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Meta-Analysis
. 2023 Sep 21;9(1):34.
doi: 10.1186/s40729-023-00494-y.

Microleakage along the implant-abutment interface: a systematic review and meta-analysis of in vitro studies

Zhen Mao  1 , Florian Beuer  1 , Daomin Wu  2 , Qiuyan Zhu  2 , Jamila Yassine  1 , Andreas Schwitalla  1 , Franziska Schmidt  3
Affiliations
Meta-Analysis

Microleakage along the implant-abutment interface: a systematic review and meta-analysis of in vitro studies

Zhen Mao et al. Int J Implant Dent. .

Abstract

Purpose: This systematic review aimed to evaluate the incidence of microleakage events (IME) and to identify the potential factors influencing the sealing ability of the implant-abutment interface (IAI) under in vitro investigation.

Material and methods: An electronic search of MEDLINE (PubMed), EMBASE, and Web of Science databases, combined with a manual literature search was conducted up to September 2022. In vitro studies that reported the degree of microleakage at IAI under dynamic loading conditions were included. A meta-analysis was performed to calculate the mean values of the incidence of microleakage events. Subgroup analysis and meta-regression were conducted to further investigate the effect of different variables.

Results: 675 studies were identified following the search process and 17 in vitro studies were selected according to the eligibility criteria. The weighted mean incidence of microleakage events was 47% (95% confidence interval: [0.33, 0.60]), indicating that contamination was observed in nearly half of the samples. Concerning possible factors that may influence microleakage (e.g., loading condition, assessment method, implant-abutment connection design, types of abutment material, the use of sealing agents), loading condition (p = 0.016) was the only variable that significantly influenced IME in the meta-regression analysis.

Conclusions: The results demonstrated that dynamic loading significantly increases the potential of bacterial penetration at the implant-abutment junction. The results should be interpreted carefully due to the data heterogeneity and further well-conducted in vitro studies with homogeneous samples are needed to standardize the methodologies.

Keywords: Bacterial leakage; Implant–abutment interface; Meta-analysis; Sealing capability; Systematic review.

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Conflict of interest statement

The authors declare that they have no competing interest.

Figures

Fig. 1
Fig. 1
Search strategy
Fig. 2
Fig. 2
A IME in meta-analysis; B IME in the subgroup analysis (loaded/unloaded)
Fig. 3
Fig. 3
IME in the subgroup analysis (A inward/outward; B internal/external connection)
Fig. 4
Fig. 4
IME in the subgroup analysis (A with/without sealing agents placed; B titanium/PEEK abutments)
See this image and copyright information in PMC

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