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Flapless versus Conventional Flapped Dental Implant Surgery: A Meta-Analysis

The aim of this study was to test the null hypothesis of no difference in the implant failure rates, postoperative infection, and marginal bone loss for patients being rehabilitated by dental implants being inserted by a flapless surgical procedure versus the open flap technique, against the alterna...

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Autores principales: Chrcanovic, Bruno Ramos, Albrektsson, Tomas, Wennerberg, Ann
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4065043/
https://www.ncbi.nlm.nih.gov/pubmed/24950053
http://dx.doi.org/10.1371/journal.pone.0100624
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author Chrcanovic, Bruno Ramos
Albrektsson, Tomas
Wennerberg, Ann
author_facet Chrcanovic, Bruno Ramos
Albrektsson, Tomas
Wennerberg, Ann
author_sort Chrcanovic, Bruno Ramos
collection PubMed
description The aim of this study was to test the null hypothesis of no difference in the implant failure rates, postoperative infection, and marginal bone loss for patients being rehabilitated by dental implants being inserted by a flapless surgical procedure versus the open flap technique, against the alternative hypothesis of a difference. An electronic search without time or language restrictions was undertaken in March 2014. Eligibility criteria included clinical human studies, either randomized or not. The search strategy resulted in 23 publications. The I(2) statistic was used to express the percentage of the total variation across studies due to heterogeneity. The inverse variance method was used for random-effects model or fixed-effects model, when indicated. The estimates of relative effect were expressed in risk ratio (RR) and mean difference (MD) in millimeters. Sixteen studies were judged to be at high risk of bias, whereas two studies were considered of moderate risk of bias, and five studies of low risk of bias. The funnel plots indicated absence of publication bias for the three outcomes analyzed. The test for overall effect showed that the difference between the procedures (flapless vs. open flap surgery) significantly affect the implant failure rates (P = 0.03), with a RR of 1.75 (95% CI 1.07–2.86). However, a sensitivity analysis revealed differences when studies of high and low risk of bias were pooled separately. Thus, the results must be interpreted carefully. No apparent significant effects of flapless technique on the occurrence of postoperative infection (P = 0.96; RR 0.96, 95% CI 0.23–4.03) or on the marginal bone loss (P = 0.16; MD −0.07 mm, 95% CI −0.16–0.03) were observed.
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spelling pubmed-40650432014-06-25 Flapless versus Conventional Flapped Dental Implant Surgery: A Meta-Analysis Chrcanovic, Bruno Ramos Albrektsson, Tomas Wennerberg, Ann PLoS One Research Article The aim of this study was to test the null hypothesis of no difference in the implant failure rates, postoperative infection, and marginal bone loss for patients being rehabilitated by dental implants being inserted by a flapless surgical procedure versus the open flap technique, against the alternative hypothesis of a difference. An electronic search without time or language restrictions was undertaken in March 2014. Eligibility criteria included clinical human studies, either randomized or not. The search strategy resulted in 23 publications. The I(2) statistic was used to express the percentage of the total variation across studies due to heterogeneity. The inverse variance method was used for random-effects model or fixed-effects model, when indicated. The estimates of relative effect were expressed in risk ratio (RR) and mean difference (MD) in millimeters. Sixteen studies were judged to be at high risk of bias, whereas two studies were considered of moderate risk of bias, and five studies of low risk of bias. The funnel plots indicated absence of publication bias for the three outcomes analyzed. The test for overall effect showed that the difference between the procedures (flapless vs. open flap surgery) significantly affect the implant failure rates (P = 0.03), with a RR of 1.75 (95% CI 1.07–2.86). However, a sensitivity analysis revealed differences when studies of high and low risk of bias were pooled separately. Thus, the results must be interpreted carefully. No apparent significant effects of flapless technique on the occurrence of postoperative infection (P = 0.96; RR 0.96, 95% CI 0.23–4.03) or on the marginal bone loss (P = 0.16; MD −0.07 mm, 95% CI −0.16–0.03) were observed. Public Library of Science 2014-06-20 /pmc/articles/PMC4065043/ /pubmed/24950053 http://dx.doi.org/10.1371/journal.pone.0100624 Text en © 2014 Chrcanovic et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Chrcanovic, Bruno Ramos
Albrektsson, Tomas
Wennerberg, Ann
Flapless versus Conventional Flapped Dental Implant Surgery: A Meta-Analysis
title Flapless versus Conventional Flapped Dental Implant Surgery: A Meta-Analysis
title_full Flapless versus Conventional Flapped Dental Implant Surgery: A Meta-Analysis
title_fullStr Flapless versus Conventional Flapped Dental Implant Surgery: A Meta-Analysis
title_full_unstemmed Flapless versus Conventional Flapped Dental Implant Surgery: A Meta-Analysis
title_short Flapless versus Conventional Flapped Dental Implant Surgery: A Meta-Analysis
title_sort flapless versus conventional flapped dental implant surgery: a meta-analysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4065043/
https://www.ncbi.nlm.nih.gov/pubmed/24950053
http://dx.doi.org/10.1371/journal.pone.0100624
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