Mark-Steven Howe1, William Keys2, Derek Richards3. 1. Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK; The School of Dentistry, University of Liverpool, Pembroke Place, Liverpool, UK; Broadway Dental Care, Broadway, Worcestershire, UK. Electronic address: mark-steven.howe@kellogg.ox.ac.uk. 2. Aberdeen Dental School and Hospital Cornhill Road Aberdeen UK. 3. Dundee Dental SchoolUniversity of Dundee Park Place Dundee UK.
Abstract
OBJECTIVES: To identify and appraise the most recent studies reporting dental implant survival in adults (≥18 years) using contemporary implant systems (solid screw, roughened surface) for a period of 10 years; and explore new predictors of implant survival. SOURCE: MEDLINE, Scopus, and the Cochrane Central Register of Controlled trials were searched from 1997 to January 2018 to focus on contemporary implant systems. STUDY SELECTION: Only prospective observational studies with at least 10 participants and 35 implants were included. The unit of study was the 'absolute survival' rate of dental implants after 10 years in the oral cavity. Study quality was assessed utilising a modified Hoy risk of bias tool for prevalence studies. A sensitivity meta-analysis was undertaken utilising a plausibly imputed model for missing data. DATA: 18 studies met the inclusion criteria. The summary estimate for 10-year survival at the implant level was 96.4% (95% CI 95.2%-97.5%) and the prediction interval was 91.5%-99.4%. The sensitivity meta-analysis summary estimate of survival was 93.2% (95% CI 90.1% to 95.8%)p = 0.041 with a prediction interval of 76.6%-100%. Older age (≥ 65 years) was a significant predictor at 91.5%, p = 0.038 in the sensitivity meta-analysis. CONCLUSIONS: A traditional analysis produced similar 10-year survival estimates to previous systematic reviews. A more realistic sensitivity meta-analysis accounting for loss to follow-up data and the calculation of prediction intervals demonstrated a possible doubling of the risk of implant loss in the older age groups. CLINICAL SIGNIFICANCE: Improved analysis provides the clinician with better estimation of the real-world risk of implant failures so helping the clinician communicate the potential risk to patients.
OBJECTIVES: To identify and appraise the most recent studies reporting dental implant survival in adults (≥18 years) using contemporary implant systems (solid screw, roughened surface) for a period of 10 years; and explore new predictors of implant survival. SOURCE: MEDLINE, Scopus, and the Cochrane Central Register of Controlled trials were searched from 1997 to January 2018 to focus on contemporary implant systems. STUDY SELECTION: Only prospective observational studies with at least 10 participants and 35 implants were included. The unit of study was the 'absolute survival' rate of dental implants after 10 years in the oral cavity. Study quality was assessed utilising a modified Hoy risk of bias tool for prevalence studies. A sensitivity meta-analysis was undertaken utilising a plausibly imputed model for missing data. DATA: 18 studies met the inclusion criteria. The summary estimate for 10-year survival at the implant level was 96.4% (95% CI 95.2%-97.5%) and the prediction interval was 91.5%-99.4%. The sensitivity meta-analysis summary estimate of survival was 93.2% (95% CI 90.1% to 95.8%)p = 0.041 with a prediction interval of 76.6%-100%. Older age (≥ 65 years) was a significant predictor at 91.5%, p = 0.038 in the sensitivity meta-analysis. CONCLUSIONS: A traditional analysis produced similar 10-year survival estimates to previous systematic reviews. A more realistic sensitivity meta-analysis accounting for loss to follow-up data and the calculation of prediction intervals demonstrated a possible doubling of the risk of implant loss in the older age groups. CLINICAL SIGNIFICANCE: Improved analysis provides the clinician with better estimation of the real-world risk of implant failures so helping the clinician communicate the potential risk to patients.
Authors: Marco Aoqi Rausch; Hassan Shokoohi-Tabrizi; Christian Wehner; Benjamin E Pippenger; Raphael S Wagner; Christian Ulm; Andreas Moritz; Jiang Chen; Oleh Andrukhov Journal: Biology (Basel) Date: 2021-04-22