Abstract
BackgroundTo systematically assess studies analyzing peri-implant bone loss in implants placed in crestal and subcrestal position.Material and MethodsFollowing the recommended methods for systematic reviews and meta-analyses (PRISMA), an electronic search was conducted in the PubMed (MEDLINE), EMBASE and LILACS databases to identify all relevant articles published up until April 2017. The search included human studies comparing marginal bone loss (MBL) between a control group and a study group with a minimum of 10 patients and a minimum follow-up of 6 months after prosthetic loading with rough neck implants. Two independent reviewers assessed the risk of bias in the selected studies based on the Newcastle-Ottawa scale for observational studies and the Cochrane Collaboration for clinical trials.ResultsOf 342 potentially eligible items, 7 complied with the inclusion criteria. One article was retrieved through the manual search. Eight articles were finally included: five experimental and three observational studies. The risk of bias assessed by the Cochrane Collaboration and Newcastle-Ottawa showed a high risk of bias. The mean follow-up period was 21 months (range 6-36 months). In four studies, implants placed in a crestal position presented higher MBL than subcrestal implants - the differences being significant in one study, while in three studies, implants placed in a subcrestal position presented greater MBL than crestal implants, with significant differences in only one study.ConclusionsDespite its limitations, the present systematic review did not find better outcomes between crestal and subcrestal implant placement, however, new studies will be needed, involving improved designs and the standardization of protocols to allow statistical comparisons and the drawing of firm conclusions. Key words:Crestal implants, subcrestal implants, placement level, systematic review.
Highlights
Many authors (1-3) have observed peri-implant bone losses of between 1-2 mm after the first year of occlusal loading, and of 0.1 to 0.2 mm over successive years
Implants placed in a crestal position presented higher marginal bone loss (MBL) than subcrestal implants - the differences being significant in one study, while in three studies, implants placed in a subcrestal position presented greater MBL than crestal implants, with significant differences in only one study
Material and Methods The present systematic review was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. -Focus question The present systematic review is justified, with the aim of answering the following pre-specified focus question developed in accordance with the recognized Population, Intervention, Comparison, Outcome (PICO) format: “Are there differences in terms of marginal bone loss (MBL) between the subcrestal and juxta-crestal placement of osseointegrated implants in patients subjected to dental implant treatment?” -Search strategy An electronic search was performed without language and time restrictions and up until April 2017 in three main databases: the MEDLINE from the United States National Library of Medicine (NLM) through PubMed, EMBASE and LILACS
Summary
Many authors (1-3) have observed peri-implant bone losses of between 1-2 mm after the first year of occlusal loading, and of 0.1 to 0.2 mm over successive years. All implant maintenance programs are focused on prevention, that is, meticulous oral hygiene practices, careful peri-implant examination, analysis of risk factors and periodic elimination of bacterial deposits from implants (21). In this line, limiting the exposure of the rough surface of the implant could be relevant to maintain a correct long-term periimplant health. The aim of this investigation was to systematically review studies analyzing peri-implant bone loss in implants placed in crestal and subcrestal position. To systematically assess studies analyzing peri-implant bone loss in implants placed in crestal and subcrestal position. Two independent reviewers assessed the risk of bias in the selected studies based on the Newcastle-Ottawa scale for observational studies and the Cochrane Collaboration for clinical trials. e673
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