Surgical and Patient Factors Affecting Marginal Bone Levels Around Dental Implants: A Comprehensive Overview of Systematic Reviews.

OBJECTIVES: The objective of this systematic review was to perform a comprehensive overview of systematic reviews and meta-analyses of surgical and patient factors affecting marginal bone loss around osseointegrated dental implants in humans.

MATERIAL AND METHODS: Electronic databases were searched for systematic reviews and meta-analyses published up to November 2015.

RESULTS: Of the 41 articles selected, 11 evaluated implant factors, 10 evaluated patient factors, 19 evaluated surgical protocol-related factors, and one evaluated all three factors. The chosen studies were AMSTAR rated for quality. The following parameters have statistically significant effect on marginal bone loss: (1) marginal bone loss was significantly more in patients with periodontitis than in periodontally healthy patients; (2) significantly greater in generalized aggressive periodontitis patients compared with chronic periodontitis patients; (3) significantly less in alveolar socket preservation techniques; (4) significantly more in alveolar ridge augmentation sites; (5) significantly more in men than in women; (6) significantly more in smokers than in nonsmokers; and (7) smokers also have significantly more marginal bone loss in the maxilla than in the mandible.

CONCLUSION: Knowledge of the surgical and patient factors that affect marginal bone loss can aid the clinician in making informed choices in selecting implant treatment options that will enhance the longevity and long-term success of their implant-supported cases.