Does the implant-abutment interface interfere on marginal bone loss? A systematic review and meta-analysis

Abstract The objective of this systematic review was to compare the conical internal connection (IC) with the external hexagonal connection (EH) on the occurrence of marginal bone loss (ΔMBL). Different databases were used to carry out the selection of the elected studies. The studies were judged according to the risk of bias as “high”, “low” and “unclear” risk. For the meta-analysis we included only studies that could extract the data of ΔMBL, survival rate (SR) and probing depth (PD). No statistically significant differences were found for ΔMBL data at one, three- and five-year survival rates between implant connections (p <0.05), however statistically significant differences were found for PD between EH and IC implants (1-year follow-up) -0.53 [95%CI -0.82 to -0.24, p = 0.0004]. This present systematic review demonstrated that there are no significant differences between IC and EH implants for both ΔMBL and SR at 1, 3 e 5 years after functional loading, although better PD values were observed for implants pertaining to the IC connections. Considering the high heterogeneity, more well-delineated, randomized clinical trials should be conducted.

摘要 本系统综述旨在对比锥形内连接（conical internal connection, IC）与外六角连接（external hexagonal connection, EH）种植体在边缘骨丧失（ΔMBL）发生情况上的差异。研究通过多数据库筛选纳入文献，并依据偏倚风险将文献划分为“高”“低”及“不确定”三个等级。本次荟萃分析仅纳入可提取边缘骨丧失、生存率（SR）及探诊深度（PD）数据的研究。结果显示，不同种植体连接类型在边缘骨丧失数据以及术后1、3、5年生存率上均未发现统计学显著差异（p<0.05）；但在1年随访时，外六角连接与锥形内连接种植体的探诊深度存在统计学显著差异：效应量为-0.53 [95%置信区间（95%CI）-0.82至-0.24，p=0.0004]。本系统综述表明，在功能性负载后1、3、5年时，锥形内连接与外六角连接种植体的边缘骨丧失及生存率均无显著差异，不过锥形内连接种植体的探诊深度表现更优。鉴于本研究存在较高异质性，未来需开展更多设计规范、描述清晰的随机对照临床试验。