Dental implants inserted in male versus female patients: a systematic review and meta‐analysis

The aim of this meta‐analysis was to test the null hypothesis of no difference in the failure rates, marginal bone loss (MBL) and post‐operative infection for implants inserted in male or female patients, against the alternative hypothesis of a difference. An electronic search without time or language restrictions was undertaken in December 2014. Eligibility criteria included clinical human studies, either randomized or not. Ninety‐one publications were included, with a total of 27 203 implants inserted in men (1185 failures), and 25 154 implants inserted in women (1039 failures). The results suggest that the insertion of dental implants in male patients statistically affected the implant failure rates (RR 1·21, 95% CI 1·07–1·37, P = 0·002). Due to the limited number of studies reporting results on MBL, it is difficult to estimate the real effect of the insertion of implants in different sexes on the marginal bone level. Due to lack of satisfactory information, meta‐analysis for the outcome ‘post‐operative infection’ was not performed. The results have to be interpreted with caution due to the presence of several confounding factors in the included studies.     

Mini‐implants and narrow diameter implants as mandibular overdenture retainers: A systematic review and meta‐analysis of clinical and radiographic outcomes

This study reviews the clinical and radiographic outcomes of Mini‐implants (MI) and Narrow Diameter Implants (NDI) as mandibular overdenture (MO) retainers. Six databases were consulted for clinical studies that evaluated implants with diameter ≤3.5 mm. Data on the MI and NDI for survival and success rate and peri‐implant bone loss and were collected and submitted to meta‐analysis. Thirty‐six studies were included, 24 reporting MI performance and 12 describing NDI results. The MI group comprised data from 1 cross‐sectional clinical study, 3 retrospective longitudinal (RL) clinical studies, 13 prospective longitudinal (PL) clinical studies and 7 randomised clinical trials (RCT) with follow‐up periods ranging from 1 day to 7 years. Eight studies used conventional loading, thirteen used immediate loading, two studies used both loading types, and one study did not report. The NDI group comprised data from 3 RL clinical studies, 6 PL clinical studies and 3 RCT with follow‐up ranging from 6 months to 10 years. Ten studies used conventional loading, 1 study used immediate loading, and 1 study did not report. The average survival rates of MI and NDI studies were 98% and 98%, respectively, while the average success rates were 93% and 96%, respectively. The average peri‐implant bone loss after 12, 24 and 36 months was 0.89, 1.18 and 1.02 mm for MI and 0.18, 0.12 and ‐0.32 mm for NDI. Both MI and NDI showed adequate clinical behaviour as overdenture retainers. The NDI showed a better long‐term predictability to retain OM with most studies adopting conventional loading.     

Turned versus anodised dental implants: a meta‐analysis

The aim of this meta‐analysis was to test the null hypothesis of no difference in the implant failure rates, marginal bone loss (MBL)and post‐operative infection for patients being rehabilitated by turned versus anodised‐surface implants, against the alternative hypothesis of a difference. An electronic search without time or language restrictions was undertaken in November 2015. Eligibility criteria included clinical human studies, either randomised or not. Thirty‐eight publications were included. The results suggest a risk ratio of 2·82 (95% CI 1·95–4·06, P < 0·00001) for failure of turned implants, when compared to anodised‐surface implants. Sensitivity analyses showed similar results when only the studies inserting implants in maxillae or mandibles were pooled. There were no statistically significant effects of turned implants on the MBL (mean difference‐MD 0·02, 95%CI ?0·16–0·20; P = 0·82) in comparison to anodised implants. The results of a meta‐regression considering the follow‐up period as a covariate suggested an increase of the MD with the increase in the follow‐up time (MD increase 0·012 mm year^?1), however, without a statistical significance (P = 0·813). Due to lack of satisfactory information, meta‐analysis for the outcome ‘post‐operative infection’ was not performed. The results have to be interpreted with caution due to the presence of several confounding factors in the included studies.     

Dental status of the Iranian elderly: A systematic review and meta‐analysis

Tooth loss is an important health dilemma. The aim of the present study was to perform a systematic review and meta‐analysis of dental status and edentulism in the elderly residing in Iran. An electronic search of the literature was carried out on Farsi and English databases using the following keywords: edentulism, dental caries, elderly, oral and dental health, edentulous, geriatric, caries, dentate, Iran, and prevalence. Articles that met the eligibility criteria according to the STROBE (Strengthening the Reporting of Observational Studies In Epidemiology) checklist were selected and entered into the meta‐analysis. Data were analyzed using Stata 13.1 software, and the metan and metareg packages for used for the meta‐regression and meta‐analysis. Of the 172 articles retrieved, 154 were used after eliminating the duplicates, and their full texts were read. Of the 4574 participants evaluated in 13 studies, 2227 (48.7%) were completely edentulous (95% confidence interval [CI]: .49‐.49). Of the 4423 participants evaluated in 12 studies, 2286 (51.7%) were dentate (95% CI: .52‐.52). The mean number of remaining teeth was 5.73 (95% CI: 5.73‐5.73) in six studies conducted on 2782 participants. Approximately 50% of the elderly in Iran are completely edentulous. Efforts should be made to improve dental care instruction, provision of dental care services in the public sector, and dental insurance coverage to promote the dental status of elderly Iranians.     

Effects of modified abutment characteristics on peri‐implant soft tissue health: A systematic review and meta‐analysis

Objectives

The purpose of this systematic review was to evaluate the impact of the abutment characteristics on peri‐implant tissue health and to identify the most suitable material and surface characteristics.

Methods

A protocol was developed aimed to answer the following focused question: “Which is the effect of the modification of the abutment design in regard to the maintenance of the peri‐implant soft tissue health?” Further subanalysis aimed to investigate the impact of the abutment material, macroscopic design, surface topography and surface manipulation. Randomised controlled trials (RCTs) with a follow‐up of at least 6 months after implant loading were considered as inclusion criteria. Meta‐analyses were performed whenever possible.

Results

Nineteen final publications from thirteen investigations were included. The results from the meta‐analysis indicated that zirconia abutments (Zi) experienced less increase in BOP values over time [n = 3; WMD = ?26.96; 95% CI (?45.00; ?8.92); p = .003] and less plaque accumulation [n = 1; MD = ?20.00; 95% CI (?41.47; 1.47); p = .068] when compared with titanium abutments (Ti). Bone loss was influenced by the method of abutment decontamination [n = 1; MD = ?0.44; 95% CI (?0.65; ?0.23); p < .001]. The rest of the studied outcomes did not show statistically significant differences.

Conclusions

The macroscopic design, the surface topography and the manipulation of the implant abutment did not have a significant influence on peri‐implant inflammation. In contrast, the abutment material demonstrated increased BOP values over time for Ti when compared to Zi abutments.

     

Dental implant loss in older versus younger patients: a systematic review and meta‐analysis of prospective studies

The aim of this systematic review was to evaluate implant loss in younger and older patients. An electronic search of four databases (MEDLINE, EMBASE, SCOPUS and the Cochrane Library) was undertaken until May 2016 without time restriction and was supplemented by manual searching. Prospective cohorts were included if they met the following criteria: (i) presence of an exposed group (older subjects) with a minimum age of 60 years; (ii) presence of a control group (younger subjects) with a maximum age of 59 years; and (iii) outcome data considering implant survival or loss. Meta‐analyses were performed to evaluate the impact of ageing on implant failure. Of 4152 potentially eligible articles, four were included in the qualitative analysis and quantitative synthesis. The pooled estimates suggest that the risk of implant loss in older patients is not significantly higher (RR = 0·92; 95% CI 0·43–1·96, P = 0·83) when compared to younger subjects. This systematic review suggests that age is not a limiting factor for dental implant therapy.