Does the Implant Surgical Technique Affect the Primary and/or Secondary Stability of Dental Implants? A Systematic Review
Identifieur interne : 001510 ( Pmc/Checkpoint ); précédent : 001509; suivant : 001511Does the Implant Surgical Technique Affect the Primary and/or Secondary Stability of Dental Implants? A Systematic Review
Auteurs : Rola Muhammed Shadid ; Nasrin Rushdi Sadaqah ; Sahar Abdo OthmanSource :
- International Journal of Dentistry [ 1687-8728 ] ; 2014.
Abstract
Url:
DOI: 10.1155/2014/204838
PubMed: 25126094
PubMed Central: 4121016
Affiliations:
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Does the Implant Surgical Technique Affect the Primary and/or Secondary Stability of Dental Implants? A Systematic Review</title>
<author><name sortKey="Shadid, Rola Muhammed" sort="Shadid, Rola Muhammed" uniqKey="Shadid R" first="Rola Muhammed" last="Shadid">Rola Muhammed Shadid</name>
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<author><name sortKey="Sadaqah, Nasrin Rushdi" sort="Sadaqah, Nasrin Rushdi" uniqKey="Sadaqah N" first="Nasrin Rushdi" last="Sadaqah">Nasrin Rushdi Sadaqah</name>
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<wicri:noCountry code="subfield">Palestine</wicri:noCountry>
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<author><name sortKey="Othman, Sahar Abdo" sort="Othman, Sahar Abdo" uniqKey="Othman S" first="Sahar Abdo" last="Othman">Sahar Abdo Othman</name>
<affiliation><nlm:aff id="I2">Department of Oral Surgery, Faculty of Dentistry, Al-Sharjah University, Al-Sharjah, UAE</nlm:aff>
<wicri:noCountry code="subfield">UAE</wicri:noCountry>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Does the Implant Surgical Technique Affect the Primary and/or Secondary Stability of Dental Implants? A Systematic Review</title>
<author><name sortKey="Shadid, Rola Muhammed" sort="Shadid, Rola Muhammed" uniqKey="Shadid R" first="Rola Muhammed" last="Shadid">Rola Muhammed Shadid</name>
<affiliation><nlm:aff id="I1">Department of Prosthodontics, Faculty of Dentistry, Arab American University, Jenin, Palestine</nlm:aff>
<wicri:noCountry code="subfield">Palestine</wicri:noCountry>
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<author><name sortKey="Sadaqah, Nasrin Rushdi" sort="Sadaqah, Nasrin Rushdi" uniqKey="Sadaqah N" first="Nasrin Rushdi" last="Sadaqah">Nasrin Rushdi Sadaqah</name>
<affiliation><nlm:aff id="I1">Department of Prosthodontics, Faculty of Dentistry, Arab American University, Jenin, Palestine</nlm:aff>
<wicri:noCountry code="subfield">Palestine</wicri:noCountry>
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<author><name sortKey="Othman, Sahar Abdo" sort="Othman, Sahar Abdo" uniqKey="Othman S" first="Sahar Abdo" last="Othman">Sahar Abdo Othman</name>
<affiliation><nlm:aff id="I2">Department of Oral Surgery, Faculty of Dentistry, Al-Sharjah University, Al-Sharjah, UAE</nlm:aff>
<wicri:noCountry code="subfield">UAE</wicri:noCountry>
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<series><title level="j">International Journal of Dentistry</title>
<idno type="ISSN">1687-8728</idno>
<idno type="eISSN">1687-8736</idno>
<imprint><date when="2014">2014</date>
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<front><div type="abstract" xml:lang="en"><p><italic>Background</italic>
. A number of surgical techniques for implant site preparation have been advocated to enhance the implant of primary and secondary stability. However, there is insufficient scientific evidence to support the association between the surgical technique and implant stability. <italic>Purpose</italic>
. This review aimed to investigate the influence of different surgical techniques including the undersized drilling, the osteotome, the piezosurgery, the flapless procedure, and the bone stimulation by low-level laser therapy on the primary and/or secondary stability of dental implants. <italic>Materials and methods</italic>
. A search of PubMed, Cochrane Library, and grey literature was performed. The inclusion criteria comprised observational clinical studies and randomized controlled trials (RCTs) conducted in patients who received dental implants for rehabilitation, studies that evaluated the association between the surgical technique and the implant primary and/or secondary stability. The articles selected were carefully read and classified as low, moderate, and high methodological quality and data of interest were tabulated. <italic>Results</italic>
. Eight clinical studies were included then they were classified as moderate or high methodological quality and control of bias. <italic>Conclusions</italic>
. There is a weak evidence suggesting that any of previously mentioned surgical techniques could influence the primary and/or secondary implant stability.</p>
</div>
</front>
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<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Int J Dent</journal-id>
<journal-id journal-id-type="iso-abbrev">Int J Dent</journal-id>
<journal-id journal-id-type="publisher-id">IJD</journal-id>
<journal-title-group><journal-title>International Journal of Dentistry</journal-title>
</journal-title-group>
<issn pub-type="ppub">1687-8728</issn>
<issn pub-type="epub">1687-8736</issn>
<publisher><publisher-name>Hindawi Publishing Corporation</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">25126094</article-id>
<article-id pub-id-type="pmc">4121016</article-id>
<article-id pub-id-type="doi">10.1155/2014/204838</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Review Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Does the Implant Surgical Technique Affect the Primary and/or Secondary Stability of Dental Implants? A Systematic Review</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Shadid</surname>
<given-names>Rola Muhammed</given-names>
</name>
<xref ref-type="aff" rid="I1"><sup>1</sup>
</xref>
<xref ref-type="corresp" rid="cor1">*</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Sadaqah</surname>
<given-names>Nasrin Rushdi</given-names>
</name>
<xref ref-type="aff" rid="I1"><sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Othman</surname>
<given-names>Sahar Abdo</given-names>
</name>
<xref ref-type="aff" rid="I2"><sup>2</sup>
</xref>
</contrib>
</contrib-group>
<aff id="I1"><sup>1</sup>
Department of Prosthodontics, Faculty of Dentistry, Arab American University, Jenin, Palestine</aff>
<aff id="I2"><sup>2</sup>
Department of Oral Surgery, Faculty of Dentistry, Al-Sharjah University, Al-Sharjah, UAE</aff>
<author-notes><corresp id="cor1">*Rola Muhammed Shadid: <email>rola_shadeed@yahoo.com</email>
</corresp>
<fn fn-type="other"><p>Academic Editor: Martin Lorenzoni</p>
</fn>
</author-notes>
<pub-date pub-type="ppub"><year>2014</year>
</pub-date>
<pub-date pub-type="epub"><day>7</day>
<month>7</month>
<year>2014</year>
</pub-date>
<volume>2014</volume>
<elocation-id>204838</elocation-id>
<history><date date-type="received"><day>17</day>
<month>3</month>
<year>2014</year>
</date>
<date date-type="rev-recd"><day>8</day>
<month>5</month>
<year>2014</year>
</date>
<date date-type="accepted"><day>26</day>
<month>5</month>
<year>2014</year>
</date>
</history>
<permissions><copyright-statement>Copyright © 2014 Rola Muhammed Shadid et al.</copyright-statement>
<copyright-year>2014</copyright-year>
<license xlink:href="https://creativecommons.org/licenses/by/3.0/"><license-p>This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
</license>
</permissions>
<abstract><p><italic>Background</italic>
. A number of surgical techniques for implant site preparation have been advocated to enhance the implant of primary and secondary stability. However, there is insufficient scientific evidence to support the association between the surgical technique and implant stability. <italic>Purpose</italic>
. This review aimed to investigate the influence of different surgical techniques including the undersized drilling, the osteotome, the piezosurgery, the flapless procedure, and the bone stimulation by low-level laser therapy on the primary and/or secondary stability of dental implants. <italic>Materials and methods</italic>
. A search of PubMed, Cochrane Library, and grey literature was performed. The inclusion criteria comprised observational clinical studies and randomized controlled trials (RCTs) conducted in patients who received dental implants for rehabilitation, studies that evaluated the association between the surgical technique and the implant primary and/or secondary stability. The articles selected were carefully read and classified as low, moderate, and high methodological quality and data of interest were tabulated. <italic>Results</italic>
. Eight clinical studies were included then they were classified as moderate or high methodological quality and control of bias. <italic>Conclusions</italic>
. There is a weak evidence suggesting that any of previously mentioned surgical techniques could influence the primary and/or secondary implant stability.</p>
</abstract>
</article-meta>
</front>
<floats-group><fig id="fig1" orientation="portrait" position="float"><label>Figure 1</label>
<caption><p>Flow diagram of literature review.</p>
</caption>
<graphic xlink:href="IJD2014-204838.001"></graphic>
</fig>
<table-wrap-group id="tab1" orientation="portrait" position="float"><label>Table 1</label>
<table-wrap id="tab1a" orientation="portrait" position="anchor"><label>(a)</label>
<table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1">Author and year</th>
<th align="center" rowspan="1" colspan="1">Geographical location</th>
<th align="left" rowspan="1" colspan="1">Sample </th>
<th align="left" rowspan="1" colspan="1">Implant dimensions (mm) and surface</th>
<th align="center" rowspan="1" colspan="1">Number of implants</th>
<th align="left" rowspan="1" colspan="1">Implant and manufacturer</th>
</tr>
</thead>
<tbody><tr><td align="left" rowspan="1" colspan="1">Padmanabhan and Gupta 2010 [<xref rid="B57" ref-type="bibr">48</xref>
]</td>
<td align="center" rowspan="1" colspan="1">India</td>
<td align="left" rowspan="1" colspan="1">Number: 5 <break></break>
Gender: 2 ♀ with a mean age of 29, 3 ♂ with a mean age of 23 </td>
<td align="left" rowspan="1" colspan="1">Length: 13 <break></break>
Diameter: 3.7<break></break>
Surface: microgrip 1–5 <italic>μ</italic>
m roughness</td>
<td align="center" rowspan="1" colspan="1">10 </td>
<td align="left" rowspan="1" colspan="1">Uniti (Equinox Medical Technologies)</td>
</tr>
<tr><td align="center" colspan="6" rowspan="1"><hr></hr>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Shayesteh et al. 2013 [<xref rid="B58" ref-type="bibr">49</xref>
]</td>
<td align="center" rowspan="1" colspan="1">Iran</td>
<td align="left" rowspan="1" colspan="1">Number: 30 <break></break>
Gender: 18 ♀, 12 ♂<break></break>
Mean age: 40.5 </td>
<td align="left" rowspan="1" colspan="1">length: 10, 12 <break></break>
Diameter: 4.1 <break></break>
Surface: sandblasted, large grit, and acid etched</td>
<td align="center" rowspan="1" colspan="1">46</td>
<td align="left" rowspan="1" colspan="1">SLA oral implants (Straumann AG) </td>
</tr>
<tr><td align="center" colspan="6" rowspan="1"><hr></hr>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Marković et al. 2013 [<xref rid="B55" ref-type="bibr">50</xref>
]</td>
<td align="center" rowspan="1" colspan="1">Belgrade </td>
<td align="left" rowspan="1" colspan="1">Number: 53<break></break>
Gender: 25 ♀, 28 ♂<break></break>
Mean age: 43.9 </td>
<td align="left" rowspan="1" colspan="1">Length: 10<break></break>
Diameter: 4 mm <break></break>
Surface: BlueSky Bredent-sandbasted and etched osseo connect;<break></break>
<break></break>
Straumann-2–4 <italic>μ</italic>
m roughness sandblasted and acid etched</td>
<td align="center" rowspan="1" colspan="1">102</td>
<td align="left" rowspan="1" colspan="1">51 self-tapping BlueSky (Bredent),<break></break>
<break></break>
51 non-self-tapping Standard Plus<break></break>
SLActive<break></break>
(Straumann) </td>
</tr>
<tr><td align="center" colspan="6" rowspan="1"><hr></hr>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Turkyilmaz et al. 2008 [<xref rid="B59" ref-type="bibr">51</xref>
]</td>
<td align="center" rowspan="1" colspan="1">Turkey</td>
<td align="left" rowspan="1" colspan="1">Number: 22 <break></break>
Gender: 10 ♀, 12 ♂<break></break>
Mean age: 49 </td>
<td align="left" rowspan="1" colspan="1">Lengths: 10, 11.5<break></break>
Diameters: 3.75, 4<break></break>
Surface: layer of titanium oxide</td>
<td align="center" rowspan="1" colspan="1">60</td>
<td align="left" rowspan="1" colspan="1">TiUnite Mk III (Nobel Biocare)</td>
</tr>
<tr><td align="center" colspan="6" rowspan="1"><hr></hr>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Alghamdi et al. 2011 [<xref rid="B50" ref-type="bibr">52</xref>
]</td>
<td align="center" rowspan="1" colspan="1">Saudi Arabia</td>
<td align="left" rowspan="1" colspan="1">Number: 29 <break></break>
Gender: 12 ♀, 17 ♂<break></break>
Mean age: 47 ± 8 </td>
<td align="left" rowspan="1" colspan="1">Length: 12<break></break>
Diameter: 4.1 <break></break>
Surface: 2–4 <italic>μ</italic>
m roughness sandblasted and acid etched</td>
<td align="center" rowspan="1" colspan="1">52</td>
<td align="left" rowspan="1" colspan="1">Standard Plus<break></break>
SLActive<break></break>
(Straumann)</td>
</tr>
<tr><td align="center" colspan="6" rowspan="1"><hr></hr>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Stacchi et al. 2013 [<xref rid="B12" ref-type="bibr">11</xref>
]</td>
<td align="center" rowspan="1" colspan="1">Italy</td>
<td align="left" rowspan="1" colspan="1">Number: 20 <break></break>
Gender: 12 ♂, 8 ♀<break></break>
Mean age: 59.7 ± 13.6</td>
<td align="left" rowspan="1" colspan="1">Length: 10 mm<break></break>
Diameter: 4.0<break></break>
Surface: nanotite surface</td>
<td align="center" rowspan="1" colspan="1">40</td>
<td align="left" rowspan="1" colspan="1">NanoTite Parallel Walled Certain (Biomet 3i)</td>
</tr>
<tr><td align="center" colspan="6" rowspan="1"><hr></hr>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Katsoulis et al. 2012 [<xref rid="B33" ref-type="bibr">32</xref>
]</td>
<td align="center" rowspan="1" colspan="1">Switzerland</td>
<td align="left" rowspan="1" colspan="1">Number: 40<break></break>
Gender: 16 ♀, 24 ♂<break></break>
Mean age: 61 ± 9 </td>
<td align="left" rowspan="1" colspan="1">Length: 10, 13<break></break>
Diameter: 3.5, 4.3 <break></break>
Surface: anodized surface</td>
<td align="center" rowspan="1" colspan="1">195</td>
<td align="left" rowspan="1" colspan="1">Replace Select Tapered (Nobel Biocare)</td>
</tr>
<tr><td align="center" colspan="6" rowspan="1"><hr></hr>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">García-Morales et al. 2012 [<xref rid="B52" ref-type="bibr">53</xref>
]</td>
<td align="center" rowspan="1" colspan="1">Brazil</td>
<td align="left" rowspan="1" colspan="1">Number: 8<break></break>
Gender: 2 ♂, 6 ♀<break></break>
Mean age: 36 </td>
<td align="left" rowspan="1" colspan="1">Diameter: 3.8<break></break>
Length: 11 <break></break>
Surface: sandblasted and acid etched</td>
<td align="center" rowspan="1" colspan="1">30</td>
<td align="left" rowspan="1" colspan="1">XiVE-S (Dentsply Friadent)</td>
</tr>
</tbody>
</table>
</table-wrap>
<table-wrap id="tab1b" orientation="portrait" position="anchor"><label>(b)</label>
<table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1">Author and year</th>
<th align="left" rowspan="1" colspan="1">Regions of implant insertion</th>
<th align="left" rowspan="1" colspan="1">Surgical technique</th>
<th align="left" rowspan="1" colspan="1">Primary stability: ISQ, PTV and/or IT (N cm) mean (SD)</th>
<th align="left" rowspan="1" colspan="1">Confounders included in analysis</th>
<th align="left" rowspan="1" colspan="1">Association between Primary stability and surgical technique</th>
<th align="left" rowspan="1" colspan="1">Secondary stability: ISQ, PTV and/or IT (N cm) mean (SD)</th>
<th align="left" rowspan="1" colspan="1">Association between Secondary stability and surgical technique</th>
</tr>
</thead>
<tbody><tr><td align="left" rowspan="1" colspan="1">Padmanabhan and Gupta <break></break>
2010 [<xref rid="B57" ref-type="bibr">48</xref>
]</td>
<td align="left" rowspan="1" colspan="1">Maxillary anterior region</td>
<td align="left" rowspan="1" colspan="1">Osteotome technique versus conventional drilling </td>
<td align="left" rowspan="1" colspan="1">ISQ: drilling 64.77 <break></break>
osteotome 59.60 </td>
<td align="left" rowspan="1" colspan="1">No confounders cited</td>
<td align="left" rowspan="1" colspan="1">ISQ drilling > ISQ osteotome significantly (<italic>P</italic>
= 0.026)</td>
<td align="left" rowspan="1" colspan="1">ISQ 6 months: drilling 55.40<break></break>
osteotome 61.50</td>
<td align="left" rowspan="1" colspan="1">No significant difference between ISQ drilling and ISQ <break></break>
osteotome 6 months after surgery (<italic>P</italic>
= 0.076) </td>
</tr>
<tr><td align="center" colspan="8" rowspan="1"><hr></hr>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Shayesteh et al. 2013 [<xref rid="B58" ref-type="bibr">49</xref>
]</td>
<td align="left" rowspan="1" colspan="1">Maxillary anterior region</td>
<td align="left" rowspan="1" colspan="1">Osteotome technique versus conventional drilling</td>
<td align="left" rowspan="1" colspan="1">ISQ: drilling 64.70 <break></break>
osteotome 70.9 </td>
<td align="left" rowspan="1" colspan="1">Implant length: cited, but not included in analysis</td>
<td align="left" rowspan="1" colspan="1">ISQ osteotome > ISQ drilling significantly (<italic>P</italic>
= 0.026)</td>
<td align="left" rowspan="1" colspan="1">ISQ 3 months: drilling 71.37<break></break>
osteotome 72.71</td>
<td align="left" rowspan="1" colspan="1">No significant difference between ISQ drilling and ISQ <break></break>
osteotome 3 months after surgery (<italic>P</italic>
= 0.06) </td>
</tr>
<tr><td align="center" colspan="8" rowspan="1"><hr></hr>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Marković et al. 2013 [<xref rid="B55" ref-type="bibr">50</xref>
]</td>
<td align="left" rowspan="1" colspan="1">Maxillary posterior region</td>
<td align="left" rowspan="1" colspan="1">Osteotome technique versus conventional drilling</td>
<td align="left" rowspan="1" colspan="1">ISQ: drilling and non-self-tapping <break></break>
61.20 ± 1.63 <break></break>
osteotome and non-self-tapping <break></break>
74.03 ± 3.53 <break></break>
<break></break>
drilling and self-tapping <break></break>
65.10 ± 3.03 <break></break>
osteotome and self-tapping <break></break>
74.34 ± 4.09</td>
<td align="left" rowspan="1" colspan="1">Implant macrodesign (self-tapping versus non-self-tapping) influenced the stability during the entire follow-up period after bone drilling and only between the 2nd and 12th postoperative weeks, following bone condensation (<italic>P</italic>
< 0.05) </td>
<td align="left" rowspan="1" colspan="1">ISQ osteotome > ISQ drilling significantly for self-tapping and non-self-tapping implants (<italic>P</italic>
< 0.05)</td>
<td align="left" rowspan="1" colspan="1">ISQ 12th weeks: drilling and non-self-tapping <break></break>
67.10 ± 0.32<break></break>
osteotome and non-self-tapping <break></break>
71.88 ± 1.10<break></break>
<break></break>
drilling and <break></break>
self-tapping <break></break>
68.20 ± 1.81 <break></break>
osteotome and self-tapping <break></break>
73.54 ± 2.58</td>
<td align="left" rowspan="1" colspan="1">ISQ osteotome > ISQ<break></break>
drilling significantly for self-tapping and non-self-tapping implants during the entire 12-week observation period (<italic>P</italic>
< 0.05) </td>
</tr>
<tr><td align="center" colspan="8" rowspan="1"><hr></hr>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Turkyilmaz <break></break>
et al. 2008 [<xref rid="B59" ref-type="bibr">51</xref>
]</td>
<td align="left" rowspan="1" colspan="1">Maxillary posterior region</td>
<td align="left" rowspan="1" colspan="1">Undersized drilling versus press-fit drilling </td>
<td align="left" rowspan="1" colspan="1">IT for 4 × 10 implants: standard drilling: <break></break>
35.9 ± 6<break></break>
undersized drilling <break></break>
37.2 ± 7<break></break>
<break></break>
IT for 4 × 11.5 implants: standard drilling: 38.5 ± 7<break></break>
Undersized drilling 41.1 ± 6</td>
<td align="left" rowspan="1" colspan="1">Implant diameter influenced the stability<break></break>
<break></break>
bone density correlated with stability</td>
<td align="left" rowspan="1" colspan="1">For 4 × 10 and 4 × 11.5 implants: no significant differences between both (ISQ and IT)<break></break>
standard drilling and both (ISQ and IT) undersized drilling (<italic>P</italic>
> 0.05)</td>
<td align="left" rowspan="1" colspan="1">Not evaluated</td>
<td align="left" rowspan="1" colspan="1">Not evaluated</td>
</tr>
<tr><td align="center" colspan="8" rowspan="1"><hr></hr>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Alghamdi et al. 2011 [<xref rid="B50" ref-type="bibr">52</xref>
]</td>
<td align="left" rowspan="1" colspan="1">Posterior maxilla and mandible</td>
<td align="left" rowspan="1" colspan="1">Undersized drilling versus press-fit drilling</td>
<td align="left" rowspan="1" colspan="1">ISQ: standard drilling <break></break>
66.69 ± 5.41<break></break>
undersized drilling <break></break>
68.58 ± 4.81 <break></break>
<break></break>
Maxilla <break></break>
66.96 ± 5.58<break></break>
mandible <break></break>
66.52 ± 5.25<break></break>
<break></break>
♀ 64.39 ± 5.15<break></break>
♂ 68.27 ± 4.85<break></break>
<break></break>
IT: standard drilling <break></break>
34.62 ± 5.82<break></break>
undersized drilling <break></break>
35.19 ± 4.79 <break></break>
<break></break>
maxilla <break></break>
34.07 ± 4.81<break></break>
mandible <break></break>
34.20 ± 4.93<break></break>
<break></break>
♀ 33.48 (±4.63) <break></break>
♂ 36.38 (±5.96) </td>
<td align="left" rowspan="1" colspan="1">Bone density and jaw position (maxilla versus mandible): cited but not included in analysis and were not accounted for to remove their confounding influence on surgical techniques between groups </td>
<td align="left" rowspan="1" colspan="1">No significant differences between both (ISQ and IT)<break></break>
standard drilling and (ISQ and IT) undersized drilling (<italic>P</italic>
> 0.05)<break></break>
<break></break>
ISQ ♂ > ISQ ♀ significantly (<italic>P</italic>
< 0.001)<break></break>
<break></break>
No significant difference for IT values between women and men (<italic>P</italic>
> 0.05)</td>
<td align="left" rowspan="1" colspan="1">Not evaluated</td>
<td align="left" rowspan="1" colspan="1">Not evaluated</td>
</tr>
<tr><td align="center" colspan="8" rowspan="1"><hr></hr>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Stacchi et al. 2013 [<xref rid="B12" ref-type="bibr">11</xref>
]</td>
<td align="left" rowspan="1" colspan="1">Maxillary premolar area</td>
<td align="left" rowspan="1" colspan="1">Piezosurgery versus conventional drilling</td>
<td align="left" rowspan="1" colspan="1">ISQ: drills <break></break>
72.2 ± 5.8 <break></break>
piezoelectric <break></break>
70.5 ± 5.8</td>
<td align="left" rowspan="1" colspan="1">No confounders cited</td>
<td align="left" rowspan="1" colspan="1">No significant difference between ISQ drills and ISQ piezoelectric (<italic>P</italic>
= 0.3215) </td>
<td align="left" rowspan="1" colspan="1">ISQ 3 months: drills <break></break>
69.2 ± 5.5 <break></break>
piezoelectric <break></break>
71.0 ± 2.9</td>
<td align="left" rowspan="1" colspan="1">ISQ piezoelectric > ISQ drills significantly during the entire period of observation (90 days): from day 14 to day 42, in particular, the difference was extremely significant (<italic>P</italic>
< 0.0001) </td>
</tr>
<tr><td align="center" colspan="8" rowspan="1"><hr></hr>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Katsoulis et al. 2012 [<xref rid="B33" ref-type="bibr">32</xref>
]</td>
<td align="left" rowspan="1" colspan="1">Complete edentulous maxilla</td>
<td align="left" rowspan="1" colspan="1">Flapless versus flap procedure </td>
<td align="left" rowspan="1" colspan="1">ISQ: flap 57.7 (±1.8)<break></break>
flapless 62.1 (±1.8)<break></break>
<break></break>
♀ 56.5 (±2.0)<break></break>
♂ 61.4 (±1.4)<break></break>
<break></break>
10 mm length: 60.5 (±3.0)<break></break>
13 mm length: 58.7 (±1.3)<break></break>
<break></break>
3.5 mm diameter: 58.0 (±2.0)<break></break>
4.3 mm diameter: 59.1 (±1.5)</td>
<td align="left" rowspan="1" colspan="1">Implant diameter and length did not influence stability <break></break>
<break></break>
Bone density not evaluated</td>
<td align="left" rowspan="1" colspan="1">ISQ standard > ISQ<break></break>
flapless significantly (<italic>P</italic>
< 0.001)<break></break>
<break></break>
ISQ ♂ > ISQ ♀ significantly (<italic>P</italic>
= 0.01)</td>
<td align="left" rowspan="1" colspan="1">ISQ 3 months: Flap 56.0 (±2.0)<break></break>
flapless 65.4 (±1.7)<break></break>
<break></break>
♀ 55.9 (2.4)<break></break>
♂ 62.0 (2.0)<break></break>
<break></break>
10 mm length: 59.5 (4.1)<break></break>
13 mm length: 59.6 (1.9)<break></break>
<break></break>
3.5 mm diameter: 60.2 (2.7)<break></break>
4.3 mm diameter: 59.0 (2.2)</td>
<td align="left" rowspan="1" colspan="1">ISQ flap > ISQ flapless significantly at 3 months (<italic>P</italic>
< 0.001)<break></break>
<break></break>
ISQ ♂ > ISQ ♀ significantly at 3 months (<italic>P</italic>
< 0.001) </td>
</tr>
<tr><td align="center" colspan="8" rowspan="1"><hr></hr>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">García-Morales et al. 2012 [<xref rid="B52" ref-type="bibr">53</xref>
]</td>
<td align="left" rowspan="1" colspan="1">Mandibular posterior region</td>
<td align="left" rowspan="1" colspan="1">Low-level laser stimulation versus placebo</td>
<td align="left" rowspan="1" colspan="1">ISQ: conventional <break></break>
75.7 (5.6) <break></break>
laser <break></break>
77.4 (3.4) </td>
<td align="left" rowspan="1" colspan="1">No confounders cited</td>
<td align="left" rowspan="1" colspan="1">No significant difference between ISQ conventional and ISQ laser (<italic>P</italic>
< 0.05)</td>
<td align="left" rowspan="1" colspan="1">ISQ 12 weeks: conventional <break></break>
78.4 (3.0)<break></break>
laser <break></break>
76.3 (4.1)</td>
<td align="left" rowspan="1" colspan="1">No significant difference between ISQ conventional and ISQ laser at 12 weeks (<italic>P</italic>
> 0.05)</td>
</tr>
</tbody>
</table>
</table-wrap>
</table-wrap-group>
<table-wrap id="tab2" orientation="portrait" position="float"><label>Table 2</label>
<caption><p>Methodological checklist for prognostic studies developed by the National Institute for Health and Clinical Excellence from United Kingdom [<xref rid="B49" ref-type="bibr">54</xref>
].</p>
</caption>
<table frame="hsides" rules="groups"><thead><tr><th align="center" colspan="5" rowspan="1">Study identification</th>
</tr>
<tr><th align="center" colspan="5" rowspan="1">Circle one option for each question </th>
</tr>
</thead>
<tbody><tr><td align="left" rowspan="1" colspan="1">(1.1)</td>
<td align="left" rowspan="1" colspan="1">The study sample represents the population of interest with regard to key characteristics, sufficient to limit potential bias to the results.<break></break>
To minimize bias, the study population should be clearly defined and described and should represent the source population of interest.<break></break>
Points to consider include the following.<break></break>
Is the source population or the population of interest adequately described with respect to key characteristics?<break></break>
Are the sampling frame and recruitment adequately described, possibly including methods to identify the sample (number and type used; e.g., referral patterns in healthcare), period of recruitment and place of recruitment (setting and geographical location)?<break></break>
Are inclusion and exclusion criteria adequately described (e.g., including explicit diagnostic criteria or a description of participants at the start of the follow-up period)?<break></break>
Is participation in the study by eligible individuals adequate?<break></break>
Is the baseline study sample (i.e., individuals entering the study) adequately described with respect to key characteristics? </td>
<td align="center" rowspan="1" colspan="1">Yes</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">Unclear</td>
</tr>
<tr><td align="center" colspan="5" rowspan="1"><hr></hr>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">(1.2)</td>
<td align="left" rowspan="1" colspan="1">Loss of follow-up is unrelated to key characteristics (i.e., the study data adequately represent the sample), sufficient to limit potential bias.<break></break>
To minimize bias, completeness of follow-up should be described and adequate. Points to consider include the following.<break></break>
Is the response rate (i.e., proportion of study sample completing the study and providing outcome data) adequate? <break></break>
Are attempts to collect information on participants who dropped out of the study described?<break></break>
Are reasons for loss to follow-up provided?<break></break>
Are the key characteristics of participants lost to follow-up adequately described?<break></break>
Are there any important differences in key characteristics and outcomes between participants who completed the study and those who did not? </td>
<td align="center" rowspan="1" colspan="1">Yes</td>
<td align="center" rowspan="1" colspan="1">no</td>
<td align="center" rowspan="1" colspan="1">unclear</td>
</tr>
<tr><td align="center" colspan="5" rowspan="1"><hr></hr>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">(1.3)</td>
<td align="left" rowspan="1" colspan="1">The prognostic factor of interest is adequately measured in study participants, sufficient to limit potential bias.<break></break>
To minimize bias, prognostic factors should have been defined and measured appropriately. Points to consider include the following.<break></break>
Is a clear definition or description of the prognostic factor(s) measured provided (including dose, level, duration of exposure, and clear specification of the measurement)?<break></break>
Are continuous variables reported, or appropriate cut-off points (i.e., not data-dependent) used?<break></break>
Are the prognostic factor measured and the method of measurement valid and reliable enough to limit misclassification bias? (This may include relevant outside sources of information on measurement properties, as well as characteristics such as blind measurement and limited reliance on recall).<break></break>
Are complete data for prognostic factors available for an adequate proportion of the study sample?<break></break>
Are the method and setting of measurement the same for all study participants? <break></break>
Are appropriate methods employed if amputation is used for missing data on prognostic factors?</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">Unclear</td>
</tr>
<tr><td align="center" colspan="5" rowspan="1"><hr></hr>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">(1.4)</td>
<td align="left" rowspan="1" colspan="1">The outcome of interest is adequately measured in study participants, sufficient to limit bias.<break></break>
Is a clear definition of the outcome of interest provided, including duration of follow-up?<break></break>
Are the outcome that was measured and the method of measurement valid and reliable enough to limit misclassification bias? (This may include relevant outside sources of information on measurement properties, as well as characteristics such as “blind” measurement and limited reliance on recall.) <break></break>
Are the method and setting of measurement the same for all study participants?</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">Unclear</td>
</tr>
<tr><td align="center" colspan="5" rowspan="1"><hr></hr>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">(1.5)</td>
<td align="left" rowspan="1" colspan="1">Important potential confounders are appropriately accounted for, limiting potential bias with respect to the prognostic factor of interest.<break></break>
To minimize bias, important confounders, should be defined and measured, and confounding should be accounted for in the design or analysis. Points to consider include the following.<break></break>
Are all important confounders, including treatments (key variables in the conceptual model), measured? Are clear definitions of the important confounders measured (including dose, level and duration of exposures) provided?<break></break>
Is measurement of all important confounders valid and reliable? (This may include relevant outside sources of information on measurement properties, as well as characteristics such as “blind” measurement and limited reliance on recall.) <break></break>
Are the method and setting of measurement of confounders the same for all study participants?<break></break>
Are appropriate methods employed if imputation is used for missing data on confounders?<break></break>
Are important potential confounders accounted for in the study design (e.g., matching for key variables, stratification or initial assembly of complete groups)?<break></break>
Are important potential confounders accounted for in the analysis (i.e., appropriate adjustment)?</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">Unclear</td>
</tr>
<tr><td align="center" colspan="5" rowspan="1"><hr></hr>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">(1.6)</td>
<td align="left" rowspan="1" colspan="1">The statistical analysis is appropriate for the design of the study, limiting potential for the presentation of invalid results.<break></break>
To minimize bias, the statistical analysis undertaken should be clearly described and appropriate for the design of the study. Points to consider include the following.<break></break>
Is the presentation of data sufficient to assess the adequacy of the analysis?<break></break>
Where several prognostic factors are investigated? Is the strategy for model building (i.e., the inclusion of variables) appropriate and based on a conceptual framework or model?<break></break>
Is the selected model adequate for the design of the study?<break></break>
Is there any selective reporting of results?<break></break>
Are only prespecified hypotheses investigated in the analyses?</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">Unclear</td>
</tr>
<tr><td align="center" colspan="5" rowspan="1"><hr></hr>
</td>
</tr>
<tr><td align="center" colspan="5" rowspan="1">It was used to perform the quality assessment and control of bias</td>
</tr>
</tbody>
</table>
</table-wrap>
<table-wrap id="tab3" orientation="portrait" position="float"><label>Table 3</label>
<table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1"> </th>
<th align="center" rowspan="1" colspan="1">Padmanabhan and Gupta 2010 [<xref rid="B57" ref-type="bibr">48</xref>
]</th>
<th align="center" rowspan="1" colspan="1">Shayesteh et al. <break></break>
2013 [<xref rid="B58" ref-type="bibr">49</xref>
]</th>
<th align="center" rowspan="1" colspan="1">Marković et al. <break></break>
2011 [<xref rid="B54" ref-type="bibr">55</xref>
]</th>
<th align="center" rowspan="1" colspan="1">Stacchi et al. <break></break>
2013 [<xref rid="B12" ref-type="bibr">11</xref>
]</th>
<th align="center" rowspan="1" colspan="1">Turkyilmaz et al. <break></break>
2008 [<xref rid="B59" ref-type="bibr">51</xref>
]</th>
<th align="center" rowspan="1" colspan="1">Marković et al. <break></break>
2013 [<xref rid="B55" ref-type="bibr">50</xref>
]</th>
<th align="center" rowspan="1" colspan="1">Alghamdi et al. <break></break>
2011 [<xref rid="B50" ref-type="bibr">52</xref>
]</th>
<th align="center" rowspan="1" colspan="1">Katsoulis et al. <break></break>
2012 [<xref rid="B33" ref-type="bibr">32</xref>
]</th>
<th align="center" rowspan="1" colspan="1">García-Morales et al. 2012 [<xref rid="B52" ref-type="bibr">53</xref>
]</th>
</tr>
</thead>
<tbody><tr><td align="left" rowspan="1" colspan="1">(1) The study sample represents the population of interest with regard to key characteristics, sufficient to limit potential bias to the results</td>
<td align="center" rowspan="1" colspan="1">Unclear </td>
<td align="center" rowspan="1" colspan="1">Yes </td>
<td align="center" rowspan="1" colspan="1">Unclear </td>
<td align="center" rowspan="1" colspan="1">Unclear </td>
<td align="center" rowspan="1" colspan="1">Unclear </td>
<td align="center" rowspan="1" colspan="1">Unclear </td>
<td align="center" rowspan="1" colspan="1">Unclear </td>
<td align="center" rowspan="1" colspan="1">Unclear</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
</tr>
<tr><td align="center" colspan="10" rowspan="1"><hr></hr>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">(2) Loss to follow-up is unrelated to key characteristics (i.e., the study data adequately represent the sample), sufficient to limit potential bias </td>
<td align="center" rowspan="1" colspan="1">Yes </td>
<td align="center" rowspan="1" colspan="1">Unclear </td>
<td align="center" rowspan="1" colspan="1">Yes </td>
<td align="center" rowspan="1" colspan="1">Yes </td>
<td align="center" rowspan="1" colspan="1">Yes </td>
<td align="center" rowspan="1" colspan="1">Yes</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
</tr>
<tr><td align="center" colspan="10" rowspan="1"><hr></hr>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">(3) The prognostic factor of interest is adequately measured in study participants, sufficient to limit potential bias. (n these studies the prognostic factor was the surgical technique)</td>
<td align="center" rowspan="1" colspan="1">Yes </td>
<td align="center" rowspan="1" colspan="1">Yes </td>
<td align="center" rowspan="1" colspan="1">Yes </td>
<td align="center" rowspan="1" colspan="1">Yes </td>
<td align="center" rowspan="1" colspan="1">Yes</td>
<td align="center" rowspan="1" colspan="1">Unclear</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
<td align="center" rowspan="1" colspan="1">Yes </td>
<td align="center" rowspan="1" colspan="1">Yes</td>
</tr>
<tr><td align="center" colspan="10" rowspan="1"><hr></hr>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">(4) The outcome of interest is adequately measured in study participants, sufficient to limit bias. (The outcome was the primary and/or secondary stability)</td>
<td align="center" rowspan="1" colspan="1">Unclear </td>
<td align="center" rowspan="1" colspan="1">Unclear </td>
<td align="center" rowspan="1" colspan="1">Yes </td>
<td align="center" rowspan="1" colspan="1">Yes </td>
<td align="center" rowspan="1" colspan="1">Unclear </td>
<td align="center" rowspan="1" colspan="1">Yes </td>
<td align="center" rowspan="1" colspan="1">Unclear</td>
<td align="center" rowspan="1" colspan="1">Unclear</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
</tr>
<tr><td align="center" colspan="10" rowspan="1"><hr></hr>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">(5) Important potential confounders are appropriately accounted for, limiting potential bias with respect to the prognostic factor of interest. (e.g., implant dimensions and bone density)</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
<td align="center" rowspan="1" colspan="1">No </td>
<td align="center" rowspan="1" colspan="1">Yes</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
</tr>
<tr><td align="center" colspan="10" rowspan="1"><hr></hr>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">(6) The statistical analysis is appropriate for the design of the study, limiting potential for the presentation of invalid results</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
<td align="center" rowspan="1" colspan="1">Yes </td>
<td align="center" rowspan="1" colspan="1">Yes</td>
<td align="center" rowspan="1" colspan="1">Yes </td>
<td align="center" rowspan="1" colspan="1">Yes </td>
<td align="center" rowspan="1" colspan="1">Yes</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
<td align="center" rowspan="1" colspan="1">yes</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
</tr>
<tr><td align="center" colspan="10" rowspan="1"><hr></hr>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Category and situation of the article</td>
<td align="center" rowspan="1" colspan="1">4 ‘‘yes:” moderate methodol quality included</td>
<td align="center" rowspan="1" colspan="1">3 ‘‘yes:” Moderate methodol quality included</td>
<td align="center" rowspan="1" colspan="1">5 ‘‘yes:” High methodol quality excluded∗</td>
<td align="center" rowspan="1" colspan="1">5 “yes:” High methodol quality included</td>
<td align="center" rowspan="1" colspan="1">4 ‘‘yes:” Moderate methodol quality included</td>
<td align="center" rowspan="1" colspan="1">4 ‘‘yes:” Moderate methodol quality included</td>
<td align="center" rowspan="1" colspan="1">3 ‘‘yes:” Moderate methodol quality included</td>
<td align="center" rowspan="1" colspan="1">3 ‘‘yes:” Moderate methodol quality included</td>
<td align="center" rowspan="1" colspan="1">6 “yes:” high methodological quality included</td>
</tr>
</tbody>
</table>
<table-wrap-foot><fn><p>*The articles conducted by the same author had some overlapping patients. After ranking these studies, the one with the highest score was included in the systematic review, the others were excluded.</p>
</fn>
</table-wrap-foot>
</table-wrap>
</floats-group>
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<tree><noCountry><name sortKey="Othman, Sahar Abdo" sort="Othman, Sahar Abdo" uniqKey="Othman S" first="Sahar Abdo" last="Othman">Sahar Abdo Othman</name>
<name sortKey="Sadaqah, Nasrin Rushdi" sort="Sadaqah, Nasrin Rushdi" uniqKey="Sadaqah N" first="Nasrin Rushdi" last="Sadaqah">Nasrin Rushdi Sadaqah</name>
<name sortKey="Shadid, Rola Muhammed" sort="Shadid, Rola Muhammed" uniqKey="Shadid R" first="Rola Muhammed" last="Shadid">Rola Muhammed Shadid</name>
</noCountry>
</tree>
</affiliations>
</record>
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