Editorial Type:
Article Category: Review Article
 | 
Online Publication Date: 14 Sept 2023

Changes in Peri-implant Marginal Bone Level by Jaw Location: A Systematic Review and Meta-Analysis of 4970 Implants

DMD, MS,
DDS, MS,
DMD,
MA, and
DDS, MS
Page Range: 444 – 455
DOI: 10.1563/aaid-joi-D-22-00252
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The purpose of this study was to evaluate the current evidence on marginal bone-level changes (ΔMBL) around internal connection implants with fixed prostheses by jaw location over time. An electronic literature search for ΔMBL (change in marginal bone level) was conducted in 6 databases. The data from the included manuscripts were categorized by jaw sextant of the implants and duration of follow-up (<2 years, 2–5 years, and >5 years). Meta-analyses were performed on groups with at least 5 studies. A total of 1270 records were screened. Full-text review of 413 papers resulted in a total of 46 studies (representing 2259 patients with 4970 implants) included for quantitative synthesis and analysis. The ΔMBL was summarized at 2 time intervals with the following results: <2 years (anterior maxilla = 0.393 mm [95% confidence interval {CI}, 0.172, 0.613], posterior maxilla = 0.468 mm [95% CI, 0.288, 0.648], and posterior mandible 0.559 mm [95% CI, 0.397, 0.72]), 2 to 5 years (anterior maxilla = 0.683 mm [95% CI, 0.224, 1.142], posterior maxilla = 0.645 mm [95% CI, 0.42, 0.87], and posterior mandible 0.563 mm [95% CI, 0.278, 0.849]). There were insufficient studies in the anterior mandible and with follow-up data over 5 years for quantitative synthesis. Within the limitations of this study, location within the maxillary and mandibular jaws does not seem to influence ΔMBL around internal connection bone level implants with fixed restorations. Although there may be a tendency for greater initial remodeling in the posterior mandible followed by long-term stability, additional studies are needed to evaluate this further.

Figure 1.
Figure 1.

PRISMA 2020 diagram of study review and selection.


Figure 2.
Figure 2.

Forest plots for change in marginal bone level (ΔMBL) in millimeters for studies with 1- to 2-year follow-up, grouped by jaw sextant. Insufficient data were available to synthesize results for anterior mandible.


Figure 3.
Figure 3.

Forest plots for change in marginal bone level (ΔMBL) in millimeters for studies with 2- to 5-year follow-up, grouped by jaw sextant. Insufficient data were available to synthesize results for anterior mandible.


Figure 4.
Figure 4.

Summary comparison of mean change in marginal bone level (ΔMBL; 95% confidence interval [CI]) for each jaw sextant.


Contributor Notes

Corresponding author, e-mail: tschoenbaum@augusta.edu
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