Interventions for replacing missing teeth: different types of dental implants
|Dental implants are available in different materials, shapes and with different surface characteristics. In particular, numerous implant designs and surface modifications have been developed for improving clinical outcome. This is an update of a Cochrane review first published in 2002, and previously updated in 2003, 2005 and 2007.|
We identified 81 different RCTs. We included 27 of these RCTs, reporting results from 1512 participants and 3230 implants in the review. We compared 38 different implant types with a follow‐up ranging from one to 10 years. All implants were made of commercially pure titanium or its alloys, and had different shapes and surface preparations. We judged two trials to be at low risk of bias, 10 to be at unclear risk of bias and 15 to be at high risk of bias. On a ‘per participant’ rather than ‘per implant’ basis, we found no significant differences between various implant types for implant failures. The only observed statistically significant difference for the primary objective regarded more peri‐implant bone loss at Nobel Speedy Groovy implants when compared with NobelActive implants (MD ‐0.59 mm; 95% CI ‐0.74 to ‐0.44, different implant shapes). The only observed statistically significant difference for the secondary objective was that implants with turned (smoother) surfaces had a 20% reduction in risk to be affected by peri‐implantitis than implants with rough surfaces three years after loading (RR 0.80; 95% CI 0.67 to 0.96). There was a tendency for implants with turned surfaces to fail early more often than implants with roughened surfaces.
Based on the results of the included RCTs, we found no evidence showing that any particular type of dental implant had superior long‐term success. There was limited evidence showing that implants with relatively smooth (turned) surfaces were less prone to lose bone due to chronic infection (peri‐implantitis) than implants with much rougher surfaces (titanium‐plasma‐sprayed). These findings were based on several RCTs, often at high risk of bias, with few participants and relatively short follow‐up periods.
|Cochrane Library, 22 July 2014,|
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