One Abutment at One Time Concept for Platform-Switched Morse Implants: Systematic Review and Meta-Analysis

Abstract The aim of this systematic review and meta-analysis was to compare the peri-implant vertical bone loss of immediate loading of implant crowns using the one abutment at one time (AOT) protocol and implants with abutment removal (AR). This systematic review with meta-analysis was reported according to the PRISMA statement, with guidance from the Cochrane Collaboration Handbook. A total of 103 publications were identified in the PubMed database and reference lists of examined articles. After the screening of titles and abstracts, the eligibility of eight full-text articles was assessed. Five studies published between 2010 and 2015 were included in the meta-analysis. There was less peri-implant vertical bone loss at implants using an AOT protocol than at implants using AR protocol (WMD -0.19, 95% CI -0.26 to -0.13; p<0.0001; random-effects model). In conclusion, the use of the AOT protocol with platform-switched Morse implants results in less bone loss than do AR procedures, but this effect may not be clinically relevant. The preservation of marginal bone level achieved with the AOT protocol may not enhance the aesthetics. These results should be interpreted with caution.

摘要
本系统综述与荟萃分析旨在对比采用一次加载单基台（AOT）方案的种植体冠即刻负重种植体，与采用基台移除（AR）方案的种植体，二者的种植体周围垂直骨丢失情况。本项结合荟萃分析的系统综述遵循PRISMA声明进行报告，并参照《Cochrane协作网手册》的指导规范开展。研究人员在PubMed数据库及纳入文献的参考文献列表中共检索到103篇文献。经标题与摘要筛选后，对8篇全文文献的纳入资格进行评估，最终将2010年至2015年间发表的5项研究纳入本次荟萃分析。采用AOT方案的种植体，其种植体周围垂直骨丢失量低于采用AR方案的种植体（加权均数差-0.19，95%置信区间[-0.26, -0.13]；p<0.0001，随机效应模型）。综上，相较于AR操作方案，采用AOT方案搭配平台转换式莫氏锥度种植体可减少骨丢失，但该效应可能不具备临床相关性。通过AOT方案实现的边缘骨水平保留，或无法提升美学效果。对本研究结果的解读应持谨慎态度。