AutoresNatalia Palacios-Garzón, Eugenio Velasco‐Ortega, José López‐López
Por qué importa
Esta revisión sistemática y meta-análisis evalúa la pérdida ósea marginal en implantes dentales colocados a nivel subcrestal frente a nivel crestal. Se analizaron 16 estudios publicados entre 2010 y 2018, comparando la cantidad de hueso perdido alrededor de los implantes en ambas posiciones. Los resultados indican que, en términos de pérdida ósea, ambas posiciones son comparables y válidas, con una pérdida media no estadísticamente diferente en ensayos controlados aleatorizados. Sin embargo, se sugiere que la colocación subcrestal podría ser beneficiosa en casos de tejido blando fino para minimizar el riesgo de exposición del implante y prevenir patologías periimplantarias futuras, lo cual es relevante para la planificación y el pronóstico de los tratamientos implantológicos.
BACKGROUND: To assess differences in marginal bone loss in implants placed at subcrestal versus crestal level. METHODS: An electronic and a manual research of articles written in English from Jaunary 2010 to January 2018 was performed by two independent reviewers. Clinical trials comparing bone loss for implants placed at crestal and subcrestal level were included. Pooled estimates from comparable studies were analyzed using a continuous random-effects model meta-analysis with the objective of assessing differences in crestal bone loss between the two vertical positions. RESULTS: 16 studies were included; 10 studies did not encounter statistically significant differences between the two groups with respect to bone loss. Three articles found greater bone loss in subcrestal implants; while 3 found more bone loss in crestal implants. A meta-analysis for randomized control trial (RCT) studies reported an average and non-statistically different crestal bone loss of 0.028 mm. CONCLUSIONS: A high survival rate and a comparable bone loss was obtained both for crestal and subcrestal implants' placement. Quantitative analysis considering a homogenous sample confirms that both vertical positions are equally valid in terms of perimplant bone loss. However, with respect to soft tissue; in presence of a thin tissue; a subcrestal placement of the implant should be preferred as it may reduce the probability for the implant to become exposed in the future and thus avoid the risk of suffering from peri-implant pathologies.
Palacios-Garzón N, Velasco‐Ortega E, López‐López J. Bone Loss in Implants Placed at Subcrestal and Crestal Level: A Systematic Review and Meta-Analysis. Materials. 2019. doi:10.3390/ma12010154
