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.

     

Effect of waterpipe smoking on peri‐implant health: A systematic review and meta‐analysis

The aim of the present review was to evaluate the effect of waterpipe smoking (WS) on clinical peri‐implant inflammatory parameters compared to non‐smokers (NS) with dental implants. Literature searches were performed using bibliographic databases up to May 2018. Primary outcomes included peri‐implant bone loss (PIBL), while secondary outcomes were probing depth (PD), plaque index, and bleeding on probing. Relative risk (RR) and 95% confidence intervals (CI) for each PIBL and PD were estimated by a random‐effect model. Four retrospective case‐control studies were included in the qualitative and quantitative syntheses. All of the included studies showed statistically‐significantly worse peri‐implant outcomes in WS compared to NS. Considering the effects of WS on peri‐implant parameters, significant heterogeneity for PIBL (Q‐value = 34.21, P < 0.0001, I² = 94.16%) and PD (Q‐value = 51.97, P < 0.0001, I² = 96.15%) was observed between both groups. The overall RR for PIBL (RR = 3.32, 95% CI = 1.01‐3.97, P = 0.001) and PD (RR = 3.40, 95% CI = 1.91‐7.17, P = 0.001) were significant between WS and NS groups. WS has detrimental effect on peri‐implant health. Clinicians should instruct and advise patients about poor prognosis and peri‐implant diseases caused by WS.     

Comparison of the effects of treatment of peri‐implant infection in animal and human studies: systematic review and meta‐analysis

Objective: The main objective of this systematic review is to compare the effects of treatment of peri‐implant infection between animal and human studies. Material and methods: A literature search was conducted using the Medline, Cochrane Central Register of Controlled Trials, and Latin American and Caribbean Health Sciences Literature databases up to and including May 2008. In addition, bibliographies of systematic reviews on peri‐implant diseases were searched manually. Non‐surgical and surgical treatments of peri‐implantitis/mucositis in animal models or human studies were compared. Meta‐analysis was conducted to investigate the difference between the reported treatment effects in animal and human studies. Changes in probing pocket depth (PPD) and probing attachment level (PAL) from baseline measurements were used as measures of outcome. Single‐level and multilevel meta‐regression analysis was performed by taking into account the different follow‐up times of the studies included. Results: The single‐level and multilevel random‐effects meta‐analysis showed that the difference in PPD reduction [0.31 mm, 95% confidence interval (CI): ?0.27, 0.88] and in PAL gain (0.21 mm, 95% CI: ?0.47, 0.88) between animal and human studies was not statistically significant. The random‐effects meta‐regression suggested that studies with longer follow‐up times revealed greater PPD reduction (0.25 mm per month, 95% CI: 0.14, 0.35). However, when the different follow‐up times were taken into account, these differences became greater. Substantial heterogeneity between studies was found in the meta‐analyses (I²=97.6% for animal studies and 99.9% for human studies). Conclusion: There was great heterogeneity between human and animal studies in terms of study designs and treatment procedures. Therefore, the results from this meta‐analysis should be interpreted with caution. Heterogeneity between studies and its causes merit further investigations. To cite this article:
Faggion CM Jr, Chambrone L, Gondim V, Schmitter M, Tu Y‐K. Comparison of the effects of treatment of peri‐implant infection in animal and human studies: systematic review and meta‐analysis.
Clin. Oral Impl. Res. 21 , 2010; 137–147.
doi: 10.1111/j.1600‐0501.2009.01753.x