Tilted versus axially placed dental implants : a meta-analysis

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Tilted versus axially placed dental implants : a meta-analysis

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Publication Article, review peer-reviewed scientific
Title Tilted versus axially placed dental implants : a meta-analysis
Author(s) Chrcanovic, Bruno ; Albrektsson, Tomas ; Wennerberg, Ann
Date 2015
English abstract
OBJECTIVES: The purpose of the present review was to test the null hypothesis of no difference in the implant failure rate, marginal bone loss, and postoperative infection for patients being rehabilitated by tilted or by axially placed dental implants, against the alternative hypothesis of a difference. METHODS: An electronic search without time or language restrictions was undertaken in July 2014. Eligibility criteria included clinical human studies, either randomised or not, interventional or observational. The estimates of an intervention were expressed in risk ratio (RR) and mean difference (MD) in millimetres. RESULTS: The search strategy resulted in 44 publications. A total of 5029 dental implants were tilted (82 failures; 1.63%), and 5732 implants were axially placed (104 failures; 1.81%). The difference between the procedures did not significantly affect the implant failure rates (P=0.40), with a RR of 1.14 (95% CI 0.84-1.56). A statistically significant difference was found for implant failures when studies evaluating implants inserted in maxillae only were pooled (RR 1.70, 95% CI 1.05-2.74; P=0.03), the same not happening for the mandible (RR 0.77, 95% CI 0.39-1.52; P=0.45). There were no apparent significant effects of tilted dental implants on the occurrence of marginal bone loss (MD 0.03, 95% CI -0.03 to 0.08; P=0.32). Due to lack of satisfactory information, meta-analysis for the outcome 'postoperative infection' was not performed. CONCLUSIONS: It is suggested that the differences in angulation of dental implants might not affect the implant survival or the marginal bone loss. The reliability and validity of the data collected and the potential for biases and confounding factors are some of the shortcomings of the present study. CLINICAL SIGNIFICANCE: The question whether tilted implants are more at risk for failure than axially placed implants has received increasing attention in the last years. As the philosophies of treatment alter over time, a periodic review of the different concepts is necessary to refine techniques and eliminate unnecessary procedures. This would form a basis for optimum treatment.
DOI http://dx.doi.org/10.1016/j.jdent.2014.09.002 (link to publisher's fulltext)
Publisher Elsevier
Host/Issue Journal of Dentistry;2
Volume 43
ISSN 0300-5712
Pages 149-170
Language eng (iso)
Subject(s) Dental implants
Tilted implant
Axial implant
Implant failure rate
Marginal bone loss
Meta-analysis
Medicine
Research Subject Categories::ODONTOLOGY
Handle http://hdl.handle.net/2043/18140 (link to this page)

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