Chun-Teh Lee1, Ya-Wei Chen2,3, Jacqueline R Starr4, Sung-Kiang Chuang5. 1. Department of Periodontics and Dental Hygiene, University of Texas Health Science Center at Houston, Houston, TX, USA. 2. Oral and Maxillofacial Surgery, Department of Stomatology, Taipei Veterans General Hospital and School of Dentistry, National Yang-Ming University, Taipei, Taiwan. 3. Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital and Harvard School of Dental Medicine, Boston, MA, USA. 4. Department of Applied Oral Sciences, The Forsyth Institute, Cambridge, MA, USA. 5. Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital and Harvard School of Dental Medicine, Boston, MA, USA. sungkiangchuang@gmail.com.
Abstract
OBJECTIVE: Wide-diameter implants are frequently placed in molar sites to obtain appropriate restoration profiles, to rescue implants that lack stability, and to engage bone in extraction sites. However, studies of wide-diameter implant placement have provided conflicting evidence regarding clinical outcomes. This systematic review aims to analyze survival rates of wide-diameter implants (platform diameter ≥5 mm) and assess clinical variables potentially affecting failure rates. MATERIAL AND METHODS: Electronic search was conducted using MEDLINE (PubMed), Cochrane Central Register of Controlled Trials (CENTRAL) and EMBASE from January 1980 to October 2014. Publication screening, data extraction, and quality assessment were performed. Failure rate per implant-year was analyzed using mix-effects Poisson regression model to obtain summary estimates of the 5-year survival rate. Relative risk (RR) was calculated to evaluate the association of different clinical variables with estimated failure rates. RESULTS: Eleven retrospective studies and eight prospective studies having at least 1-year follow-up period were included in the analysis. The estimated 5-year survival rate was 92.67% (95% confidence interval: [79.60, 97.50]) in the retrospective studies and 97.76% (Confidence interval: [93.25, 99.27]) in the prospective studies. Implant surface and implant diameter were significantly associated with the failure events in the retrospective studies. CONCLUSIONS: Placement of wide-diameter implants demonstrated a promising survival rate during 5-year follow-up. Further controlled trials with the control group and longer follow-up period are needed to provide the direct evidence comparing survival rates of wide implants with survival rates of narrower implants.
OBJECTIVE: Wide-diameter implants are frequently placed in molar sites to obtain appropriate restoration profiles, to rescue implants that lack stability, and to engage bone in extraction sites. However, studies of wide-diameter implant placement have provided conflicting evidence regarding clinical outcomes. This systematic review aims to analyze survival rates of wide-diameter implants (platform diameter ≥5 mm) and assess clinical variables potentially affecting failure rates. MATERIAL AND METHODS: Electronic search was conducted using MEDLINE (PubMed), Cochrane Central Register of Controlled Trials (CENTRAL) and EMBASE from January 1980 to October 2014. Publication screening, data extraction, and quality assessment were performed. Failure rate per implant-year was analyzed using mix-effects Poisson regression model to obtain summary estimates of the 5-year survival rate. Relative risk (RR) was calculated to evaluate the association of different clinical variables with estimated failure rates. RESULTS: Eleven retrospective studies and eight prospective studies having at least 1-year follow-up period were included in the analysis. The estimated 5-year survival rate was 92.67% (95% confidence interval: [79.60, 97.50]) in the retrospective studies and 97.76% (Confidence interval: [93.25, 99.27]) in the prospective studies. Implant surface and implant diameter were significantly associated with the failure events in the retrospective studies. CONCLUSIONS: Placement of wide-diameter implants demonstrated a promising survival rate during 5-year follow-up. Further controlled trials with the control group and longer follow-up period are needed to provide the direct evidence comparing survival rates of wide implants with survival rates of narrower implants.