Cochrane · intervention · CD006698
Interventions for replacing missing teeth: 1- versus 2-stage implant placement
Cochrane Database of Systematic Reviews · 2009 · Cochrane Library
Full textEvery question was extracted from the full review (methods and results), not only its Summary of Findings table.
Questions
6
current version
GRADE rated
2
No studies
1
Included studies
5
as reported
No studies 1 · 16.7%Ungraded 3 · 50%Very low 0 · 0%Low 0 · 0%Moderate 2 · 33.3%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Any subject receiving osseointegrated dental implants | 239 patients with 761 implants placed in mandibles and maxillae; 5 trials (Italy n=2, Netherlands n=1, Sweden and Norway n=1, USA n=1); 3 at university or specialty clinics and 2 in private practice; industry-supported; adults only |
| Intervention | 1-stage (non-submerged) implant placement, using the same implant type as the comparator | 1-stage implant placement (121 patients; 375 implants) |
| Comparison | 2-stage (submerged) implant placement | 2-stage implant placement (123 patients; 386 implants) |
| Outcomes | Prosthesis failure (if secondary to implant failure); Implant failure (implant mobility and removal of stable implants dictated by progressive marginal bone loss or infection); Radiographic marginal bone level changes; Patient preference including aesthetics (split-mouth studies only); Aesthetics evaluated by dentists; Complications (any biological and biomechanical complication up to delivery of the implant-supported prosthesis) | Prosthesis failures (n=5); Implant failures (n=5); Radiographic marginal bone level changes (n=1 analyzable, Cordaro 2009); Aesthetics evaluated by dentists / soft tissue recession (n=1); Complications (n=3 reported, 1 pooled) |
| Study designs | Randomised controlled trials (parallel group and split-mouth designs) comparing 1-stage versus 2-stage placement of the same implant type; minimum 6 months follow-up after loading | Four parallel-group trials and one split-mouth trial (Barber 1996); four at high risk of bias, one at low risk of bias (Cordaro 2009) |
| Timing | Minimum follow up of 6 months after loading (comparisons presented at 1 year in function when possible) | Follow up 6 months to 1 year after loading; load-free healing period 3 to 4 months for mandibular implants and 6 months for maxillary implants |
Search date: 2009-01. Databases: Cochrane Oral Health Group's Trials Register; Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE; EMBASE
Questions and results
Current version only1-stage (non-submerged) implant placement vs 2-stage (submerged) implant placement
Population: Any subject receiving osseointegrated dental implants
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Prosthesis failure 6 to 12 months after loading | RR 1.87 [0.33, 10.40] Low risk population 10 per 1000; High risk population 100 per 1000 vs Low risk population 19 per 1000 (3 to 104); High… | 3 studies · 153 participants | Moderate Downgraded: risk of bias |
Patient preference including aesthetics (split-mouth studies only) 6 to 12 months after loading | Planned outcome (patient preference including aesthetics, only in split-mouth studies); no included trial reported it. | 0 studies | No studies |
Implant failure 6 to 12 months after loading | RR 1.39 [0.59, 3.27] Low risk population 10 per 1000; High risk population 200 per 1000 vs Low risk population 14 per 1000 (6 to 32); High… | 4 studies · 230 participants | Moderate Downgraded: risk of bias |
Aesthetics evaluated by dentists (soft tissue recession) 6 to 12 months after loading | MD -0.20 [-0.67, 0.27] | 1 study · 29 participants | Ungraded |
Radiographic marginal bone level changes 6 to 12 months after loading | MD -0.10 [-0.40, 0.20] | 1 study · 29 participants | Ungraded |
Complications (biological and biomechanical) 6 to 12 months after loading | RR 0.13 [0.01, 2.25] | 1 study · 30 participants | Ungraded |
1-stage (non-submerged) implant placement vs 2-stage (submerged) implant placement
Population: Any subject receiving osseointegrated dental implants
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Prosthesis failure 6 months to 1 year after loading | RR 1.0 [0.07, 14.90] | 2 studies · 50 participants | Ungraded |
Implant failure 6 months to 1 year after loading | RR 1.0 [0.07, 14.90] | 2 studies · 50 participants | Ungraded |
Aesthetics evaluated by dentists 6 months to 1 year after loading | Planned outcome (aesthetics evaluated by dentists); no included trial reported it. | 0 studies | No studies |
Complications (biological and biomechanical) 6 months to 1 year after loading | Barber 1996 assessed biological complications and reported none; no other included trial reported complications; no pooled estimate. | 1 study | Ungraded |
Radiographic marginal bone level changes 6 months to 1 year after loading | Radiographic marginal bone level changes were measured in Heijdenrijk 2002 but were not included in the analyses because baseline data were collected 4 weeks after prosthesis delivery; no usable pooled estimate. | 1 study | Ungraded |
Patient preference including aesthetics (split-mouth studies only) 6 months to 1 year after loading | Planned outcome (patient preference including aesthetics, only in split-mouth studies); no included trial reported it. | 0 studies | No studies |