Objective To use a meta-analytic technique to estimate the survival of implants between immediate loading/early loading and delayed loading. Methods We carried out a systematic search of electronic databases for all prospective trials comparing conventional delayed implant loading with early or immediate implant loading, reported between 1997 and 2007. The outcome of interest was implant failure rate. Quality assessment was performed for prospective trials that met the eligibility criteria and the data were then extracted and analyzed. Results Sixteen articles were found to meet the eligibility criteria, but two studies were reported in four articles, so that 14 articles were analyzed. There were five randomized controlled trials (RCTs). Compared to delayed loading, implant failure occurred sl ightly, but not statistically significant,less often with early implant loading (OR=0.54, 95%CI 0.22 to 1.33, P =0.18). We combined all cohort studies and this analysis was consistent with this result. Immediate implant loading was associated with slightly, but not statistically significant, worse outcomes (OR=1.51, 95%CI 0.53 to 4.25, P =0.44). We only pooled the RCTs and results showed better implant success rate with immediate implant loading, but with no significant difference. When sensitivity analyses were performed by the sequential dropping of a single study, no significant differences were observed except when the study of Jo et al was excluded. Conclusion Early implant loading was associated with better outcomes compared to delayed loading when the implants were placed into good quality bone. There was no significant difference of the implant success rate between immediate loading and delayed loading. Further evaluations in adequately powered large RCTs are needed to confirm these findings.
ObjectivesTo systematically review the efficacy of resorbable membrane and non-resorbable membrane in dental implant to guide bone regeneration.MethodsPubMed, EMbase, The Cochrane Library, Web of Science, VIP, CNKI and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) of the efficacy of resorbable membrane and non-resorbable membrane in dental implant to guide bone regeneration from inception to February 20th, 2019. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 22 RCTs involving 1 995 patients were included. The results of meta-analysis showed that: the resorbable membrane group was superior to non-resorbable membrane group in terms of repair success (RR=1.21, 95%CI 1.17 to 1.26, P<0.000 01), the bone thickness (MD=0.40, 95%CI 0.36 to 0.43, P<0.000 01), bone graft thickness(MD=0.40, 95%CI 0.35 to 0.46, P<0.000 01), patient satisfaction (RR=1.19, 95%CI 1.04 to 1.36, P=0.009), histological evaluation in bone contact (MD=4.82, 95%CI 0.14 to 9.50, P=0.04) and the total mineralized tissue (MD=3.73, 95%CI 0.32 to 7.14, P=0.03). They also had lower adverse reaction rate(RR=0.28, 95%CI 0.20 to 0.39, P<0.000 01) and changes of bone defect width from preoperative to 6 months postoperatively (MD=−0.62, 95%CI −0.93 to −0.31, P<0.000 01) with statistically significant differences. However, there was no significant difference in histological evaluation of non-mineralized tissue(MD=−2.48, 95%CI −5.81 to 0.85, P=0.14) between two groups.ConclusionsCurrent evidence shows that the resorbable membrane has better repairing effects, for which helps to promote the development of bone and bone graft, reduce the incidence of adverse reactions, which has good safety and effectiveness. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify above conclusion.