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BMJ Open Aug 2016The need for denture treatment in public health will increase as the population ages. However, the impact of dentures on nutrition, particularly overdenture treatment,... (Comparative Study)
Comparative Study Meta-Analysis Review
OBJECTIVES
The need for denture treatment in public health will increase as the population ages. However, the impact of dentures on nutrition, particularly overdenture treatment, remains unclear although the physical and psychological effects are known. We investigated whether treatment with a mandibular implant supported overdenture improves nutrient intake and markers of nutritional status better than a conventional complete denture in edentulous patients.
DESIGN
Systematic review and meta-analysis.
METHODS
Medline, EMBASE and the Cochrane Central Register of Controlled Trials were searched for eligible studies published up to April 2016. We included studies which compared the treatment effect of an overdenture to conventional denture on nutrition, in which primary outcomes included changes in intake of macronutrients and/or micronutrients and/or indicators of nutritional status. Two reviewers independently evaluated eligible studies and assessed the risk of bias. We used a fixed effects model to estimate the weighted mean difference (WMD) and 95% CI for change in body mass index (BMI), albumin and serum vitamin B12 between overdenture and conventional denture 6 months after treatment.
RESULTS
Of 108 eligible studies, 8 studies involving 901 participants were included in the narrative appraisal. Four studies reported changes in markers of nutritional status and nutrient intake after treatment with a prosthetic, regardless of type. In a meta-analysis of 322 participants aged 65 years or older from three studies, pooled analysis suggested no significant difference in change in BMI between an overdenture and conventional denture 6 months after treatment (WMD=-0.18 kg/m(2) (95% CI -0.52 to 0.16)), and no significant difference in change in albumin or vitamin B12 between the two treatments.
CONCLUSIONS
The modifying effect of overdenture treatment on nutritional status might be limited. Further studies are needed to evaluate the effectiveness and efficacy of denture treatments.
Topics: Dental Prosthesis, Implant-Supported; Denture, Complete; Denture, Overlay; Diet; Humans; Mouth, Edentulous; Nutritional Status; Patient Satisfaction; Randomized Controlled Trials as Topic; Serum Albumin, Human; Vitamin B 12
PubMed: 27489156
DOI: 10.1136/bmjopen-2016-011799 -
The International Journal of...To evaluate the current literature and provide clinical recommendations related to the number of implants, implant characteristics, loading protocols, survival rates,...
PURPOSE
To evaluate the current literature and provide clinical recommendations related to the number of implants, implant characteristics, loading protocols, survival rates, biologic and mechanical complications, patient satisfaction, and financial considerations for mandibular implant-supported full-arch prostheses.
MATERIALS AND METHODS
A PubMed/MEDLINE search for literature published between January 1, 1980 and February 8, 2019, was performed for systematic reviews on this topic. The PICO question was: In mandibular fully edentulous patients treated with implant full-arch prostheses, is there any difference between fixed and removable implant prostheses in terms of implant and prosthesis survival rates? Only systematic reviews with or without meta-analyses were included. The findings varied based on the type of implant full-arch prosthesis.
RESULTS
High survival rates for implants and prostheses have been reported for fixed and removable implant full-arch prostheses in the mandible. Immediate loading procedures present with high survival rates for both fixed and removable prostheses. There are differences in the number of implants, implant characteristics, complications, and financial implications between these two types of prostheses, which clinicians need to account for as part of the treatment planning process.
CONCLUSION
Implant-supported overdentures and implant-supported fixed complete dentures represent clinically successful treatment approaches. In cases where both treatment options are indicated, patient expectations and cost should be the determining factors for selecting a treatment modality.
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Complete; Denture, Overlay; Follow-Up Studies; Humans; Mandible; Treatment Outcome
PubMed: 33571328
DOI: 10.11607/ijp.6911 -
Head & Neck Sep 2020The aim of this review was to provide an update on survival rates of osseointegrated implants into common composite free flaps used for maxillary and mandibular... (Review)
Review
The aim of this review was to provide an update on survival rates of osseointegrated implants into common composite free flaps used for maxillary and mandibular reconstructions and identify factors affecting outcomes. PubMed, Medline, Embase, and Cochrane databases were searched. Included studies reported implant survival by flap type. Results were pooled and survival was estimated with the Kaplan-Meier method. Variables affecting survival were assessed using Cox regression. Thirty-two of the 2631 articles retrieved were included, totaling 2626 implants placed into fibula, iliac crest, scapula, and radial forearm free flaps. Pooled survival showed 94% 5-year survival of implants in fibula and iliac crest with no difference between groups (P = .3). Factors effecting survival included radiotherapy (HR 2.3, 95% CI 1.2-4.6, P = .027) and malignant disease (HR 2.2, 95%CI 1.6-3.1, P < .001). Implant survival appears adequate across common flap types; however, there are limited numbers reported in less common flaps.
Topics: Bone Transplantation; Bone-Anchored Prosthesis; Fibula; Free Tissue Flaps; Humans; Plastic Surgery Procedures; Retrospective Studies; Survival Rate
PubMed: 32400954
DOI: 10.1002/hed.26238 -
Australian Dental Journal Dec 2016Conventional complete dentures and implant supported overdentures are commonly used by dentists to treat completely edentulous mandibular arches. There have been... (Meta-Analysis)
Meta-Analysis Review
Comparison of implant supported mandibular overdentures and conventional dentures on quality of life: a systematic review and meta-analysis of randomized controlled studies.
BACKGROUND
Conventional complete dentures and implant supported overdentures are commonly used by dentists to treat completely edentulous mandibular arches. There have been problems associated with retention and stability while treating completely edentulous mandibular arches compared to maxillary arches. Many factors have been attributed to this, primarily focusing on the decreased area available for support and increased resorption. Implant supported overdentures have increased the treatment options for resorbed ridges, especially the mandible. However, no reports have proved the superiority of one treatment option over the other, especially in terms of patient-centric outcome measures such as the Oral Health Impact Profile (OHIP). Hence, this meta-analysis was conducted.
METHODS
A literature search of Medline (via PubMed), the Cochrane Central Register of Clinical Trials (CENTRAL) and the Database of Abstracts of Reviews of Effects (DARE) was performed. The reviewers screened titles, abstracts and performed full-text screening of eligible studies. The references from these studies were further screened for additional relevant studies. A random effects model was applied to measure the significance of the per cent mean difference in OHIP scale improvement between implant and conventional dentures. The Cochrane Risk of Bias Tool was applied to assess the selection, ascertainment and selective reporting biases.
RESULTS
Five studies were reviewed and identified. Results of 441 patients (228 implant and 213 conventional) were pooled for analysis of primary outcome and other secondary outcomes. A forest plot of total OHIP scores and for secondary outcomes were obtained between the interventions. Results of 441 patients (228 implant and 213 conventional) were pooled for analysis of primary outcome with a mean difference [95% confidence interval] in the score of -30.72[-48.39, -13.05]; mean difference [95% confidence interval] in the score of -26.45[-43.56, -9.35] for functional limitation; -29.16[-60.89, 2.56] for physical pain; -77.61[-154.63, -0.60] for psychological discomfort; -33.70[-47.96, -19.44] for physical disability; -41.17[-55.93, -26.40] for psychological disability; -17.27[-29.44, 5.10] for social disability; and -28.45[-33.97, -22.92] for handicap. A statistically significant difference favouring the implant group was obtained except for physical pain.
CONCLUSIONS
The implant overdenture group performed better in regard to patient satisfaction as measured using the OHIP questionnaire. Further studies are required to identify superiority between the two treatment options.
Topics: Dental Prosthesis, Implant-Supported; Denture, Complete, Lower; Humans; Jaw, Edentulous; Quality of Life; Treatment Outcome
PubMed: 26836981
DOI: 10.1111/adj.12416 -
Journal of Clinical and Experimental... Apr 2021Information about the risk of early loss and crestal bone loss of dental implants which have been loaded early is scant if compared with data available for those... (Review)
Review
BACKGROUND
Information about the risk of early loss and crestal bone loss of dental implants which have been loaded early is scant if compared with data available for those conventionally or immediately loaded. A meta-analysis of early loss and crestal bone loss in immediate or delayed loaded full mandibular denture retaining dental implants has been recently published. It is interesting to evaluate also the risks of early versus immediate and delayed loading in complete mandibular restorations. The purpose of this systematic review and meta-analysis was to study early (EL) versus immediate (IL) and delayed loading (DL) protocols in edentulous mandibles to determine whether differences exist in implant success and crestal bone loss.
MATERIAL AND METHODS
The literature review was conducted in PubMed, Web of Science, and the Cochrane Library. Seven randomized clinical trials were included.
RESULTS
The result of a meta-analysis of implant loss before 1 year in EL versus IL was 0.34 (95% CI: 0.08, 1.52), favoring the EL control group, while the outcome for crestal bone loss at the three-year observation was -0.10 (95% CI: -0.28, 0.09), with a tendency toward reduced bone loss for EL. In the EL versus DL group, the result of the meta-analysis of implant loss before one year was inconclusive, while in the comparison regarding crestal bone loss in the first year of observation, the result was -0.03 (95% CI: -0.08,-0.02) with a tendency to less bone loss in EL.
CONCLUSIONS
The risk of early implant loss in the IL group was higher than in the EL group. The results in terms of early implant loss in EL versus DL are inconclusive. Besides, crestal bone loss is greater in immediately and delayed loaded implants, at 1 and 3 years of observation, compared to those loaded early. Dental implants, early dental implant loading, dental prostheses, implant- supported, alveolar bone loss, meta-analysis.
PubMed: 33841740
DOI: 10.4317/jced.57966 -
The Journal of Oral Implantology Feb 2022Clinicians treating overdenture patients need to know if immediate loading and conventional loading results in similar outcomes. This study aimed to perform a systematic... (Meta-Analysis)
Meta-Analysis
Clinicians treating overdenture patients need to know if immediate loading and conventional loading results in similar outcomes. This study aimed to perform a systematic literature search of studies comparing immediate and conventional loading of mandibular overdentures irrespective of the number of implants and conduct a meta-analysis of implant failure and marginal bone loss (MBL). A literature search of PubMed, ScienceDirect, Ovoid, Springer, and Google Scholar databases was performed for randomized controlled trials (RCTs) comparing immediate vs conventional loading of mandibular overdentures. The primary outcome was implant failure and the secondary outcome was marginal bine loss (MBL). A descriptive analysis was performed for other outcomes. Thirteen trials were included. Only one trial compared the immediate and delayed loading of single implant-supported overdenture. Seven trials used 2 implants, 1 trial used 3 implants while 4 trials used 4 implants. Meta-analysis indicated no statistically significant difference in implant failure and MBL between immediate and conventional loading of 2- and 4-implant supported overdentures. Descriptive analysis indicated no difference in peri-implant tissue indices, implant stability, and quality of life outcomes between the 2 loading protocols. There may be no difference in implant failure and MBL with immediate loading or conventional loading of 2- and 4-implant supported mandibular overdentures. Literature review indicates that there may be no difference in peri-implant tissue indices, implant stability, and quality of life outcomes between the 2 loading protocols. The overall quality of evidence is moderate. Further, adequately powered RCTs are required to strengthen the evidence.
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Overlay; Humans; Immediate Dental Implant Loading; Mandible; Randomized Controlled Trials as Topic
PubMed: 33206979
DOI: 10.1563/aaid-joi-D-20-00265 -
The Journal of Prosthetic Dentistry Jun 2015A number of authors have reported the placement of a distal implant associated with a partial removable dental prosthesis (PRDP) to make this rehabilitation more stable.... (Review)
Review
Placement of a distal implant to convert a mandibular removable Kennedy class I to an implant-supported partial removable Class III dental prosthesis: A systematic review.
STATEMENT OF PROBLEM
A number of authors have reported the placement of a distal implant associated with a partial removable dental prosthesis (PRDP) to make this rehabilitation more stable. This strategy may represent an option for resolving the problem of the intrusive movements of the PRDP and for reducing treatment costs.
PURPOSE
The purpose of this systematic review was to evaluate the current evidence about the placement of a distal implant associated with a mandibular PRDP to improve patient satisfaction and the clinical performance of the abutment tooth and distal implant.
MATERIAL AND METHODS
Two independent prosthetic specialist reviewers conducted this systematic review. The search was performed using selected clinical studies with PRDP associated with distal implants published in English up to May 2014 from the PubMed and Cochrane Library databases. A data extraction form was developed to collect general information: authors, title, year of publication, aim of study, level of evidence, number of participants, number of implants used, implant system, implant length and diameter, abutment type, masticatory performance, patient satisfaction, implant mean bone loss, abutment tooth mean bone loss, prosthetic complications, follow-up period, and implant survival rate. The quality of the selected studies and the risk of bias were also reported.
RESULTS
The initial electronic search identified 231 studies, and the manual process identified 15 studies (total of 246 studies). After the title and abstract reading and the removal of duplicates, the full texts of 43 studies were obtained. The articles that did not meet the inclusion criteria were excluded (28 studies), and the data from 15 studies were extracted. Seven were retrospective studies, 1 a crossover pilot study, 2 case series, 2 paired clinical studies, and 3 case reports, demonstrating that a high number of the selected studies were of low methodological quality. Nevertheless, the high survival rates for PRDP associated with dental implants have been described.
CONCLUSIONS
The use of a PRDP associated with dental implants to convert a Kennedy class I to class III dental prosthesis benefits patients by improving their satisfaction and masticatory abilities without decreasing implant survival rates. Considering the abutment tooth survival rate, clinical studies with comparable methodology are still lacking to define protocols regarding the use of distal implants associated with PRDP. Long-term, prospective clinical trials are still needed to understand which implant abutments increase abutment tooth survival rate.
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Denture Design; Denture, Partial, Removable; Humans; Jaw, Edentulous, Partially; Mandible; Mastication; Patient Satisfaction; Survival Analysis
PubMed: 25818673
DOI: 10.1016/j.prosdent.2014.12.011 -
Clinical Oral Implants Research Sep 2023This review evaluated the effects of rehabilitation with implant-supported prostheses on the oral function of completely edentulous adults. (Meta-Analysis)
Meta-Analysis
OBJECTIVES
This review evaluated the effects of rehabilitation with implant-supported prostheses on the oral function of completely edentulous adults.
MATERIALS AND METHODS
Systematic literature searches were performed to identify records reporting on oral function in completely edentulous adults rehabilitated with implant-supported prostheses. Meta-analyses were performed on various outcomes including bite force, masticatory performance, muscle activity, mandibular movement/chewing pattern, and salivary flow.
RESULTS
5507 records were identified. Thirty studies qualified for data extraction and analysis. The kappa (𝛋) for the search and identification strategy ranged between 0.50 and 1.00. Meta-analysis was performed grouping the studies by outcomes and split by time points of 6-12 months, 12-36 months, and >36 months after implant therapy. The meta-analyses revealed a significant improvement in oral function of completely edentulous adults after rehabilitation with implant-supported prostheses at 6-12 months (Z = -4.895, p < .001; 95% CI: -0.703, -0.301; τ = .609; Q = 114.953, df = 17, p < .001; I = 85.2%), at 12-36 months (Z = -4.886, p < .001; 95% CI: -0.580, -0.248; τ = .908; Q = 280.611, df = 35, p < .001; I = 87.5%) and at more than 36 months (Z = -9.108, p < .001; 95% CI: -1.472, -0.951; τ = .019; Q = 7.918, df = 7, p = .340; I = 11.6%). The included studies demonstrated a low to moderate risk of bias.
CONCLUSIONS
This systematic review concluded that the oral function of completely edentate adults significantly improved with implant-supported/retained prostheses, even when only one jaw received implant therapy. Therefore, implant therapy should be promoted for edentulous adults to alleviate the shortcomings of conventional complete removable dental prostheses.
Topics: Adult; Humans; Dental Prosthesis, Implant-Supported; Dental Implants; Bite Force; Mandible; Mastication; Mouth, Edentulous
PubMed: 37750517
DOI: 10.1111/clr.14068 -
International Journal of Oral and... Jun 2018This systematic review provides an overview of the historical evolution of the prosthetic temporomandibular joint and addresses the challenges and complications faced by... (Review)
Review
This systematic review provides an overview of the historical evolution of the prosthetic temporomandibular joint and addresses the challenges and complications faced by engineers and surgeons, in an effort to shed light on why only a few systems remain available. A better understanding of the history of temporomandibular joint prostheses might also provide insights into the origin of the negative public opinion of the prosthesis, which is based on outdated information. A computerized search using the PubMed Central, ScienceDirect, Wiley Online, Ovid, and Cochrane Library databases was performed following the PRISMA guidelines. Out of 7122 articles identified, 41 met the inclusion criteria for this systematic review. Although several historical reviews have been published previously, none has covered such an extensive time period or has described all designs. Furthermore, besides providing a historical overview, this review discusses the rationale behind the evolution in design and biomaterials, which have largely contributed to the outcomes of the prosthetic systems.
Topics: Arthroplasty, Replacement; Humans; Mandibular Prosthesis; Prosthesis Design; Temporomandibular Joint; Temporomandibular Joint Disorders
PubMed: 29433767
DOI: 10.1016/j.ijom.2018.01.014 -
Journal of Advanced Periodontology &... 2022This systematic review and meta-analysis investigated the prevalence of proximal contact loss and its associated factors. A bibliographic search was conducted in June...
This systematic review and meta-analysis investigated the prevalence of proximal contact loss and its associated factors. A bibliographic search was conducted in June 2021 with no limitation in the article date or language and updated in January 2022 by hand searching. There was no time limit on the search to retrieve all studies. The search included randomized controlled trials or quasi-experiments, and cross-sectional or cohort studies were included in the absence of these studies. Two authors screened the title and abstract. After evaluating the full texts of selected articles, irrelevant studies and or non-English papers that were impossible to translate were excluded. Disagreements between the re-viewers' selection process were resolved by debate on the eligibility of studies. Standardized critical appraisal instruments from the Joanna Briggs Institute for different types of studies were used to assess the studies' quality. Comprehensive Meta-Analysis (CMA) software (Version 2.2; Biostat, Englewood, NJ) was used for data analysis. The proximal contact loss (PCL) frequency was %29. According to the results, the frequencies of PCL for the distal and mesial aspects were %7 and %21, respectively. The meta-analysis results showed that the contact loss events on the mesial aspect were statistically higher than on the distal aspect (P<0.0001). There were no significant differences between other associated factors such as the mandibular or maxillary arch, retention type, opposing dentition, implant type, molar or non-molar, parafunction behaviors, and vitality of adjacent teeth. There was a significant association between bone loss and PCL, and in individuals with bone loss >%50, the proximal contact loss was higher (OR: %95[ 2.43 CI: 4.03‒1.47], P=0.0006). The PCL in the anterior area was lower than in the posterior area (P=0.004). Although the frequency of contact loss in females was higher than in males, this rate was not statistically significant. The PCL on the mesial aspect and the posterior area was high. In individuals with bone loss >%50, the proximal contact loss was higher than in others.
PubMed: 36714081
DOI: 10.34172/japid.2022.023