Long‐term biological complications of dental implants placed either in pristine or in augmented sites: A systematic review and meta‐analysis

Abstract

Aim:To investigate and compare the prevalence of biological complications and failure of implants placed in pristine vs. augmented sites after a mean observation period of at least 10 years. Materials and methods:The focused question "In patients with osseointegrated dental implants, are there differences in biological complications and implant failure at implants placed in pristine vs. augmented sites?" was addressed using the Population, Exposure, Comparison and Outcome criteria. Electronic and manual searches supplemented by the screening of the grey literature were carried out. A case definition of peri-implant mucositis and peri-implantitis had to be specified. The binary randomeffects method was chosen to conduct meta-analyses. Results are presented as Forest plots with weighted mean values and 95% confidence intervals (CI). The I 2 statistic test was applied to quantify heterogeneity. The Newcastle-Ottawa Scale and the parameters provided in the Cochrane Center and CONSORT statement were used for quality assessment. The results are reported according to the PRISMA guidelines. Results:No randomized clinical trial (RCT) comparing the outcomes of implants placed in pristine vs. augmented sites was identified. Five case-series studies, one casecontrol study, one cross-sectional study and one RCT were eligible for qualitative and quantitative analyses. No statistically significant differences (p > .05) were observed between implants placed in pristine vs. augmented sites for any outcome variables both at patient and at implant levels, respectively. High heterogeneity concerning patient sampling, case definitions of biological complications and eligibility criteria was observed. Conclusion:The studies included in the present systematic review did not directly address the focused questions. Hence, the outcomes of the meta-analysis should be interpreted with caution due to high variability with respect to study design.

Effectiveness of vertical ridge augmentation interventions: A systematic review and meta‐analysis

“…The aggregated mean implant survival rate ( n studies = 27) was comparable to previous studies reporting implants placed in pristine sites (Pjetursson, Asgeirsson, Zwahlen, & Sailer, ; Pjetursson, Thoma, Jung, Zwahlen, & Zembic, ; Salvi et al., ). However, bone level changes were seldom reported ( n studies = 9).…”

“…Due to the associated comorbidities of augmentation procedures, such as post‐operative infections, wound dehiscences or neurosensory disorders, other approaches besides VRA have been proposed (e.g., short dental implants). These therapeutic modalities have proven to be effective and valid alternative treatments to sinus floor elevation or VRA, with reduced morbidity and high patient satisfaction (Hammerle & Jung, ; Nisand, Picard, & Rocchietta, ; Salvi, Monje, & Tomasi, ; Thoma, Haas, et al., ; Thoma, Zeltner, Husler, Hammerle, & Jung, ). However, in cases with limited bone availability for placing short implants, or due to restorative considerations, VRA may be the best therapy choice as it offers an opportunity for augmenting lost bony structure and often leads to improved aesthetic outcomes (Salvi et al., ).…”

Spontaneous progression of experimental peri‐implantitis in augmented and pristine bone: A pre‐clinical in vivo study

“…DBBM has a slow bio‐absorbability and presents with the most extensive documentation among biomaterials used in augmentation procedures in implant dentistry (Haugen, Lyngstadaas, Rossi, & Perale, ; Sanz et al, ). The question whether there are differences in the occurrence of peri‐implantitis or other biological complications around implants placed in augmented or pristine bone sites was addressed in a systematic review by Salvi, Monje, and Tomasi (). It was reported that the included studies presented with a high variability regarding patient selection, eligibility criteria, and case definitions of peri‐implantitis.…”

“…It was reported that the included studies presented with a high variability regarding patient selection, eligibility criteria, and case definitions of peri‐implantitis. Although the meta‐analysis by Salvi et al () failed to disclose differences in the occurrence of biological complications between pristine and augmented bone sites, it was concluded that implants placed in augmented bone exhibited higher variability and lower predictability concerning peri‐implantitis than implants placed in pristine bone. Considering the challenges in performing clinical studies with appropriate study design and patient selection as pointed out by Salvi et al (), the question on potential differences between augmented and pristine bone sites regarding peri‐implantitis may also be addressed in pre‐clinical in vivo trials.…”

Group 4 ITI Consensus Report: Risks and biologic complications associated with implant dentistry

“…Long-term biological complications of dental implants placed either in pristine or in augmented sites: A systematic review and metaanalysis (Salvi, Monje, Tomasi, 2018).…”