The influence of two distinct surface modification techniques on the clinical efficacy of titanium implants: A systematic review and meta-analysis

To compare the effectiveness of anodized and sandblasted large-grit acid-etched surface modification implants in clinical applications. This systematic review has been registered at PROSPERO (CRD42023423656). A systematic search was performed using seven databases. The meta-analysis was performed using the RevMan 5.4 program and Stata 17.0 software. An analysis of the risk of bias in the included studies was conducted using the Cochrane Handbook for Systematic Reviews of Interventions and the Newcastle-Ottawa scale. A comprehensive analysis of 16 studies, which collectively encompassed a total of 2768 implants. Following a five years follow-up, the meta-analysis showed that the cumulative survival rate of implants was lower in the anodized group when compared to the sandblasted large-grit acid-etched group (RR, 3.47; 95% confidence interval [CI], 1.23 to 9.81; P=0.02). Furthermore, the anodized group and the sandblasted large-grit acid-etched group had similar marginal bone loss over the one to three years follow-up period. However, it was observed that the marginal bone loss increased at the five years follow-up period in the anodized group in comparison to the sandblasted large-grit acid-etched group (SMD, 2.98; 95% CI, 0.91 to 5.06; P=0.005). As far as biological complications, plaque index, bleeding on probing, and probing pocket depth were concerned, we found no statistically significant differences between anodized and sandblasted large-grit acid-etched groups. The sandblasted large-grit acid-etched group exhibited higher implants cumulative survival rate and less marginal bone loss compared to the anodized group. Moreover, both groups demonstrated similar incidences of biological complications, plaque index, bleeding on probing, and probing pocket depth, suggesting their overall equivalence in these aspects.