Major clinical approaches to osseointegrated implants: a concise systematic review

Introduction: Reconstructive surgery is an important component of the specialty of oral and maxillofacial surgery. The maxillofacial skeleton is subject to various types of defects secondary to trauma, craniofacial/congenital deformities, and tumor ablation. The complex anatomy and function of the maxillomandibular complex impact the choice of reconstruction for maxillofacial defects. Objective: It was to carry out a concise systematic review to present the main considerations of osseointegrated implants. Methods: The systematic review rules of the PRISMA Platform were followed. The research was carried out from September to November 2022 in Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 127 articles were found, and 57 articles were evaluated and 30 were included in this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 10 studies with a high risk of bias and 28 studies that did not meet GRADE. Most studies showed homogeneity in their results, with I2 =95.8% >50%. It was concluded that orofacial defects affect both the form and function of the most prominent and complex part of the body, the face. Several options, such as vascularized flaps, non-vascularized autogenous grafts, or allogeneic materials, are available to reconstruct maxillofacial defects. The complex anatomy and function of the maxillomandibular complex impact the choice of reconstruction for maxillofacial defects. The real effect of bisphosphonates on osseointegration and survival of dental implants is still not well established