RESUMEN
STATEMENT OF PROBLEM: The use of tilted implants has been considered a suitable option for completely edentulous patients. However, consensus on their clinical performance is lacking, specifically for partial rehabilitation. PURPOSE: The purpose of this systematic review and meta-analysis was to evaluate the marginal bone loss and implant survival rate of tilted implants compared with those of axial implants for implant-supported fixed partial dentures (ISFPDs). MATERIAL AND METHODS: A systematic search of the MEDLINE/PubMed, Web of Science, Embase, Cochrane, and ProQuest databases and reference lists for articles published until May 2022 was performed by 2 independent reviewers without language or publication date restrictions. A meta-analysis was performed using the RevMan version 5.4 program. Quality assessments were performed using the Newcastle-Ottawa scale. RESULTS: Nine studies were included, totaling 258 participants and 604 implants (269 tilted implants and 335 axial implants). No significant differences were found between the tilted and axial implants for the implant survival rate (P=.81; risk ratio: 1.14). However, higher marginal bone loss values were observed for tilted implants (P=.001; mean difference: 0.12 mm). No significant heterogeneity was observed in either analysis. CONCLUSIONS: No significant relationship was found between tilted and axial implants for ISFPD rehabilitation. However, tilted implants presented greater risks of marginal bone loss than axial implants.
RESUMEN
There are controversies related to the effects of bone grafts on tooth eruption and impaction in patients with cleft lip and palate. The aim of this systematic review was to evaluate the effectiveness of bone grafting on eruption of canines in patients with unilateral cleft lip and palate (UCLP). An electronic search was conducted in six electronic databases and gray literature, without limitations on year of publication or language. The primary outcome was the increase in rate of canine eruption; the secondary outcomes were success of the bone graft, canine impaction due to agenesis of the lateral incisor, and effect of orthodontic treatment before and after bone grafting. The risk of bias was analyzed by means of the tool Cochrane risk of bias in nonrandomized controlled trials (NRCTs) of interventions (ROBINS-I). The certainty of the evidence was assessed for outcomes reported through a narrative synthesis using grading of recommendations, assessment, development and evaluation (GRADE) approach. Four NRCTs were included, with a total of 360 patients, 283 UCLP and 77 bilateral cleft lip and palate (BCLP). The studies reported association between the increase in the rate of tooth eruption and bone graft with very low certainty of evidence, and greater experience of surgical success, with low certainty of evidence. The majority of the studies found an association between increase in the rate of canine impaction and agenesis of the lateral incisor, with very low certainty of evidence. There was very low certainty of the efficacy of secondary alveolar bone grafting for increasing the rates of eruption and reducing impaction of the maxillary canine.