Serveur d'exploration sur le patient édenté (maquette)

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Flapless versus Conventional Flapped Dental Implant Surgery: A Meta-Analysis

Identifieur interne : 000E48 ( Ncbi/Merge ); précédent : 000E47; suivant : 000E49

Flapless versus Conventional Flapped Dental Implant Surgery: A Meta-Analysis

Auteurs : Bruno Ramos Chrcanovic [Suède] ; Tomas Albrektsson [Suède] ; Ann Wennerberg [Suède]

Source :

RBID : PMC:4065043

Abstract

The aim of this study was to test the null hypothesis of no difference in the implant failure rates, postoperative infection, and marginal bone loss for patients being rehabilitated by dental implants being inserted by a flapless surgical procedure versus the open flap technique, against the alternative hypothesis of a difference. An electronic search without time or language restrictions was undertaken in March 2014. Eligibility criteria included clinical human studies, either randomized or not. The search strategy resulted in 23 publications. The I2 statistic was used to express the percentage of the total variation across studies due to heterogeneity. The inverse variance method was used for random-effects model or fixed-effects model, when indicated. The estimates of relative effect were expressed in risk ratio (RR) and mean difference (MD) in millimeters. Sixteen studies were judged to be at high risk of bias, whereas two studies were considered of moderate risk of bias, and five studies of low risk of bias. The funnel plots indicated absence of publication bias for the three outcomes analyzed. The test for overall effect showed that the difference between the procedures (flapless vs. open flap surgery) significantly affect the implant failure rates (P = 0.03), with a RR of 1.75 (95% CI 1.07–2.86). However, a sensitivity analysis revealed differences when studies of high and low risk of bias were pooled separately. Thus, the results must be interpreted carefully. No apparent significant effects of flapless technique on the occurrence of postoperative infection (P = 0.96; RR 0.96, 95% CI 0.23–4.03) or on the marginal bone loss (P = 0.16; MD −0.07 mm, 95% CI −0.16–0.03) were observed.


Url:
DOI: 10.1371/journal.pone.0100624
PubMed: 24950053
PubMed Central: 4065043

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PMC:4065043

Le document en format XML

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<p>The aim of this study was to test the null hypothesis of no difference in the implant failure rates, postoperative infection, and marginal bone loss for patients being rehabilitated by dental implants being inserted by a flapless surgical procedure versus the open flap technique, against the alternative hypothesis of a difference. An electronic search without time or language restrictions was undertaken in March 2014. Eligibility criteria included clinical human studies, either randomized or not. The search strategy resulted in 23 publications. The I
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<name sortKey="Leao, Nlc" uniqKey="Leao N">NLC Leão</name>
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<author>
<name sortKey="Chrcanovic, Br" uniqKey="Chrcanovic B">BR Chrcanovic</name>
</author>
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<analytic>
<author>
<name sortKey="Wennerberg, A" uniqKey="Wennerberg A">A Wennerberg</name>
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<author>
<name sortKey="Albrektsson, T" uniqKey="Albrektsson T">T Albrektsson</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Chrcanovic, Br" uniqKey="Chrcanovic B">BR Chrcanovic</name>
</author>
<author>
<name sortKey="Oliveira, Dr" uniqKey="Oliveira D">DR Oliveira</name>
</author>
<author>
<name sortKey="Cust Dio, Al" uniqKey="Cust Dio A">AL Custódio</name>
</author>
</analytic>
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<analytic>
<author>
<name sortKey="Van De Velde, T" uniqKey="Van De Velde T">T Van de Velde</name>
</author>
<author>
<name sortKey="Glor, F" uniqKey="Glor F">F Glor</name>
</author>
<author>
<name sortKey="De Bruyn, H" uniqKey="De Bruyn H">H De Bruyn</name>
</author>
</analytic>
</biblStruct>
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<analytic>
<author>
<name sortKey="Campelo, Ld" uniqKey="Campelo L">LD Campelo</name>
</author>
<author>
<name sortKey="Camara, Jr" uniqKey="Camara J">JR Camara</name>
</author>
</analytic>
</biblStruct>
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<analytic>
<author>
<name sortKey="Chiapasco, M" uniqKey="Chiapasco M">M Chiapasco</name>
</author>
<author>
<name sortKey="Zaniboni, M" uniqKey="Zaniboni M">M Zaniboni</name>
</author>
</analytic>
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<analytic>
<author>
<name sortKey="Annibali, S" uniqKey="Annibali S">S Annibali</name>
</author>
<author>
<name sortKey="Ripari, M" uniqKey="Ripari M">M Ripari</name>
</author>
<author>
<name sortKey="La Monaca, G" uniqKey="La Monaca G">G La Monaca</name>
</author>
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<name sortKey="Tonoli, F" uniqKey="Tonoli F">F Tonoli</name>
</author>
<author>
<name sortKey="Cristalli, Mp" uniqKey="Cristalli M">MP Cristalli</name>
</author>
</analytic>
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<author>
<name sortKey="Wood, Dl" uniqKey="Wood D">DL Wood</name>
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<author>
<name sortKey="Hoag, Pm" uniqKey="Hoag P">PM Hoag</name>
</author>
<author>
<name sortKey="Donnenfeld, Ow" uniqKey="Donnenfeld O">OW Donnenfeld</name>
</author>
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<name sortKey="Rosenfeld, Ld" uniqKey="Rosenfeld L">LD Rosenfeld</name>
</author>
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<name sortKey="Chrcanovic, Br" uniqKey="Chrcanovic B">BR Chrcanovic</name>
</author>
<author>
<name sortKey="Abreu, Mh" uniqKey="Abreu M">MH Abreu</name>
</author>
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<name sortKey="Freire Maia, B" uniqKey="Freire Maia B">B Freire-Maia</name>
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<name sortKey="Souza, Ln" uniqKey="Souza L">LN Souza</name>
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<name sortKey="Abreu, Mh" uniqKey="Abreu M">MH Abreu</name>
</author>
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<name sortKey="Freire Maia, B" uniqKey="Freire Maia B">B Freire-Maia</name>
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<author>
<name sortKey="Souza, Ln" uniqKey="Souza L">LN Souza</name>
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</TEI>
<pmc article-type="research-article">
<pmc-dir>properties open_access</pmc-dir>
<front>
<journal-meta>
<journal-id journal-id-type="nlm-ta">PLoS One</journal-id>
<journal-id journal-id-type="iso-abbrev">PLoS ONE</journal-id>
<journal-id journal-id-type="publisher-id">plos</journal-id>
<journal-id journal-id-type="pmc">plosone</journal-id>
<journal-title-group>
<journal-title>PLoS ONE</journal-title>
</journal-title-group>
<issn pub-type="epub">1932-6203</issn>
<publisher>
<publisher-name>Public Library of Science</publisher-name>
<publisher-loc>San Francisco, USA</publisher-loc>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="pmid">24950053</article-id>
<article-id pub-id-type="pmc">4065043</article-id>
<article-id pub-id-type="publisher-id">PONE-D-14-12786</article-id>
<article-id pub-id-type="doi">10.1371/journal.pone.0100624</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Research Article</subject>
</subj-group>
<subj-group subj-group-type="Discipline-v2">
<subject>Medicine and Health Sciences</subject>
<subj-group>
<subject>Oral Medicine</subject>
<subj-group>
<subject>Oral Diseases</subject>
<subj-group>
<subject>Periodontal Diseases</subject>
</subj-group>
</subj-group>
<subj-group>
<subject>Dentistry</subject>
<subject>Oral Health</subject>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v2">
<subject>Physical Sciences</subject>
<subj-group>
<subject>Mathematics</subject>
<subj-group>
<subject>Statistics (Mathematics)</subject>
<subj-group>
<subject>Statistical Methods</subject>
<subj-group>
<subject>Meta-Analysis</subject>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v2">
<subject>Research and Analysis Methods</subject>
<subj-group>
<subject>Mathematical and Statistical Techniques</subject>
</subj-group>
<subj-group>
<subject>Research Assessment</subject>
<subj-group>
<subject>Systematic Reviews</subject>
</subj-group>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>Flapless versus Conventional Flapped Dental Implant Surgery: A Meta-Analysis</article-title>
<alt-title alt-title-type="running-head">Flapless vs. Flapped Dental Implant Surgery: A Meta-Analysis</alt-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Chrcanovic</surname>
<given-names>Bruno Ramos</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<xref ref-type="corresp" rid="cor1">
<sup>*</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Albrektsson</surname>
<given-names>Tomas</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<xref ref-type="aff" rid="aff2">
<sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Wennerberg</surname>
<given-names>Ann</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
</contrib>
</contrib-group>
<aff id="aff1">
<label>1</label>
<addr-line>Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden,</addr-line>
</aff>
<aff id="aff2">
<label>2</label>
<addr-line>Department of Biomaterials, Göteborg University, Göteborg, Sweden</addr-line>
</aff>
<contrib-group>
<contrib contrib-type="editor">
<name>
<surname>Glogauer</surname>
<given-names>Michael</given-names>
</name>
<role>Editor</role>
<xref ref-type="aff" rid="edit1"></xref>
</contrib>
</contrib-group>
<aff id="edit1">
<addr-line>University of Toronto, Canada</addr-line>
</aff>
<author-notes>
<corresp id="cor1">* E-mail:
<email>bruno.chrcanovic@mah.se</email>
</corresp>
<fn fn-type="conflict">
<p>
<bold>Competing Interests: </bold>
The authors have declared that no competing interests exist.</p>
</fn>
<fn fn-type="con">
<p>Contributed to the writing of the manuscript: BRC. Conception and design of the work and acquisition of data: BRC TA AW. Meta-analysis: BRC. Interpretation of data: BRC TA AW. Revised the article critically for important intellectual content: BRC TA AW. Final approval of the version to be published: BRC TA AW.</p>
</fn>
</author-notes>
<pub-date pub-type="collection">
<year>2014</year>
</pub-date>
<pub-date pub-type="epub">
<day>20</day>
<month>6</month>
<year>2014</year>
</pub-date>
<volume>9</volume>
<issue>6</issue>
<elocation-id>e100624</elocation-id>
<history>
<date date-type="received">
<day>21</day>
<month>3</month>
<year>2014</year>
</date>
<date date-type="accepted">
<day>29</day>
<month>5</month>
<year>2014</year>
</date>
</history>
<permissions>
<copyright-year>2014</copyright-year>
<copyright-holder>Chrcanovic et al</copyright-holder>
<license>
<license-p>This is an open-access article distributed under the terms of the
<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">Creative Commons Attribution License</ext-link>
, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</license-p>
</license>
</permissions>
<abstract>
<p>The aim of this study was to test the null hypothesis of no difference in the implant failure rates, postoperative infection, and marginal bone loss for patients being rehabilitated by dental implants being inserted by a flapless surgical procedure versus the open flap technique, against the alternative hypothesis of a difference. An electronic search without time or language restrictions was undertaken in March 2014. Eligibility criteria included clinical human studies, either randomized or not. The search strategy resulted in 23 publications. The I
<sup>2</sup>
statistic was used to express the percentage of the total variation across studies due to heterogeneity. The inverse variance method was used for random-effects model or fixed-effects model, when indicated. The estimates of relative effect were expressed in risk ratio (RR) and mean difference (MD) in millimeters. Sixteen studies were judged to be at high risk of bias, whereas two studies were considered of moderate risk of bias, and five studies of low risk of bias. The funnel plots indicated absence of publication bias for the three outcomes analyzed. The test for overall effect showed that the difference between the procedures (flapless vs. open flap surgery) significantly affect the implant failure rates (
<italic>P</italic>
 = 0.03), with a RR of 1.75 (95% CI 1.07–2.86). However, a sensitivity analysis revealed differences when studies of high and low risk of bias were pooled separately. Thus, the results must be interpreted carefully. No apparent significant effects of flapless technique on the occurrence of postoperative infection (P = 0.96; RR 0.96, 95% CI 0.23–4.03) or on the marginal bone loss (
<italic>P</italic>
 = 0.16; MD −0.07 mm, 95% CI −0.16–0.03) were observed.</p>
</abstract>
<funding-group>
<funding-statement>This work was supported by CNPq, Conselho Nacional de Desenvolvimento Científico e Tecnológico – Brazil. The supportive institution had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.</funding-statement>
</funding-group>
<counts>
<page-count count="14"></page-count>
</counts>
<custom-meta-group>
<custom-meta id="data-availability">
<meta-name>Data Availability</meta-name>
<meta-value>The authors confirm that all data underlying the findings are fully available without restriction. Not applicable.</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
<notes>
<title>Data Availability</title>
<p>The authors confirm that all data underlying the findings are fully available without restriction. Not applicable.</p>
</notes>
</front>
</pmc>
<affiliations>
<list>
<country>
<li>Suède</li>
</country>
<region>
<li>Götaland</li>
<li>Suède occidentale</li>
</region>
<settlement>
<li>Göteborg</li>
</settlement>
<orgName>
<li>Université de Göteborg</li>
</orgName>
</list>
<tree>
<country name="Suède">
<noRegion>
<name sortKey="Chrcanovic, Bruno Ramos" sort="Chrcanovic, Bruno Ramos" uniqKey="Chrcanovic B" first="Bruno Ramos" last="Chrcanovic">Bruno Ramos Chrcanovic</name>
</noRegion>
<name sortKey="Albrektsson, Tomas" sort="Albrektsson, Tomas" uniqKey="Albrektsson T" first="Tomas" last="Albrektsson">Tomas Albrektsson</name>
<name sortKey="Albrektsson, Tomas" sort="Albrektsson, Tomas" uniqKey="Albrektsson T" first="Tomas" last="Albrektsson">Tomas Albrektsson</name>
<name sortKey="Wennerberg, Ann" sort="Wennerberg, Ann" uniqKey="Wennerberg A" first="Ann" last="Wennerberg">Ann Wennerberg</name>
</country>
</tree>
</affiliations>
</record>

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