Format of Original
Nature Publishing Group (Macmillan Publishers Limited)
Original Item ID
Medline, Embase, the Cochrane Oral Health Group's Trials Register and OpenGREY databases were searched together with the reference lists of identified articles.
Randomised controlled trials (RCTs) and prospective cohort studies of at least six month duration were included. Studies/case series in which there was only one implant surface (SLA or SLActive) and one loading protocol (immediate or early) were also considered.
Data extraction and synthesis
Two reviewers screened, selected and abstracted data, independently. RCTs were assessed for quality using the Cochrane risk of bias approach and observational studies using the Newcastle-Ottawa scale (NOS). The primary outcomes were changes from baseline to follow-up of clinical attachment level (CAL), probing depth (PD) and radiographic changes in the peri-implant bone level and number of implants lost. Cumulative survival rates (%) of each included study were calculated.
Twenty-three articles reporting 19 studies (seven RCTs; 12 prospective observational studies) were included. The seven RCTs included 407 patients with 853 implants (8% titanium plasma-sprayed, 41.5% SLA and 50.5% SLActive). Only one RCT was considered to be at low risk of bias, the others were considered to be at unclear risk. The 12 observational studies included 1394 SLA and 145 SLActive implants and were considered to be of medium methodological quality based on the NOS. A narrative summary of the studies was undertaken owing to marked heterogeneity of the loading periods, types of implants described and lack of occurrence of the outcome of interest. There were no significant differences reported in the studies in relation to implant loss or clinical parameters between the immediate/early loading and delayed loading protocols. Overall, 95% of SLA and 97% of SLActive implants still survive at the end of follow-up.
Despite the positive findings achieved by the included studies, few RCTs were available for analysis for SLActive implants. Study heterogeneity, scarcity of data and the lack of pooled estimates represent a limitation between studies' comparisons and should be considered when interpreting the present findings.