Clinical outcomes of narrow- and regular-diameter implants with bone augmentation in the anterior maxilla: a systematic review and meta-analysis.

OBJECTIVES: To evaluate the clinical outcomes of narrow-diameter implants (NDIs) and regular-diameter implants (RDIs) with bone augmentation in the anterior maxilla, with implant survival rate (ISR) as the primary outcome. Additionally, secondary outcomes such as peri-implant marginal bone loss (MBL), pocket probing depth (PPD), mechanical complications, and biological complications were also considered. MATERIALS AND METHODS: A thorough literature search was performed to identify randomized controlled trials and cohort studies comparing outcomes of NDIs and RDIs with bone augmentation in the anterior maxilla published up to February 2024. Only studies with a minimum follow-up period of 12 months were selected for analysis. Meta-analysis was performed if at least two articles with similar characteristics were available. RESULTS: Of the 288 articles initially considered, 5 were included in the analysis, involving 282 NDIs and 100 RDIs. At the 36-month follow-up, no statistically significant differences in ISR, which ranged 93.8-100% for NDIs and were 100% for RDIs, were observed between the two groups (relative risk, 0.989; 95% confidence interval, 0.839-1.165; p = 0.896). Similarly, MBL and PPD did not differ significantly between the two groups. Soft tissue dehiscence was the most common complication found in RDIs. CONCLUSION: The results indicate that NDIs yield clinical outcomes similar to those of RDIs with bone augmentation in the anterior maxilla over a 36-month follow-up period. CLINICAL RELEVANCE: Considering the similar clinical outcomes, the shortened treatment duration and more rapid esthetic improvement associated with NDIs may render them preferrable to RDIs with bone augmentation, particularly in this esthetic zone.

The influence of two distinct surface modification techniques on the clinical efficacy of titanium implants: A systematic review and meta-analysis.

PURPOSE: To compare the effectiveness of anodized and sandblasted large-grit acid-etched surface modification implants in clinical applications. METHODS: This systematic review has been registered at PROSPERO (CRD42023423656). A systematic search was performed using seven databases. The meta-analysis was performed using the RevMan 5.4 program and Stata 17.0 software. An analysis of the risk of bias in the included studies was conducted using the Cochrane Handbook for Systematic Reviews of Interventions and the Newcastle-Ottawa scale. RESULTS: A comprehensive analysis of 16 studies, which collectively encompassed a total of 2768 implants, was finished. Following a five years follow-up, the meta-analysis showed that the cumulative survival rate of implants was lower in the anodized group compared to the sandblasted large-grit acid-etched group (RR, 3.47; 95 % confidence interval [CI], 1.23 to 9.81; P = 0.02). Furthermore, the anodized group and the sandblasted large-grit acid-etched group had similar marginal bone loss over the one to three years follow-up period. However, it was observed that the marginal bone loss increased at the five years follow-up period in the anodized group in comparison to the sandblasted large-grit acid-etched group (SMD, 2.98; 95 % CI, 0.91 to 5.06; P = 0.005). In terms of biological complications, plaque index, bleeding on probing, and probing pocket depth, we found no statistically significant differences between the anodized and sandblasted large-grit acid-etched group. CONCLUSIONS: The sandblasted large-grit acid-etched group exhibited higher implants cumulative survival rate and less marginal bone loss compared to the anodized group. Moreover, both groups demonstrated similar incidences of biological complications, plaque index, bleeding on probing, and probing pocket depth, suggesting overall equivalence in these aspects.