Statement of problem

A consensus on the clinical performance in dental implants placed with different insertion torques is lacking.

Purpose

The purpose of this systematic review and meta-analysis was to evaluate the effect of high insertion torque compared with regular or low torques during dental implant placement in terms of implant survival rate and marginal bone loss.

Material and methods

Two independent reviewers searched electronic databases for studies published until April 2019. The population, intervention, comparison, outcome (PICO) question was “Do patients who receive implants with a high torque (equal or higher than 50 Ncm) show similar implant survival rates and marginal bone loss as compared with those who receive implants with a regular or low torque (less than 50 Ncm)?”. The meta-analysis was based on the Mantel-Haenszel (MH) and the inverse variance (IV) methods (α=.05).

Results

The search yielded 6 articles, which included 389 patients (mean age: 55.28 years) who had received 651 dental implants (437 with high torque and 214 with low or regular torque). Most studies evaluated delayed loading, except 1 study that evaluated immediate implant loading (n=50 for each group). Low or regular insertion torque had a high failure rate (4.2%) compared with high insertion torque (1.1%), chiefly because of immediate loading. However, the meta-analysis indicated no significant difference between high- and regular- or low-torque implant placement in implant survival rate (P=.52, risk ratio [RR]: 0.51, 95% confidence interval [CI]: 0.06-4.06) and marginal bone loss (P=.30, mean difference [MD]: 0.15, 95% CI: -0.14 to 0.44).

Conclusions

A high insertion torque during implant placement does not affect implant survival rate or marginal bone loss. However, further research is recommended to reassess this clinical performance.

中文翻译：

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高插入扭矩对牙种植体的临床效果：系统评价和荟萃分析

问题陈述

对于以不同插入扭矩放置的牙种植体的临床性能缺乏共识。

目的

本系统回顾和荟萃分析的目的是评估高插入扭矩与常规或低扭矩相比在牙种植体植入过程中对种植体存活率和边缘骨丢失的影响。

材料与方法

两位独立审查员在电子数据库中搜索了截至 2019 年 4 月发表的研究。人口、干预、比较、结果 (PICO) 问题是“接受高扭矩（等于或高于 50 Ncm）种植体的患者是否表现出相似的种植体存活率和与接受常规或低扭矩（小于 50 Ncm）种植体的患者相比，边际骨质流失？”。荟萃分析基于 Mantel-Haenszel (MH) 和逆方差 (IV) 方法 (α=.05)。

结果

搜索产生了 6 篇文章，其中包括 389 名患者（平均年龄：55.28 岁），他们接受了 651 颗牙种植体（437 颗高扭矩种植体，214 颗低扭矩或常规扭矩种植体）。大多数研究评估延迟加载，除了一项评估即刻种植体加载的研究（每组 n=50）。与高插入扭矩 (1.1%) 相比，低或常规插入扭矩的故障率较高 (4.2%)，这主要是因为立即加载。然而，荟萃分析表明，高扭矩和常规扭矩或低扭矩种植体植入在种植体存活率方面没有显着差异（P =.52，风险比 [RR]：0.51，95% 置信区间 [CI]：0.06- 4.06) 和边缘骨丢失（P =.30，平均差 [MD]：0.15，95% CI：-0.14 至 0.44）。

结论

种植体植入期间的高插入扭矩不会影响种植体存活率或边缘骨丢失。然而，建议进一步研究以重新评估这种临床表现。