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Stomatologija 2017To evaluate the success rate, complications, maintenance and patient satisfaction with implant-supported overdentures with the Locator® system, by means of a systematic...
OBJECTIVE
To evaluate the success rate, complications, maintenance and patient satisfaction with implant-supported overdentures with the Locator® system, by means of a systematic review.
MATERIALS AND METHODS
PICO approach was used to formulate the clinical question. Research was conducted in primary (PubMed® and B-On®) and secondary (Cochrane®) information sources using different logical combination strategies of text words and MESH terms. Articles were selected according to research theme and scientific level evidence.
RESULTS
55 articles were found. After reading the title and summary, and evaluating the article's level of scientific evidence, only ten were included for analysis. Eight studies were related to rehabilitations in the mandible and two were bi-maxillary. The analysis of the studies showed that complications and type of maintenance are primarily related to the loss of retention and the need to replace the nylon male component of the system. Patient's satisfaction was highlighted in five articles of this research.
CONCLUSION
The overall satisfaction rates of patients seem to indicate this system as a viable clinical option of prosthetic rehabilitation. Overdentures with the Locator® system appear to hold a good retention, either in the upper or lower jaw, but require frequent maintenance visits, due to complications observed in these prosthodontic rehabilitations.
Topics: Dental Prosthesis Design; Dental Prosthesis, Implant-Supported; Denture, Overlay; Patient Satisfaction; Prosthesis Failure
PubMed: 29806650
DOI: No ID Found -
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 -
BMC Oral Health May 2021Implant-supported overdentures offer enhanced mechanical properties, which lead to better patient satisfaction and survival rates than conventional dentures. However, it... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Implant-supported overdentures offer enhanced mechanical properties, which lead to better patient satisfaction and survival rates than conventional dentures. However, it is unclear whether these satisfaction levels and survival rates depend on the number of implants supporting the overdenture. Therefore, this systematic review aimed to compare maxillary overdentures supported by four or six splinted implants in terms of patient satisfaction, implant survival, overdenture survival, and prosthodontic complications.
METHODS
Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (PubMed), and EMBASE databases were systematically searched and complemented by hand searching from 2000 to 2019, employing a combination of specific keywords. Studies comparing the use of four versus six implants for supporting overdentures with at least one-year of follow-up after prosthesis installation and including ten fully edentulous patients were included. The risk of bias (RoB) was analyzed with Cochrane's RoB 2 and Newcastle-Ottawa tools. Implants and prosthesis survival rates were analyzed by random-effects meta-analysis and expressed as risk ratios or risk differences, respectively, and by the non-parametric unpaired Fisher's test.
RESULTS
A total of 15 from 1865 articles were included, and reported follow-up times after implant placement ranged from 1 to 10 years. Irrespective of the number of implants used, high scores were reported by all studies investigating patient satisfaction. Meta-analysis and non-parametric Fisher's test showed no statistical differences regarding the survival rate of implants (P = 0.34, P = 0.3) or overdentures (P = 0.74, P = 0.9) when using 4 versus 6 splinted implants to support overdentures, and no significant differences regarding prosthodontic complications were found between groups. Randomized studies presented high RoB and non-randomized studies presented acceptable quality.
CONCLUSIONS
Within the limits of this systematic review, we can conclude that the bar-supported overdenture on four implants is not inferior to the overdenture supported by six implants for rehabilitating the edentulous maxilla, in terms of patient satisfaction, survival rates of implants and overdentures, and prosthodontic complications.
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Denture Retention; Denture, Overlay; Humans; Jaw, Edentulous; Maxilla; Patient Satisfaction
PubMed: 33962612
DOI: 10.1186/s12903-021-01572-6 -
International Journal of Oral and... Sep 2018The aim of this meta-analysis was to verify the clinical viability of single implant-retained mandibular overdentures (SIMO). An electronic search of the PubMed and... (Meta-Analysis)
Meta-Analysis
The aim of this meta-analysis was to verify the clinical viability of single implant-retained mandibular overdentures (SIMO). An electronic search of the PubMed and Cochrane databases was performed (end date July 2017); this was supplemented by a manual search of the literature. Only prospective clinical trials and randomized controlled trials (RCTs) that evaluated SIMO with a minimum follow-up of 12 months were included. The meta-analysis was based on the Mantel-Haenszel method. Dental implant and prosthetic failure were the dichotomous outcome measures; these were evaluated through the risk ratio (RR) and odds ratio (OR), with corresponding 95% confidence intervals (CI). Of 499 articles identified, nine fulfilled the inclusion criteria. A total of 205 implants were placed in patients with a mean age of 64.1 years; the cumulative survival rate was 96.6% over a mean follow-up period of 37.3 months. The procedure used (SIMO vs. two implant-retained mandibular overdenture) did not affect dental implant failure (P=0.45) or prosthetic failure (P=0.65): RR 1.06 (95% CI 0.91-1.23) and RR 0.88 (95% CI 0.51-1.51), respectively; OR 2.56 (95% CI 0.27-24.39; P=0.41) and OR 0.44 (95% CI 0.15-1.26; P=0.13), respectively. Within the limitations of this systematic review and meta-analysis, SIMO with a complete denture as the opposing arch may be considered an alternative treatment for completely edentulous patients. However, this study also confirmed the need for more RCTs on this topic.
Topics: Dental Implants, Single-Tooth; Dental Prosthesis Design; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Denture, Overlay; Humans; Mandible
PubMed: 29459128
DOI: 10.1016/j.ijom.2018.01.021 -
The International Journal of... 2021To assess the clinical outcomes of maxillary overdentures supported by dental implants by conducting a literature review.
PURPOSE
To assess the clinical outcomes of maxillary overdentures supported by dental implants by conducting a literature review.
MATERIALS AND METHODS
An electronic search was undertaken in March 2019. Eligibility criteria included publications reporting cases of implant-supported maxillary overdentures with follow-up information.
RESULTS
A total of 131 publications were included (1,478 overdentures supported by 6,681 implants). The mean number of attachments per overdenture was 3.8 ± 1.2 (range: 1 to 9), and a bar-clip system was used in about half of the cases. The prostheses were followed up for a mean of 47.9 ± 32.8 (range 1: to 240) months. A total of 401 implants (6.0%) failed in 219 patients (14.8%), and 55 prostheses (3.7%) failed at a mean of 40.2 ± 53.2 (6 to 240) months after placement. Most of the failures happened within the first year after placement for both implants (52.1%) and prostheses (41.8%). Patients with fewer implants per prosthesis presented higher prosthesis failure rates than patients with more implants per prosthesis. The cumulative survival rate for dental implants after 19 years was 70.4%, and for implant-supported maxillary overdentures was 79.8%. Presence of palatal coverage and/or metallic structure/reinforcement does not seem to have an influence on failure rate. Of the most commonly used attachment systems, the ball/O-ring and the Ceka were the ones with the highest rates of patients having at least one implant failure.
CONCLUSION
Most of the prosthesis failures were due to loss of implants, and the first year was the most critical period for failures. The number of dental implants placed per patient seemed to have an impact on the occurrence of overdenture failure.
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Denture Retention; Denture, Overlay; Humans; Maxilla; Prosthesis Failure
PubMed: 33625390
DOI: 10.11607/ijp.6905 -
The Journal of Advanced Prosthodontics Oct 2014The aim of this review was to analyze the evaluation criteria on mandibular implant overdentures through a systematic review and suggest standardized evaluation criteria.
PURPOSE
The aim of this review was to analyze the evaluation criteria on mandibular implant overdentures through a systematic review and suggest standardized evaluation criteria.
MATERIALS AND METHODS
A systematic literature search was conducted by PubMed search strategy and hand-searching of relevant journals from included studies considering inclusion and exclusion criteria. Randomized clinical trials (RCT) and clinical trial studies comparing attachment systems on mandibular implant overdentures until December, 2011 were selected. Twenty nine studies were finally selected and the data about evaluation methods were collected.
RESULTS
Evaluation criteria could be classified into 4 groups (implant survival, peri-implant tissue evaluation, prosthetic evaluation, and patient satisfaction). Among 29 studies, 21 studies presented implant survival rate, while any studies reporting implant failure did not present cumulative implant survival rate. Seventeen studies evaluating peri-implant tissue status presented following items as evaluation criteria; marginal bone level (14), plaque Index (13), probing depth (8), bleeding index (8), attachment gingiva level (8), gingival index (6), amount of keratinized gingiva (1). Eighteen studies evaluating prosthetic maintenance and complication also presented following items as evaluation criteria; loose matrix (17), female detachment (15), denture fracture (15), denture relining (14), abutment fracture (14), abutment screw loosening (11), and occlusal adjustment (9). Atypical questionnaire (9), Visual analog scales (VAS) (4), and Oral Health Impact Profile (OHIP) (1) were used as the format of criteria to evaluate patients satisfaction in 14 studies.
CONCLUSION
For evaluation of implant overdenture, it is necessary to include cumulative survival rate for implant evaluation. It is suggested that peri-implant tissue evaluation criteria include marginal bone level, plaque index, bleeding index, probing depth, and attached gingiva level. It is also suggested that prosthetic evaluation criteria include loose matrix, female detachment, denture fracture, denture relining, abutment fracture, abutment screw loosening, and occlusal adjustment. Finally standardized criteria like OHIP-EDENT or VAS are required for patient satisfaction.
PubMed: 25352954
DOI: 10.4047/jap.2014.6.5.325 -
Journal of Oral Rehabilitation Jan 2021To review the literatures concerning the effect of the single-implant mandibular overdenture (SIMO) on patient-reported outcome measures (PROMs) and masticatory function...
AIM
To review the literatures concerning the effect of the single-implant mandibular overdenture (SIMO) on patient-reported outcome measures (PROMs) and masticatory function in the fully edentulous patients.
MATERIALS AND METHODS
Electronic databases (PubMed, Cochrane Library, EMBASE and Web of Science) were searched, complemented with manual resources. Prospective studies published in English up to February 2020 reporting the effect of SIMO on PROMs and masticatory function in the edentulous patients were included. This review focused on oral health-related quality of life (OHRQoL), satisfaction and masticatory function outcomes.
RESULTS
Of 1157 initially screened articles, 9 randomised controlled trials (RCTs) and 8 prospective studies involving 551 subjects fulfilled the inclusion criteria. Two RCTs were graded as high risk of bias or some concern, while others were low risk. All prospective studies had adequate representativeness and assessment, but only one study had a controlled cohort. In general, the edentulous patients restored with SIMOs had improved OHRQoL and general satisfaction compared to those with conventional complete dentures (CCDs), but the outcome of masticatory function was controversial. Compared with two-implant mandibular overdenture (TIMO), SIMO showed no significant differences regarding general satisfaction and satisfaction with speech, comfort, chewing ability, aesthetics and social life. Conflicting results were observed in OHRQoL and satisfaction with retention and stability. Better masticatory performance was observed in TIMO group than SIMO group.
CONCLUSION
Within the limitation of this review, SIMO is featured with better OHRQoL and satisfaction than CCD. SIMO and TIMO rendered similar patient satisfaction, but TIMO had better masticatory performance.
Topics: Dental Prosthesis, Implant-Supported; Denture, Overlay; Esthetics, Dental; Humans; Mandible; Mastication; Mouth, Edentulous; Patient Reported Outcome Measures; Patient Satisfaction; Quality of Life
PubMed: 32989781
DOI: 10.1111/joor.13103 -
The European Journal of Prosthodontics... Aug 2022This study aimed to perform a systematic review and meta-analysis to analyze the results obtained clinically for bar-clip versus stud-retainers in overdentures. Three... (Meta-Analysis)
Meta-Analysis
This study aimed to perform a systematic review and meta-analysis to analyze the results obtained clinically for bar-clip versus stud-retainers in overdentures. Three databases (PubMed Central, MEDLINE, and BvSalud) were used beyond a manual search. The study followed strictly the inclusion and exclusion criteria, considering the PICO strategy. For the risk of bias and quality assessment of studies, in the case of RCT, there were six domains of analysis, and for non-RCT studies, the Modified Newcastle-Ottawa Scale was performed. A meta-analysis was developed using the available data for marginal bone loss (MBL) and survival rate. 25 studies were included. The stud-retentor had the lowest implant SR (87.6%) and the greatest MBL (1.96 mm). For the bar-clip system, the mean survival rate was 95.91%, with only 4 studies included for this system, and the mean MBL was 1.13 mm. Only 3 studies directly compared both systems quantitatively, showing a significantly greater MBL toward the stud-retention group. The results may not allow determination of the best system for overdenture (stud retentor or bar-clip). Therefore, most of the studies suggested the stud-retentor as a more preferable system due to better distribution of forces, biological peri-implant behavior, low-cost, and ease for removal facilitating the sanitization and/or repair.
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Denture Retention; Denture, Overlay; Mandible; Surgical Instruments
PubMed: 35333010
DOI: 10.1922/EJPRD_2338deCastro19 -
Oral and Maxillofacial Surgery Jun 2024Critically evaluate the existing literature and answer the question, "Does the dental implant/mini-implant design influence the stress distribution in prosthetic... (Review)
Review
PURPOSE
Critically evaluate the existing literature and answer the question, "Does the dental implant/mini-implant design influence the stress distribution in prosthetic overdentures according to finite element analysis?".
METHODS
This systematic review was registered in the Open Science Framework (osf.io/2bquj) and followed the PRISMA protocols. The custom search strategy was applied to 4 databases. In vitro experimental studies that evaluated the influence of dental implant/mini-implant design on stress distribution in overdentures by FEM, without time and language restrictions, were included. The selection process was carried out in two stages by two reviewers independently. Risk of bias analysis was performed by a checklist of important parameters.
RESULTS
Sixty articles were evaluated by their title and abstract, four were selected for full reading, three were relevant, and nine were included by additional search. The 12 studies have a low risk of bias. The meta-analysis could not be performed due to the heterogeneity of the data (implant type, design variation, load intensity, and direction).
CONCLUSION
It can be inferred from the evaluated literature that design modifications influence the stress distribution, but as the FEM presents limitations inherent to the in vitro study, clinical trials are necessary to infer the effectiveness of the modifications. It should be noted that there is no consensus on which is the best thread design and that implants with a very narrow diameter are subject to the highest stress concentration.
Topics: Denture, Overlay; Humans; Dental Implants; Finite Element Analysis; Dental Prosthesis, Implant-Supported; Dental Stress Analysis; Dental Prosthesis Design; Stress, Mechanical
PubMed: 37665393
DOI: 10.1007/s10006-023-01177-z -
The International Journal of Oral &... 2019This systematic review evaluated the mean survival rate and marginal bone loss (MBL) of dental implants with ≤ 6 mm in length, across a time frame of 5 years. The...
PURPOSE
This systematic review evaluated the mean survival rate and marginal bone loss (MBL) of dental implants with ≤ 6 mm in length, across a time frame of 5 years. The overall prosthetic and biologic complications were evaluated, and their survival rates obtained. In addition, the complication rates of the splinted vs nonsplinted implants were assessed.
MATERIALS AND METHODS
An electronic literature search in PubMed (MEDLINE) and EMBASE (OVID) and Cochrane were performed, in addition to a manual search through all periodontics and implantology-related journals, up to October 2017, to identify relevant articles.
RESULTS
Out of 515 potentially eligible articles, 19 investigations assessing a total of 910 extra-short (≤ 6 mm) implants were included and further evaluated. After 5 years of follow-up, a mean survival rate of 94.1% (90% in the maxilla and 96% in the mandible) and a maximum bone loss of 0.53 mm were demonstrated. Additionally, a statistically significant difference in terms of bone loss was observed between tissue-level (0.12 mm) and bone-level implants (0.36 mm) at 12 months (P < .01), but not between internal and external abutment connections (P = .17). The most commonly reported prosthetic complication was screw loosening. Finally, splinted implants showed less overall prosthetic complications (RR = 3.32; 95% CI: 1.9 to 5.7), screw loosening (RR = 15.2; 95% CI: 5.92 to 39.31), and implant failure (RR = 1.96; 95% CI: 0.8 to 4.8) than nonsplinted implants.
CONCLUSION
Extra-short implants are a viable treatment alternative in ridges exhibiting atrophy, demonstrating a satisfactory survival rate, as well as a low rate of prosthetic and biologic complications across a 5-year follow-up. Additionally, splinting extra-short implants is associated with fewer prosthetic complications and lower implant failure rate compared with nonsplinted implants.
Topics: Adult; Alveolar Bone Loss; Cohort Studies; Dental Implants; Dental Prosthesis Design; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Denture, Overlay; Female; Humans; Jaw, Edentulous; Male; Mandible; Maxilla; Middle Aged
PubMed: 30695086
DOI: 10.11607/jomi.6893