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.
© 2023. Deutsche Gesellschaft für Implantologie im Zahn‐, Mund‐ und Kieferbereich e.V., Japanese Society of Oral Implantology.