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Clinical Oral Implants Research Jan 2016This systematic review was performed to compare the survival of 1- vs. 2-implant overdentures (IODs) in the edentulous mandible. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
This systematic review was performed to compare the survival of 1- vs. 2-implant overdentures (IODs) in the edentulous mandible.
MATERIALS AND METHODS
Manual and electronic database (PubMed, EMBASE and CENTRAL) searches were performed to identify scientific articles, published in English, reporting on mandibular IODs utilizing unsplinted attachments. Studies were included if they were prospective human studies reporting on two-piece microrough surface implants with a diameter ≥3 mm. Data were extracted by two independent investigators, and an overall inter-investigator kappa score was calculated. A meta-analysis was performed on the included comparative studies.
RESULTS
The search shortlisted 30 prospective studies for data extraction and statistical analysis. The included studies comprised of only two randomized controlled trials (RCTs) comparing 1- vs. 2-IODs, and a further 28 prospective studies. The kappa score calculated was between 0.86 and 1 for the various parameters. One RCT favored 1-IODs (RD: 0.08, 95% CI: 0.01, 0.14) while the other favored 2-IODs (RD:-0.04, 95% CI: -0.27, 0.19). However, the overall random effects model did not reveal a significant risk difference (RD) for implant failure between the two interventions (I(2) = 36.6%, P = 0.209; RD: 0.05, 95% CI: -0.07, 0.18).
CONCLUSIONS
The results of this meta-analysis conclude that the postloading implant survival of 1-IODs is not significantly different from 2-IODs. However, the existing scientific evidence in the literature in terms of prospective comparative studies is scarce. Hence, before recommending the 1-IOD as a treatment modality, long-term observations are needed and a larger range of functional, prosthodontic, and patient-centered outcome measures should be considered.
Topics: Dental Implants; Dental Prosthesis Design; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Denture Retention; Denture, Complete, Lower; Denture, Overlay; Humans; Jaw, Edentulous; Mandible; Surface Properties
PubMed: 25350235
DOI: 10.1111/clr.12513 -
Journal of Dentistry Feb 2017The purpose of this systematic review was to evaluate the use of mini implants to retain complete overdentures in terms of survival rates of mini implants, marginal bone... (Review)
Review
OBJECTIVE
The purpose of this systematic review was to evaluate the use of mini implants to retain complete overdentures in terms of survival rates of mini implants, marginal bone loss, satisfaction, and quality of life.
DATA
This report followed the PRISMA Statement and PICO question. This review has been registered at PROSPERO under the number CRD42016036141.
SOURCE
Two independent reviewers performed a comprehensive search of studies published until September 2016 and listed in the PubMed/MEDLINE, Embase, and The Cochrane Library databases. The focused question was: is the use of mini implants feasible for prosthodontic rehabilitation with complete overdentures?
RESULTS
The 24 studies selected for review evaluated 1273 patients whose mean age was 65.93 years; these patients had received 2494 mini implants and 386 standard implants for retaining overdenture prosthesis. The mean follow-up time was 2.48 years (range: 1-7 years). There was a higher survival rate of mini implants (92.32%). More frequent failures for maxillary (31.71%) compared with mandibular arches (4.89%). The majority of studies revealed marginal bone loss values similar to those of standard implants (<1.5mm). All studies verified an increase in satisfaction and quality of life after rehabilitation treatment with mini dental implants.
CONCLUSION
The present systematic review indicates that the use of mini implants for retaining overdenture prosthesis is considered an alternative treatment when standard treatment is not possible, since it presents high survival rates, acceptable marginal bone loss, and improvements in variables related to satisfaction and quality of life.
CLINICAL SIGNIFICANCE
Based on the results of this study, the use of a minimum 4 and 6 mini implants can be considered a satisfactory treatment option for rehabilitation of the mandibular and maxillary arches respectively with a complete overdenture.
Topics: Aged; Alveolar Bone Loss; Dental Implants; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Denture Design; Denture Retention; Denture, Complete; Denture, Overlay; Humans; Mandible; Maxilla; Mouth, Edentulous; Patient Satisfaction; Quality of Life; Rehabilitation
PubMed: 27888049
DOI: 10.1016/j.jdent.2016.11.009 -
The Journal of Prosthetic Dentistry Apr 2022A consensus based on patients' perceptions as to whether to use overdentures or fixed prostheses to rehabilitate mandibular edentulous arches is limited. (Meta-Analysis)
Meta-Analysis Review
Patient-reported outcome measures and clinical assessment of implant-supported overdentures and fixed prostheses in mandibular edentulous patients: A systematic review and meta-analysis.
STATEMENT OF PROBLEM
A consensus based on patients' perceptions as to whether to use overdentures or fixed prostheses to rehabilitate mandibular edentulous arches is limited.
PURPOSE
The purpose of this systematic review and meta-analysis was to compare the patient-reported outcome measures (PROMs) and clinical outcomes associated with implant-supported overdentures and fixed prostheses in edentulous mandibles.
MATERIAL AND METHODS
Nine electronic databases were searched for randomized clinical trials (RCTs) and nonrandomized clinical trials (N-RCTs). The risk of bias was assessed by the revised Cochrane risk of bias tool for RCTs (RoB 2) and N-RCT (ROBINS-I). Data sets for oral health-related quality of life (OHRQoL), satisfaction, survival rate, implant probing depth, and marginal bone loss were plotted, and the appropriate analyses were applied by using the Rev Man 5.3 software program. Certainty of evidence was also evaluated by means of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.
RESULTS
Ten eligible trials were included and evaluated quantitatively. For 3 domains of OHRQoL, fixed prostheses showed significantly higher quality of life when compared with overdentures regarding functional limitation (P<.001), physical disability (P=.001), and physical pain (P=.003). Fixed prostheses also improved satisfaction, when compared with overdentures for comfort (P=.02), ease of mastication (P<.001), retention (P<.001), and stability (P<.001). The same pattern was observed for overall OHRQoL (P=.01) and satisfaction (P=.01) in which fixed prostheses improved patient satisfaction. Only ease of cleaning presented greater satisfaction for the overdenture group. Clinical parameters did not differ statistically (P>.05) between both types of prosthesis.
CONCLUSIONS
Fixed rehabilitations for mandibular edentulous patients seem to be a well-accepted treatment from the patients' oral health perspective. However, mandibular overdentures are no less efficient than fixed prostheses in terms of clinical outcomes.
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Overlay; Humans; Jaw, Edentulous; Mandible; Mouth, Edentulous; Patient Reported Outcome Measures; Patient Satisfaction; Quality of Life
PubMed: 33390270
DOI: 10.1016/j.prosdent.2020.11.005 -
Oral Surgery, Oral Medicine, Oral... Feb 2016The aim of this review was to examine all publicly available literature on the current treatments of the dentoskeletal deformity due to condylar resorption and their... (Review)
Review
OBJECTIVES
The aim of this review was to examine all publicly available literature on the current treatments of the dentoskeletal deformity due to condylar resorption and their outcomes and to suggest management guidelines.
STUDY DESIGN
A systematic review was performed of all literature located on the electronic PubMed database from 1970 to 2012.
RESULTS
The search resulted in 21 papers and 210 cases treated from 1991 to 2012. Orthognathic surgery was the most commonly used option (42%) and was sometimes combined with open joint surgery (19%). Stability was observed, respectively, in 57% and 100% of the orthognathic surgery and open joint surgery cases. Condylectomy and reconstruction with chondrocostal graft or temporomandibular joint total joint prosthesis were used in 19% and 10% of all cases of orthognathic surgery and open joint surgery with good results (95% and 100%, respectively). Osteogenic distraction was anecdotic (1%). Nine percent of all cases received conservative treatment.
CONCLUSIONS
Larger comparative studies are necessary to obtain evidence-based recommendations.
Topics: Bone Resorption; Humans; Joint Prosthesis; Mandibular Condyle; Mandibular Diseases; Orthognathic Surgical Procedures; Risk Factors; Temporomandibular Joint Disorders
PubMed: 26460272
DOI: 10.1016/j.oooo.2015.08.013 -
The Journal of Prosthetic Dentistry Jun 2022A systematic review of the effect of different overdenture attachments with different loading protocols on peri-implant health is lacking. (Meta-Analysis)
Meta-Analysis Review
Effect of 2-implant mandibular overdenture with different attachments and loading protocols on peri-implant health and prosthetic complications: A systematic review and network meta-analysis.
STATEMENT OF PROBLEM
A systematic review of the effect of different overdenture attachments with different loading protocols on peri-implant health is lacking.
PURPOSE
The purpose of this systematic review and network meta-analysis was to evaluate the effect of different overdenture attachments with delayed or immediately loaded 2-implant-retained mandibular overdentures on peri-implant tissue health.
MATERIAL AND METHODS
A comprehensive search of the PubMed, EMBASE, and Cochrane library was conducted to identify eligible randomized controlled trials (RCTs). The outcomes were marginal bone loss, probing depth, plaque index, bleeding on probing, implant survival rate, and prosthetic complications. The Bayesian network meta-analysis accompanied by a random effect model and 95% credible intervals was calculated.
RESULTS
Sixteen RCT (n=599 participants receiving 1198 dental implants) were included. Five common overdenture attachment systems with delayed or immediate loading were compared. The difference in marginal bone loss and probing depth was not statistically significant when comparing different overdenture attachments with different loading protocols. The rank probability test showed that bar+ immediate loading ranked highest (63.8%) in terms of marginal bone loss, whereas ball+ delayed loading (73.3%) ranked highest in terms of probing depth. The implant survival rate was 100% for the LOCATOR+ delayed loading, resilient telescopic+ delayed loading, and magnet+ immediate loading; however, bar+ delayed loading, ball+ delayed loading, magnet+ delayed loading, LOCATOR+ immediate loading, ball+ immediate loading, and bar+ immediate loading had survival rates of 99.1%, 98.8%, 96.0%, 94.7%, 93.1%, and 91.2%, respectively.
CONCLUSIONS
All types of overdenture attachment with immediate loading or delayed loading had a similar effect on peri-implant health. Bar+ immediate loading was associated with the least marginal bone loss, whereas ball+ delayed loading showed the least probing depth.
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Overlay; Humans; Immediate Dental Implant Loading; Jaw, Edentulous; Mandible; Network Meta-Analysis; Treatment Outcome
PubMed: 33546861
DOI: 10.1016/j.prosdent.2020.12.016 -
The International Journal of... 2017This systematic review evaluated treatment outcomes for mandibular mini-implant-retained overdentures (MMIOs) in terms of (1) implant survival rate, (2) peri-implant... (Review)
Review
PURPOSE
This systematic review evaluated treatment outcomes for mandibular mini-implant-retained overdentures (MMIOs) in terms of (1) implant survival rate, (2) peri-implant marginal bone loss, (3) prosthodontic maintenance and complication occurrence, and (4) patient satisfaction.
MATERIALS AND METHODS
Pertinent literature published in English before October 12, 2015 was identified using a MEDLINE and EMBASE search strategy and hand searching of relevant journals. Inclusion and exclusion criteria were applied to the titles and abstracts and subsequently to the full text of included studies. A total of 16 articles were included, from which qualitative and quantitative data were extracted for analysis.
RESULTS
Of the 16 evaluated articles, 5 were randomized controlled trials, 8 were prospective studies, and 3 were retrospective studies. The follow-up time range from implant placement was 1 to 6 years, and only four studies included more than 3 years of follow-up. The mini-implant survival rate ranged from 86.9% to 100%. Mean marginal bone resorption was 0.28 to 1.2 mm after 1 year of loading. Of the 16 studies, 5 reported prosthodontic maintenance and complications, and all included studies showed significant improvement in patient satisfaction.
CONCLUSION
Despite the limitations of this systematic review, particularly the short follow-up periods, the results suggest that MMIOs showed predictable results regarding implant survival rates, marginal bone resorption, and patient satisfaction.
Topics: Alveolar Bone Loss; Dental Implants; Dental Prosthesis Design; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Denture Design; Denture Retention; Denture, Overlay; Humans; Mandible; Patient Satisfaction; Treatment Outcome
PubMed: 28319212
DOI: 10.11607/ijp.4929 -
European Journal of Oral Implantology 2017To compare prosthesis and implant failure, patient satisfaction, prosthetic complications and peri-implant marginal bone loss of mandibular overdentures (IOD) supported... (Comparative Study)
Comparative Study Review
PURPOSE
To compare prosthesis and implant failure, patient satisfaction, prosthetic complications and peri-implant marginal bone loss of mandibular overdentures (IOD) supported by a single or two implants.
MATERIALS AND METHODS
Manual and electronic database (PubMed and Cochrane) searches were performed to identify randomised controlled trials, without language restriction, comparing single vs two implant supported mandibular overdentures. Two investigators extracted data independently. The Cochrane tool was used for assessing the quality of included studies. Meta-analyses were performed for the included RCTs.
RESULTS
Six publications corresponding to four RCTs were identified. Three RCTs (corresponding to five publications) were included and one trial was excluded. Follow-ups in function were 1, 3 and 5 years after loading. All included studies were considered to be at a high risk of bias. The pooled result revealed more prosthesis failures at overdentures supported by two implants at 1 year (three trials) (P = 0.02; Risk Difference: -0.12, 95% CI: -0.22, -0.02), however, there were non-significant differences at 3 years (two trials) (P = 0.22; Risk Difference: -0.32, 95% CI: -0.83, 0.19) and at 5 years (one trial) (P = 0.95; Risk Difference: 0.01, 95% CI: -0.22, 0.24). Regarding implant failures, there were more implant losses in overdentures supported by two implants at 1 year (three trials) (P = 0.02; Risk Difference: -0.12, 95% CI: -0.22, -0.02) and at 5 years (one trial) (P = 0.95; Risk Difference: -0.15, 95% CI: -0.28, -0.02), however, there were non-significant difference at 3 years (two trials) (P = 0.2; Risk Difference: -0.33, 95% CI: -0.84, 0.18). After 5 years in function, meta-analyses revealed that there were non-significant differences regarding overall prosthetic complications when mandibular overdentures supported by a single implant were compared with overdentures supported by two implants (P = 0.43; RD: 0.04, 95% CI: -0.06, 0.15).
CONCLUSION
Mandibular overdentures retained by a single implant have comparable results to those retained by two implants. However, this should be interpreted with caution as all the included studies were considered at a high risk of bias.
Topics: Dental Prosthesis Design; Dental Prosthesis, Implant-Supported; Denture, Overlay; Humans; Jaw, Edentulous; Mandible; Randomized Controlled Trials as Topic
PubMed: 28944354
DOI: No ID Found -
International Journal of Oral and... Mar 2018The treatment of mandibular fractures by open reduction and internal fixation is very variable. Thus, there are many controversies about the best fixation system in... (Review)
Review
The treatment of mandibular fractures by open reduction and internal fixation is very variable. Thus, there are many controversies about the best fixation system in terms of stability, functional recovery, and postoperative complications. This systematic review sought scientific evidence regarding the best indication for the use of three-dimensional (3D) plates in the treatment of mandibular fractures. A systematic search of the PubMed/MEDLINE, Elsevier/Scopus, and Cochrane Library databases was conducted to include articles published up until November 2016. Following the application of the inclusion criteria, 25 scientific articles were selected for detailed analysis. These studies included a total of 1036 patients (mean age 29 years), with a higher prevalence of males. The anatomical location most involved was the mandibular angle. The success rate of 3D plates was high at this location compared to other methods of fixation. In conclusion, the use of 3D plates for the treatment of mandibular fractures is recommended, since they result in little or no displacement between bone fragments.
Topics: Bone Plates; Fracture Fixation, Internal; Humans; Mandibular Fractures; Postoperative Complications; Prosthesis Design
PubMed: 28928010
DOI: 10.1016/j.ijom.2017.08.009 -
The Journal of Contemporary Dental... Nov 2021The purpose of this review is to compare randomized clinical trials evaluating the peri-implant tissue outcomes using different unsplinted attachment systems in two... (Review)
Review
AIM
The purpose of this review is to compare randomized clinical trials evaluating the peri-implant tissue outcomes using different unsplinted attachment systems in two implant-retained mandibular overdentures.
BACKGROUND
Literature lacks information on various unsplinted attachment systems and their effect on peri-implant tissue health. A focus question (as per PICOS) was set as follows: Does one particular unsplinted attachment system (I) compared with another (C) results in better peri-implant outcomes (O) in two implant-retained mandibular overdentures (P) using randomized controlled trials (RCTs) (S)? The literature search was conducted in the PubMed, MEDLINE and Cochrane Central Register of Controlled Trials (CENTRAL) databases between January 2011 and December 2021. The keywords used were "denture, overlay," "denture," "overlay" AND "dental prosthesis, implant supported," "dental implants," "dental implant abutment design" AND "jaw, edentulous," "mouth, edentulous" AND "mandible." Only RCTs on two implant-retained mandibular overdentures using unsplinted attachment systems measuring peri-implant tissue outcomes with minimum 1-year follow-up were selected. In total, 224 studies were identified in initial search, and 25 were shortlisted for full-text evaluation. Four studies were included for systematic review upon considering inclusion and exclusion criteria. The risk of bias was evaluated using Cochrane Risk of Bias Tool 2.0 (RoB 2.0).
REVIEW RESULTS
A total of 41 patients received ball attachments (in 3 studies), 36 patients received low-profile attachments (in 3 studies), 16 patients received magnet attachments (in 1 study), and 13 patients received telescopic attachments (in 1 study). All four studies used standard sized implants, however, differed in implant manufacturers. Two studies which compared ball attachments low-profile attachments revealed-similar peri-implant tissue health parameters but differed in crestal bone-level changes. One study compared ball with telescopic attachments and revealed similar results in crestal bone-level changes and all four peri-implant tissue health parameters. Single study compared magnets with low-profile attachments and shown lesser bone loss with magnet attachments. Single study was judged to have low risk of bias, single with some concerns, and remaining two to have high risk of bias.
CONCLUSION
Gingival index and bleeding index of the patients were not influenced by any of the unsplinted overdenture attachment (stud, magnet, telescopic) system. Inconclusive results found among the studies evaluated comparing crestal bone loss and plaque index.
CLINICAL SIGNIFICANCE
This review manuscript has simplified comparative analysis of different unsplinted attachment systems used in two implant mandibular overdentures to help clinicians choose correct system in such situation.
Topics: Dental Prosthesis, Implant-Supported; Denture Retention; Denture, Overlay; Humans; Jaw, Edentulous; Mandible; Randomized Controlled Trials as Topic
PubMed: 35343463
DOI: No ID Found -
International Journal of Oral and... May 2023The aim of this systematic review was to determine the most prevalent complications resulting from total temporomandibular joint (TMJ) replacement. An electronic search... (Meta-Analysis)
Meta-Analysis Review
The aim of this systematic review was to determine the most prevalent complications resulting from total temporomandibular joint (TMJ) replacement. An electronic search was performed using the Embase, LILACS, MEDLINE (via PubMed), SciELO, Scopus, and Web of Science databases up to June 2022. Prospective and retrospective clinical studies on patients who underwent TMJ replacement were included. Two reviewers performed the study selection, data extraction, and individual risk of bias assessment using the Joanna Briggs Institute Critical Appraisal Tools. The pooled prevalence of each complication was calculated through a proportion meta-analysis using the random-effects model. Twenty-eight studies met the eligibility criteria and were included in the review. All of the eligible studies had a low risk of bias. The results of the meta-analysis revealed that the most prevalent complication was paresis or paralysis of the facial nerve branches (7.8%; 95% confidence interval (CI) 2.6-15.1%, I = 94.5%), followed by sensory alterations (1.8%; 95% CI 0.6-4.9%, I = 88.8%), heterotopic bone formation (1.0%; 95% CI 0.1-2.5%, I = 75.8%), and infection (0.7%; 95% CI 0.1-1.6%, I = 22.7%). In conclusion, TMJ replacement has a low prevalence of complications, and most of them can be managed successfully.
Topics: Humans; Temporomandibular Joint Disorders; Prospective Studies; Retrospective Studies; Temporomandibular Joint; Joint Prosthesis
PubMed: 36494246
DOI: 10.1016/j.ijom.2022.10.009