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O uso de implantes subperiósteos de titânio impressos em 3D em maxilares atróficos : uma revisão sistemática e meta-análise
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Abstract(s)
Objetivo: estudar o rácio de incidência de perda implantar dos implantes subperiósteos em maxilares atróficos, produzidos por impressão 3D de titânio, face aos implantes endósseos convencionais.
Métodos: a pesquisa foi efetuada com recurso a três bases de dados digitais universais: PubMed, B-on e Google Scholar. Os valores de sobrevivência implantar foram convertidos em rácios de incidência de perda implantar, dentro de um período de follow-up, compreendido entre os 6 e os 24 meses. As estatísticas e gráficos das meta- -análises e meta-regressões foram efetuados no software OpenMeta [Analyst]. Os modelos meta-analíticos foram ajustados considerando a presença de efeitos randomizados e mediante o método de DerSimonian & Laird (1986). As diferenças entre os resultados obtidos foram avaliadas através do teste Z para amostras independentes. Para avaliar o grau de discordância associado a cada resultado global utilizou-se o índice de heterogeneidade (I2). Considerou-se que a diferença observada é estatisticamente suportada sempre que p < 0.05.
Resultados: De entre todas as meta-regressões e meta-análises de subgrupo realizadas aos implantes endósseos, apenas as meta-regressões da idade média e da latitude mostraram ter coeficientes estatisticamente significativos. Por outro lado, todas as meta--regressões e meta-análises de subgrupo realizadas aos implantes subperiósteos mostraram coeficientes não significativos, ou seja, os parâmetros estudados não parecem ter efeito nas diferenças encontradas no rácio de incidência de perda implantar. De uma forma geral, os valores de rácio de incidência associados aos implantes subperiósteos perdidos foram em média 1.64× superiores aos que se observaram nos implantes endósseos.
Conclusão: Os resultados da meta-análise sugerem, no que toca à avaliação de perda implantar intermédia, que os implantes subperiósteos impressos em 3D têm um risco aumentado de perda implantar na ordem dos 64% em comparação com os implantes endósseos. No entanto, são necessários mais estudos para confirmar os resultados obtidos.
Objective: study the ratio of incidence of implant loss regarding subperiosteal implants in atrophic jaws, produced by 3D printing, of titanium, compared to conventional endosseous implants. Methods: the systematic research was carried out using three universal digital databases: PubMed, B-on and Google Scholar. Implant survival values were converted into implant loss incidence ratios, within a follow-up period, between 6 and 24 months. The statistics and graphs of the meta-analyses and meta-regressions were performed using the OpenMeta [Analyst] software. The meta-analytical models were adjusted considering the presence of randomized effects and using the method of DerSimonian & Laird (1986). The differences between the results obtained were evaluated using the Z test for independent samples. To assess the degree of disagreement associated with each global result, the heterogeneity index (I2) was used. The observed difference was statistically supported whenever p < 0.05. Results: Of all the meta-regressions and subgroup meta-analyses performed on endosseous implants, only the age and latitude meta-regressions were found to have statistically significant coefficients. On the other hand, all subgroup meta-regressions and meta-analyses performed on subperiosteal implants showed non-significant coefficients, that is, the studied parameters do not seem to have an effect on the differences found in the implant incidence loss ratio. In general, the incidence ratio values associated with lost subperiosteal implants were, on average, 1.64× higher than those observed in endosseous implants. Conclusion: The results of the meta-analysis suggest, about intermediate implant loss assessment, that 3D printed subperiosteal implants have an increased risk of implant loss in the order of 64% compared to endosseous implants. However, further studies are needed to confirm the results obtained.
Objective: study the ratio of incidence of implant loss regarding subperiosteal implants in atrophic jaws, produced by 3D printing, of titanium, compared to conventional endosseous implants. Methods: the systematic research was carried out using three universal digital databases: PubMed, B-on and Google Scholar. Implant survival values were converted into implant loss incidence ratios, within a follow-up period, between 6 and 24 months. The statistics and graphs of the meta-analyses and meta-regressions were performed using the OpenMeta [Analyst] software. The meta-analytical models were adjusted considering the presence of randomized effects and using the method of DerSimonian & Laird (1986). The differences between the results obtained were evaluated using the Z test for independent samples. To assess the degree of disagreement associated with each global result, the heterogeneity index (I2) was used. The observed difference was statistically supported whenever p < 0.05. Results: Of all the meta-regressions and subgroup meta-analyses performed on endosseous implants, only the age and latitude meta-regressions were found to have statistically significant coefficients. On the other hand, all subgroup meta-regressions and meta-analyses performed on subperiosteal implants showed non-significant coefficients, that is, the studied parameters do not seem to have an effect on the differences found in the implant incidence loss ratio. In general, the incidence ratio values associated with lost subperiosteal implants were, on average, 1.64× higher than those observed in endosseous implants. Conclusion: The results of the meta-analysis suggest, about intermediate implant loss assessment, that 3D printed subperiosteal implants have an increased risk of implant loss in the order of 64% compared to endosseous implants. However, further studies are needed to confirm the results obtained.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Implante subperiósteo Implante endósseo 3D Atrofia óssea