Long-term survival of calcium phosphate-coated dental implants: a meta-analytical approach to the clinical literature.

BACKGROUND: Calcium phosphate ceramic coatings have the potential to compensate for challenging bone conditions such as delayed or impaired bone healing and low bone quantity or density. Thus, the increasing universal prevalence of subjects with such challenging bone conditions might be paralleled by an enhanced global use of calcium phosphate ceramic-coated dental implants. However, it is speculated that the long-term clinical survival of calcium phosphate-coated dental implants might be adversely affected by coating delamination.
OBJECTIVE: The aims of the current review were (1) to systematically appraise and (2) to meta-analyse long-term survival data of calcium phosphate-coated dental implants in clinical trials.
MATERIALS AND METHODS: An extensive search in the electronic databases of the National Library of Medicine (http://www.ncbi.nlm.nih.gov), The Cochrane Central Register of Controlled Trials and the ISI Web of Knowledge, was carried out for articles published between January 2000 and November 2011 to identify randomized controlled clinical trials, prospective clinical trials as well as retrospective analysis of cases (RA) presenting survival data on the topic of calcium phosphate-coated dental implants. Only publications in English were considered, and the search was narrowed to studies in humans with a follow-up of at least 5 years only. Furthermore, the reference lists of related review articles and publications selected for inclusion in this review were systematically screened. The primary outcome variable was percentage annual failure rate (AFR), and the secondary outcome variable was percentage cumulative survival rate (CSR).
RESULTS: The electronic search in the database of the National Library of Medicine, The Cochrane Central Register of Controlled Trials and the ISI Web of Knowledge, resulted in the identification of 385 titles. These titles were initially screened by the two independent reviewers for possible inclusion, resulting in 29 publications suitable for further consideration. Screening the abstracts led to 20 full-text articles. From these articles, 15 reports were excluded. Finally, five of these original research reports could be selected for evaluation. No additional publications were identified by manual search. Thus, a total of five articles were included for analysis. Meta-analysis revealed that neither AFRs of calcium phosphate-coated dental implants increased progressively nor that long-term CSRs for calcium phosphate-coated dental implants were inferior to survival rates of noncoated implants.
CONCLUSION: We conclude that (1) published long-term survival data for calcium phosphate-coated dental implants are very limited, (2) AFRs of calcium phosphate-coated dental implants do not increase progressively, and (3) long-term CSRs for calcium phosphate-coated dental implants are comparable to survival rates of noncoated implants.