阳极氧化及大颗粒喷砂酸蚀种植体近十年临床效果评价研究的荟萃分析

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目的:对阳极氧化种植体和大颗粒喷砂酸蚀(sandblasted,large-grit,acid-etched,SLA)种植体的近10年临床应用效果研究进行荟萃分析,为种植体的临床选择及评估提供参考。方法:设置检索时限为2010年1月至2020年4月,检索Pubmed、Cochrane Library、Embase、中国知网、万方数据库,查找阳极氧化及SLA种植体相关临床研究。按照纳入及排除标准严格筛选文献、提取数据后,对纳入的研究依照非随机对照试验方法学评价指标(methodological index for non-randomized studies,MINORS)质量评价工具进行质量评价,并用Stata 14.0软件进行荟萃分析。评价指标主要有:累积存留率(cumulative survive rate,CSR)、边缘骨丧失(marginal bone loss,MBL),并对文献间的异质性和发表偏倚进行综合评价。结果:阳极氧化种植体分析共汇总22篇文献,包含6 276枚阳极氧化种植体。单组率荟萃分析显示,总CSR为98%(6 094/6 276)(95%n CI:97%~98%,n P<0.05),其中5年内CSR为98%(3 177/3 249)(95%n CI:98%~99%,n P<0.05),10年内CSR为97%(2 917/3 023)(95%n CI:96%~98%,n P<0.05);总MBL为1.02 mm(95%n CI:0.69~1.34)。SLA种植体分析共汇总17篇文献,包含4 567枚SLA种植体。单组率荟萃分析显示,总CSR为99%(4 484/4 567)(95%n CI:98%~100%,n P<0.05),其中5年内CSR为99%(2 844/2 905)(95%n CI:98%~100%,n P<0.05),10年内CSR为99%(1 640/1 662)(95%n CI:97%~100%,n P<0.05);总MBL为0.69 mm(95%n CI:0.44~0.95,n P<0.05)。上述结果的偏倚检验n P值分别为0.822和0.284,提示无明显发表偏倚。n 结论:荟萃分析提示,SLA种植体较阳极氧化种植体具有更高的CSR和更小的MBL。“,”Objective:To systematically evaluate the clinical effect of anodized implants and sandblasted, large-grit, acid-etched (SLA) implants in the recent 10 years, so as to provide a reference for the selection and evaluation of implants.Methods:The data from Pubmed, Cochrane Library, Embase, CNKI, and Wanfang Data database from January 2010 to April 2020 were searched, to find clinical studies on anodized and SLA implants. According to the inclusion and exclusion criteria, literature was strictly screened, and data was extracted. Included studies were evaluated by using the methodological index for non-randomized studies (MINORS) and were analyzed by Stata14.0. The outcome of interest was cumulative survival rate (CSR) and marginal bone loss (MBL). Heterogeneity and publication bias among included literature was evaluated comprehensively.Results:A total of 22 articles, including 6 276 anodized implants, were collected for the analysis of anodized implants. Meta-analysis of proportions showed that anodized implants CSR were 98% (95%n CI: 97%-98%, n P<0.05) in total, at 5 years were 98% (95%n CI: 98%-99%, n P<0.05), and at 10 years were 97% (95%n CI: 96%-98%, n P<0.05). MBL change was 1.02 mm (95%n CI: 0.69-1.34, n P<0.05) in total. A total of 17 articles, including 4 567 SLA implants, were collected for the analysis of SLA implants. Meta-analysis of proportions showed that SLA implants CSR were 99% (95%n CI: 98%-100%, n P<0.05) in total, 99% at 5 years (95%n CI: 98%-100%, n P<0.05), and 99% at 10 years (95%n CI: 97%-100%, n P<0.05). MBL change was 0.69 mm (95%n CI: 0.44-0.95, n P0.05), indicating no significant publication bias.n Conclusions:Meta-analysis suggested that SLA implants have higher CSR and lower MBL than anodized implants.
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