Dental implant placement has become a common treatment option in dentistry in recent decades and high success rates are reported. To further enhance their performance a range of surface modifications have been used. Calcium phosphate-coated implants are one modification although concerns have been raised over their long-term survival.
The aim of this review was to evaluate long-term success data of calcium phosphate plasma-spray-coated dental implants in clinical trials
Searches were conducted in Medline, The Cochrane Central Register of Controlled Trials and the ISI Web of Knowledge databases for papers published in English after 2000.
Two reviewers independently screened studies and abstracted data. Randomized controlled clinical trials (RCT), prospective clinical trials (PCT) as well as retrospective analysis of cases (RA) involving a minimum of 10 patients with a minimum 5-year follow-up were considered
- 8 studies (1 RCT, 4 PCTs, 3 RAs) were included
- 5 studies used life tables were used to report cumulative implant success 3 used overall percentages.
- Follow up period range from 5-12 years.
- The percentage of implants in function after the first year was estimated to be 98.4 % in the maxilla and 99.2 % in the mandible.
- The estimates of the weighted mean annual complication rates percentage increased over the years up to 2.6 (SE 0.7) during the fifth year of function for the maxilla and to 9.4 (SE 8.4) for the mandible in the tenth year of function.
- After 10 years, the mean percentage of successful implants was estimated to be 71.1 % in the maxilla and 72.2 % in the mandible.
The authors concluded
Published long-term survival and success data for calcium phosphate plasma- spray-coated dental implants are limited, comparison of the data is difficult due to differences in success criteria among the studies, and long-term cumulative success rates demonstrate very weak evidence for progressive complications around calcium phosphate plasma-spray- coated dental implants.
The authors have previously published a review on this topic in 2012 (Dental Elf 18th Dec 2012) and the current review has used a similar methodology. While 3 large databases have been searched the restrictions to publications post 2000 and presented in English may mean that relevant publications have been missed. This review included 8 studies compared with the 5 in the 2012 review. However, no formal assessment of study quality has been presented so assessing the overall quality of the evidence is problematic. 6 of the 8 studies selected for the review are used in the quantitative summary, four of these are PCTs and 2 RAs.
The 2014 update of the Cochrane review by Esposito et al compared different type of implants included 27 RCTs and concluded
Based on the results of the included RCTs, we found no evidence showing that any particular type of dental implant had superior long-term success. There was limited evidence showing that implants with relatively smooth (turned) surfaces were less prone to lose bone due to chronic infection (peri-implantitis) than implants with much rougher surfaces (titanium-plasma-sprayed). These findings were based on several RCTs, often at high risk of bias, with few participants and relatively short follow-up periods.
van Oirschot BA, Bronkhorst EM, van den Beucken JJ, Meijer GJ, Jansen JA, Junker R. A systematic review on the long-term success of calcium phosphate plasma-spray-coated dental implants. Odontology. 2016 Feb 17. [Epub ahead of print] PubMed PMID: 26886570.
Esposito M, Ardebili Y, Worthington HV. Interventions for replacing missing teeth: different types of dental implants. Cochrane Database of Systematic Reviews 2014, Issue 7. Art. No.: CD003815. DOI: 10.1002/14651858.CD003815.pub4.
Dental Elf 25th Jul 2014
Dental Elf 18th Dec 2012