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Interventions for Dental Implant Placement in Atrophic Edentulous Mandibles: Vertical Bone Augmentation and Alternative Treatments. A Meta-Analysis of Randomized Clinical Trials


Camps-Font, Octavi; Burgueño-Barris, Genís; Figueiredo, Rui; Jung, Ronald E; Gay-Escoda, Cosme; Valmaseda-Castellón, Eduard (2016). Interventions for Dental Implant Placement in Atrophic Edentulous Mandibles: Vertical Bone Augmentation and Alternative Treatments. A Meta-Analysis of Randomized Clinical Trials. Journal of Periodontology, 87(12):1444-1457.

Abstract

BACKGROUND The purpose was to assess which vertical bone augmentation technique is most effective for restoring atrophic posterior areas of the mandible with dental implants, and compare these procedures with alternative treatments. METHODS Electronic literature searches in PubMed (MEDLINE), Ovid and The Cochrane Library were conducted to identify all relevant articles published up to July 1st 2015. Eligibility was based on inclusion criteria, and quality assessments were conducted. The primary outcome variables were implant and prosthetic failure. After data extraction, meta-analyses were performed. RESULTS Out of 527 potentially eligible papers, 14 randomized clinical trials were included. Out of these 14 studies, 4 trials assessed short implants (5 to 8 mm) as an alternative to vertical bone augmentation in sites with a residual ridge height of 5 to 8 mm. No statistically significant differences were found in implant (OR: 1.02; 95%CI: 0.31 to 3.31; p=0.98; I(2): 0%) or prosthetic failure (OR: 0.64; 95%CI: 0.21 to 1.96; p=0.43; I(2): 0%) after 12 months of loading. However, complications at treated sites increased with the augmentation procedures (OR: 8.33; 95%CI: 3.85 to 20.0; p<0.001; I(2): 0%). There was no evidence of any vertical augmentation procedure being of greater benefit than any other for the primary outcomes (implant and prosthetic failure). CONCLUSION Short implants in the posterior area of the mandible seem to be preferable to vertical augmentation procedures, which present similar implant and prosthetic failure rates but greater morbidity. All the vertical augmentation technique comparisons showed similar inter-group results.

BACKGROUND The purpose was to assess which vertical bone augmentation technique is most effective for restoring atrophic posterior areas of the mandible with dental implants, and compare these procedures with alternative treatments. METHODS Electronic literature searches in PubMed (MEDLINE), Ovid and The Cochrane Library were conducted to identify all relevant articles published up to July 1st 2015. Eligibility was based on inclusion criteria, and quality assessments were conducted. The primary outcome variables were implant and prosthetic failure. After data extraction, meta-analyses were performed. RESULTS Out of 527 potentially eligible papers, 14 randomized clinical trials were included. Out of these 14 studies, 4 trials assessed short implants (5 to 8 mm) as an alternative to vertical bone augmentation in sites with a residual ridge height of 5 to 8 mm. No statistically significant differences were found in implant (OR: 1.02; 95%CI: 0.31 to 3.31; p=0.98; I(2): 0%) or prosthetic failure (OR: 0.64; 95%CI: 0.21 to 1.96; p=0.43; I(2): 0%) after 12 months of loading. However, complications at treated sites increased with the augmentation procedures (OR: 8.33; 95%CI: 3.85 to 20.0; p<0.001; I(2): 0%). There was no evidence of any vertical augmentation procedure being of greater benefit than any other for the primary outcomes (implant and prosthetic failure). CONCLUSION Short implants in the posterior area of the mandible seem to be preferable to vertical augmentation procedures, which present similar implant and prosthetic failure rates but greater morbidity. All the vertical augmentation technique comparisons showed similar inter-group results.

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Additional indexing

Item Type:Journal Article, refereed, further contribution
Communities & Collections:04 Faculty of Medicine > Center for Dental Medicine > Clinic for Fixed and Removable Prosthodontics
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:29 July 2016
Deposited On:14 Oct 2016 14:15
Last Modified:22 Nov 2016 02:02
Publisher:American Academy of Periodontology
ISSN:0022-3492
Publisher DOI:https://doi.org/10.1902/jop.2016.160226
PubMed ID:27468794
Permanent URL: https://doi.org/10.5167/uzh-126622

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