title: Systematic assessment of clinical outcomes in bone-level and tissue-level endosseous dental implants.
abstract: OBJECTIVE
  The aim of the present systematic review was to address the following question: in patients treated with dental implants placed in pristine bone, what are the clinical and radiographic outcomes of bone-level (BL) implants in comparison to tissue-level (TL) implants after restoration with dental prostheses?
  
  
  METHODS
  Scanning of online literature databases from 1966 to January 2012, supplemented by hand searching, was conducted to identify relevant prospective randomized controlled trials, controlled clinical trials, and cohort studies. Sequential screenings at the title, abstract, and full-text levels were performed independently and in duplicate. A meta-analysis was conducted to compile data from the primary studies included in this systematic review.
  
  
  RESULTS
  The search strategy revealed a total of 5,998. Screening at the title level resulted in 752 papers, while screening at the abstract level yielded 92 publications. Full-text reading identified nine articles that fulfilled the inclusion criteria of this review. The pooled estimated difference between BL and TL implants in mean marginal bone loss was 0.05 mm (95% confidence interval [CI], -0.03 to 0.13 mm), with no statistically significant difference between the groups at 1 year after placement of the definitive prostheses. The relative risk of implant loss was estimated at 1.00 (95% CI, 0.99 to 1.02) at 1 year and at 1.01 (95% CI, 0.99 to 1.03) at 3 years after restoration, indicating no evidence of an increased risk of implant loss in BL compared to TL implants.
  
  
  CONCLUSIONS
  No statistically significant differences in bone loss and survival rates were detected between BL and TL dental implants over a short-term observation period (1 to 3 years). Thus, both implant systems fulfill the requirements for the replacement of missing teeth in implant dentistry.
authors.affiliation: Department of Preventive Dentistry, Periodontology and Implant Biology, School of Dentistry, Aristotle University, Thessaloniki, Greece. jvou@med.auth.gr
authors.forename: Ioannis D
authors.initials: ID
authors.lastname: Vouros
authors.forename: Christos D R
authors.initials: CD
authors.lastname: Kalpidis
authors.forename: Attila
authors.initials: A
authors.lastname: Horvath
authors.forename: Aviva
authors.initials: A
authors.lastname: Petrie
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Donos
mesh_terms: D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging / Q000209:etiology*; D003757:Dental Implantation / Q000379:methods*; D003758:Dental Implantation, Endosseous / Q000379:methods; D015921:Dental Implants / Q000009:adverse effects*; D019232:Dental Restoration Failure; D006801:Humans; D011446:Prospective Studies; D011859:Radiography
chemical_list: D015921:Dental Implants