May 1st, 2016 for articles on implant-supported prostheses with cantilever. Meta analysis was performed for studies reporting implant success rate, implant survival rate and marginal bone loss of implant-supported prostheses with and without cantilever. RESULTS： Two hundred and sixty-three titles and abstracts were retrieved from the electronic search for possible inclusion in the review. Finally, 16 studies were included. For implant-supported fixed partially prostheses, meta analysis showed no significant differences in implant survival, success and marginal bone loss. For implant-supported full arch prostheses, 10 studies reported that survival rate ranged from 97% to 100%, success rate ranged from 52% to 98% and marginal bone loss ranged from 0.23 to 1.73 mm. No unfavorable effect of cantilever length was reported. CONCLUSIONS： Based on the current evidence, implant-supported fixed partial prostheses with cantilever could be considered as a predictable treatment option. High survival rates and acceptable marginal bone loss were reported in implant-supported full arch prostheses with cantilever. The cantilever length less than 9 mm was safe in implant-supported partial prostheses, while cantilever length less than 15.6 mm was acceptable in implant-supported full arch prostheses.