Marginal bone loss one year after implantation: a systematic review of different loading protocols

The aim of this study was to analyse the influence of different loading protocols on marginal bone loss (MBL). The outcomes of different implant loading protocols were assessed at 1 year after implantation, with focus on MBL; protocols included immediate, immediate non-occlusal, early, and conventional loading. The search strategy resulted in 889 studies. Twenty-two of these studies fulfilled the inclusion criteria. Among the included studies, the lowest MBL was for immediately loaded implants (0.05 ± 0.67 mm) and the highest for immediate non-occlusally loaded implants (1.37 ± 0.5 mm). The results of the meta-analysis showed an estimated mean MBL of 0.457 mm (95% confidence interval (CI) 0.133–0.781) for immediate loading, 0.390 mm (95% CI 0.240–0.540) for immediate non-occlusal loading, 0.488 mm (95% CI 0.289–0.687) for early loading (>2 days to <3 months), and 0.852 mm (95% CI 0.429–1.275) for conventional loading (>3 months) implant protocols. The lowest decrease in 1-year implant survival per millimetre increase in MBL was observed for immediate loading and the highest for conventional loading. Conventional loading showed a significantly higher MBL than the other three loading protocols. This systematic review and meta-analysis indicates that the immediate loading protocol is a reasonable alternative to the conventional loading protocol.     

Efficacy of antibiotic prophylaxis in intraoral bone grafting procedures: a systematic review and meta-analysis

The purpose of this systematic review was to investigate the efficacy of antibiotic prophylaxis (AP) in intraoral bone grafting procedures for the prevention of postoperative infection (POI). Electronic and manual searches were conducted to identify randomized controlled trials (RCTs). The primary outcome assessed was receptor site POI; secondary outcomes assessed included donor site POI, wound dehiscence, pain, graft failure, need for re-grafting, adverse events, patient satisfaction, and quality of life. A random-effects meta-analysis was conducted to obtain risk ratios of dichotomous data. Four RCTs were selected: one examined AP versus placebo and concluded that there was an increased risk of POI without AP; three examined comparative antibiotic regimens and found no statistically significant difference between them. A meta-analysis of prophylactic regimens, including data from the two RCTs that compared preoperative AP to perioperative AP, indicated no statistically significant difference in POI outcomes (P =  0.94, risk ratio 0.94). It was not possible to conduct further meta-analyses for POIs or for any secondary outcomes due to insufficient published data. The risk of bias assessment indicated an overall unclear risk of bias. On the basis of the present review, there is insufficient evidence to support or refute AP for the prevention of POIs in intraoral bone graft placement procedures.