国际口腔医学杂志 ›› 2022, Vol. 49 ›› Issue (5): 537-547.doi: 10.7518/gjkq.2022087

• 论著 • 上一篇    下一篇

根盾技术对即刻种植临床效果的影响:基于随机对照研究的Meta分析

龚佳明1,2(),赵瑞敏1,2,李婉昕1,苏琳涵2,余占海1,李健学2()   

  1. 1.兰州大学口腔医学院·口腔医院种植科 兰州 730000
    2.解放军联勤保障部队第940医院口腔科 兰州 730050
  • 收稿日期:2022-01-05 修回日期:2022-05-20 出版日期:2022-09-01 发布日期:2022-09-16
  • 通讯作者: 李健学
  • 作者简介:龚佳明,医师,硕士,Email:gongjm19@lzu.edu.cn
  • 基金资助:
    甘肃省自然科学基金(20JR10RA006)

The socket-shield technique for immediate implant placement: a meta-analysis of randomized controlled trials

Gong Jiaming1,2(),Zhao Ruimin1,2,Li Wanxin1,Su Linhan2,Yu Zhanhai1,Li Jianxue2()   

  1. 1.Dept. of Implantology, School & Hospital of Stomatology, Lanzhou University, Lanzhou 730000, China
    2.Dept. of Stomatology, The 940th Hospital of Joint Logistics Support Force of People’s Liberation Army, Lanzhou 730050, China
  • Received:2022-01-05 Revised:2022-05-20 Online:2022-09-01 Published:2022-09-16
  • Contact: Jianxue Li
  • Supported by:
    Natural Science Foundation of Gansu Province(20JR10RA006)

摘要:

目的 探讨与传统即刻种植(CII)相比,即刻种植联合根盾技术(SST)的临床应用效果。 方法 电子检索2010年5月—2021年11月PubMed、Embase、Cochrane Library、Web of Science、CNKI、万方数据库有关SST和CII的随机对照研究(RCT),且对关键文献进行引文索引。使用Cochrane风险评估工具评估偏倚风险,使用RevMan 5.4对数据进行分析,探讨2种技术对种植体周软硬组织、种植体稳定性(ISQ)、并发症和失败率的影响。 结果 共14篇RCT纳入本研究,其中英文8篇,中文6篇。随访时间从6个月至36个月不等,平均随访时间为14.21个月。Meta分析结果显示,2组除ISQ的差异无统计学意义外(P>0.05),SST组具有更少的唇侧骨板改变(P<0.05),更稳定的种植体边缘骨水平(P<0.05)和更好的美学效果(P<0.05);但是在并发症和种植失败率方面,2组差异均无统计学意义(P>0.05)。 结论

关键词: 即刻种植, 根盾技术, 骨丧失, 粉红色美学, Meta分析

Abstract:

Objective To systematically evaluate and compare the clinical effect of immediate implant placement with socket-shield technique (SST) and conventional immediate implant (CII). Methods Databases in PubMed, Embase, Cochrane Library, Web of Science, CNKI, and Wanfang were searched to identify randomized controlled trials (RCTs) that compared SST and CII, and citation indexes were carried out for the critical pieces of literature from May 2010 to November 2021. The Cochrane Collaboration’s tool was used to assess the risk of bias. Data were analyzed using the Review Manager 5.4 software. To discuss the effects of two techniques on the clinical performance of peri-implant soft and hard tissue, implant stability quotient (ISQ), and complications and failure rate. Results A total of 14 RCTs were inclu-ded in this study, including eight in English and six in Chinese. Follow-ups ranged from 6 to 36 months, with an average of 14.21 months. Meta-analysis showed that the SST group resulted in a significantly lesser labial bone plate changes (P<0.05), stabler margin bone level (P<0.05), and better esthetic presentation (P<0.05), except for the ISQ (P>0.05). How-ever, there were no significant differences in complications and implant failure rates between the two groups (P>0.05). Conclusion In the immediate implant placement procedure, employing SST has medium- to short-term positive effects on reducing the peri-implant bone resorption and maintaining the soft tissue morphology. To supervise the current manifestation, further evidence from long-term RCTs is needed.

Key words: immediate implant, socket shield technique, bone loss, pink esthetics, meta-analysis

中图分类号: 

  • R 783

图1

文献筛选流程图"

表 1

纳入研究的基本特征"

纳入研究

(发表时间)

国家研究类型

种植

位点

种植体型号

(品牌/尺寸)

患者/种植体数临床干预随访时间/月主要结局指标次要结局指标
植骨程序修复程序
SSTCII
SSTCII
Abd-Elrahman等[24](2020)埃及RCT美学区

Titan Industries/

直径3.3、3.7 mm,

长度14、16 mm

NR/20NR/20NN即刻修复6①②④⑤⑥⑦
Atef等[25](2021)埃及RCT美学区NR21/2121/21NXenograft Tutobone

术后

4个月

12①②⑤⑥⑦
Bramanti等[27](2018)意大利RCT美学区NR20/2020/20NAllograft CopiOs即刻修复36⑤⑥⑦
Barakat等[26](2017)埃及RCT

上颌

前牙区

Dentium superline/

直径3.6~5.8 mm,

长度7~14 mm

10/1010/10NN

术后

4个月

7①②④⑥⑦
Fattouh[29](2018)埃及RCT

上颌

美学区

NR/直径4.1 mm,

长度13 mm

10/1010/10NBio-Oss Spongiosa+Bio-Gide即刻修复12⑤⑥⑦

Hana等[30]

(2020)

伊拉克RCT

上颌

前牙区

NR20/2020/20NN即刻修复12NR⑤⑥⑦
Sun等[28](2020)中国RCT

前牙

美学区

Nobel Replace?cc/NR15/1515/15间隙>1 mm则放置Bio-Oss

间隙>1 mm则

放置Bio-Oss

即刻修复24①②⑤⑥⑦
Tiwari等[31](2019)印度RCT

上颌

前牙区

NR8/88/8NN

术后

4个月

12①②
秦蓉等[33](2021)中国RCT

上颌

前牙区

NR35/3535/35间隙>1 mm则放置Bio-OssBio-Oss

术后

6个月

12NR⑤⑥⑦
李云杉[32](2021)中国RCT

上颌

前牙区

ITI/NR40/4040/40Bio-OssBio-OssNR12④⑤⑦
张宾等[36](2020)中国RCT

上颌

前牙区

Zimmer/NR30/3030/30Bio-OssBio-Oss即刻修复12⑤⑥⑦
谭蕾等[35](2019)中国RCT

前牙

美学区

NR15/1515/15NN即刻修复6①②
闫圣杰[37](2019)中国RCT

上颌

前牙区

NR12/1314/15间隙>1 mm则放置Bio-OssBio-Oss

术后

6个月

12⑤⑥⑦
张超等[34](2021)中国RCT前牙区NR31/3132/32

Bio-Oss+

Bio-Gide

Bio-Oss+

Bio-Gide

NR24①②④⑤⑥⑦

图 2

纳入研究的偏倚风险评价Random sequence generation (selection bias):随机序列产生(选择偏倚);Allocation concealment (selection bias):分配隐藏(选择偏倚);Blinding of participants and personnel (performance bias):研究对象和研究者的盲法(实施偏倚);Blinding of outcome assessment (detection bias) :结果评估的盲法(测量偏倚);Incomplete outcome data (attrition bias):结果数据不完整(随访偏倚);Selective reporting (reporting bias):选择性报告(报告偏倚);Other bias:其他偏倚。"

图 3

2组在不同随访时间内唇侧骨宽度变化的Meta分析"

图 4

2组在6、12个月时唇侧骨高度变化的Meta分析"

图 5

2组在6个月时种植体边缘骨水平的Meta分析"

图 6

2组在6、12个月时ISQ的Meta分析"

图 7

2组在不同随访时间PES的Meta分析"

图 8

2组发生并发症的Meta分析"

图 9

2组种植失败率的Meta分析"

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