-
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 Journal of Prosthetic Dentistry May 2024Immediately loaded mandibular overdentures are clinically acceptable treatment options that have gained popularity because their use shortens the treatment duration.... (Meta-Analysis)
Meta-Analysis Review
Patient-reported outcome measures and prosthetic events in implant-supported mandibular overdenture patients after immediate versus delayed loading: A systematic review and meta-analysis.
STATEMENT OF PROBLEM
Immediately loaded mandibular overdentures are clinically acceptable treatment options that have gained popularity because their use shortens the treatment duration. However, whether the immediate loading of dental implants can match the prosthetic events, satisfaction, and quality of life of delayed loading is still unclear.
PURPOSE
The purpose of this systematic review and meta-analysis was to compare the prosthetic events, satisfaction, and quality of life of immediate versus delayed loading implants in patients rehabilitated with mandibular overdentures.
MATERIAL AND METHODS
This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and was registered at The International Prospective Register of Systematic Reviews (PROSPERO) (CRD42021258187). Electronic searches were carried out by 2 independent reviewers in the PubMed/MEDLINE, Cochrane Library, and Web of Science databases up to May 2021. Only randomized clinical trials and prospective studies with at least 10 participants that compared immediate versus delayed loading were selected. A meta-analysis was performed by using the RevMan 5 software program for complications and maintenance outcomes.
RESULTS
Seven articles were included in the qualitative analysis, and 4 were included in the quantitative analysis. The meta-analysis demonstrated no significant difference between immediate and delayed loading for prosthetic complications (RR=1.71; 95% CI=0.67-4.37; I=85%, P=.27) or maintenance (RR=1.92, 95% CI=0.44-8.28; I=94%, P=.38).
CONCLUSIONS
Although the prosthetic complications and maintenance were more likely to favor the delayed loading group, available evidence showed no statistical difference for prosthetic complications and maintenance between immediate loading and delayed loading in mandibular overdentures.
Topics: Humans; Denture, Overlay; Dental Prosthesis, Implant-Supported; Immediate Dental Implant Loading; Patient Reported Outcome Measures; Mandible; Quality of Life; Patient Satisfaction
PubMed: 35501187
DOI: 10.1016/j.prosdent.2022.03.015 -
Dental and Medical Problems 2023The ball attachments and their O-rings used for the retention and stabilization of overdentures showed a decrease in retention as the number of cycles increased. This... (Review)
Review
The ball attachments and their O-rings used for the retention and stabilization of overdentures showed a decrease in retention as the number of cycles increased. This fact resulted in a decrease in the retention of the prosthesis. The purpose of this study was to evaluate the fatigue resistance of ball attachments through a systematic review. An electronic search was performed using the Cochrane Library, LILACS, PubMed, ScienceDirect, and Web of Science databases. The search was conducted based on the PICOS framework. The inclusion criteria involved in the search comprised research articles written in English and published between the years 2000 and 2020. In the final selection, 18 articles were included in the review. Most of these studies performed the fatigue retention tests using parallel implants without angles. However, some studies used different angles to analyze the fatigue retention values. With the passage of time, the wear results in deformation and, as a consequence, a decrease in the retention of most attachments, leading to treatment failure. The main factor to be considered is the loss of retention of these components and their low durability. The loss of retention is due to large extent to the materials used to manufacture the attachments and O-rings, the size and angulation of the implants, and the length of the prosthesis. Future research is needed to further elucidate the reasons for the failure of the attachments.
Topics: Humans; Dental Implants; Dental Prosthesis, Implant-Supported; Denture Retention; Denture, Overlay
PubMed: 37023344
DOI: 10.17219/dmp/146719 -
Journal of Indian Prosthodontic Society 2022The purpose of this study is to evaluate the retention effectiveness of Molloplast B as a female attachment compared to O rings' in implant supported overdentures. (Meta-Analysis)
Meta-Analysis
AIM
The purpose of this study is to evaluate the retention effectiveness of Molloplast B as a female attachment compared to O rings' in implant supported overdentures.
SETTINGS AND DESIGN
This systematic review and meta-analysis was evaluated using the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines.
MATERIALS AND METHODS
Sixteen female part models were divided into two groups: eight female parts made with O ring (Group A) and eight female parts made with Molloplast B (Group B). All of the models were soaked in artificial saliva for 24 h, then, their retention force was measured in Newton using a Universal mechanical testing machine, initially, after 500, after 1000, and after 1500 of loading and dislodging cycles.
STATISTICAL ANALYSIS USED
: The statistical analysis was conducted by using one way ANOVA test and Bonferroni test. SPSS Software (SPSS, Version 27, IBM Co., Chicago, IL, USA).
RESULTS
After 1500 loading and dislodging cycles, Group B has the highest mean retention force (4.09), followed by Group A, which has a mean retention force of 3.73.
CONCLUSION
Molloplast B with a 2.7 mm diameter ball attachment lost the least amount of retention force after 1500 loading and dislodging cycles.
Topics: Female; Humans; Denture Retention; Dental Prosthesis, Implant-Supported; Dental Stress Analysis; Dental Implants; Denture, Overlay
PubMed: 36511057
DOI: 10.4103/jips.jips_43_22 -
Journal of Prosthodontics : Official... Oct 2023The aim of this systematic review was to compare treatment outcomes in terms of implant survival rate, marginal bone loss, and patient-reported outcome measures (PROMs)... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
The aim of this systematic review was to compare treatment outcomes in terms of implant survival rate, marginal bone loss, and patient-reported outcome measures (PROMs) between narrow-diameter implants and regular-diameter implants (RDIs) for mandibular implant overdentures (MIOs).
METHODS
This study was based on the methodology adapted as per Cochrane. Medline, Embase, the Cochrane Central Register of Controlled Trials, Web of Science, and Scopus were searched for pertinent studies published by July 22, 2022. Outcome parameters included in this meta-analysis were implant survival rate, marginal bone loss, visual analogue scale score for patient satisfaction, and value of oral health impact profile.
RESULTS
A total of 782 non-duplicate articles and 83 clinical study registrations were identified from database and hand searches, of which 26 were eligible for full-text searches. Finally, 12 publications reporting on 8 independent studies were included in this review. In the meta-analysis, implant survival rate and marginal bone loss did not significantly differ between narrow-diameter implants and RDIs. Regarding RDIs, narrow-diameter implants were associated with significantly better outcomes in general patient satisfaction and oral health-related quality of life than RDIs for mandibular overdentures.
CONCLUSIONS
Narrow-diameter implants have competitive treatment outcomes compared to RDIs in terms of implant survival rate, marginal bone loss, and PROMs. [Correction added on July 21, 2023, after first online publication: The abbreviation RDIs was changed to PROMs in the preceding sentence.] Thus, narrow-diameter implants might be an alternative treatment option for MIOs in situations with limited alveolar bone volume.
Topics: Humans; Dental Implants; Quality of Life; Denture, Overlay; Dental Prosthesis, Implant-Supported; Treatment Outcome; Mandible; Alveolar Bone Loss
PubMed: 37365991
DOI: 10.1111/jopr.13726 -
Journal of Oral Rehabilitation Dec 2023Adequate muscle activity is important for the success of oral rehabilitation: it maintains the integrity of the stomatognathic system and is responsible for chewing... (Review)
Review
BACKGROUND
Adequate muscle activity is important for the success of oral rehabilitation: it maintains the integrity of the stomatognathic system and is responsible for chewing movements needed to break, crush and grind food.
OBJECTIVE
To compare muscle activity using electromyography (EMG) while clenching or chewing soft and/or hard foods among individuals with natural dentition (ND) and edentulous patients rehabilitated with dental prostheses.
METHODS
This review was conducted until March, 2023, and the research question was "Is the muscle activity of edentulous patients rehabilitated with dental prostheses similar to that of dentate individuals?" A search strategy was conducted in PubMed/MEDLINE, The Cochrane Library, Web of Science, Lilacs, Embase and manual journal searches.
RESULTS
Ten studies were included in the analysis. Most of them reported that individuals with ND had significant higher muscle activity (clenching or chewing) than complete dentures (CD) users. However, no difference was observed between patients with full mouth implant-supported fixed dental prosthesis (ISFDP) and ND. Additionally, two studies compared patients with mandibular ISFDP with maxillary CD and individuals with ND and found no differences; however, one study concluded that patients with ISFDP with CD (maxillary or mandibular) had lower muscle activity than individuals with ND. Only one study reported a higher muscle activity in patients with full-mouth ISFDP than in individuals with ND.
CONCLUSIONS
Bimaxillary CD users had lower muscle activity than individuals with ND. During rehabilitation, the muscle activity of patients with full-mouth ISFDP and mandibular ISFDP with maxillary CD is similar to individuals with ND.
Topics: Humans; Dental Prosthesis, Implant-Supported; Mouth, Edentulous; Denture, Complete; Mastication; Muscles; Dental Implants; Denture, Overlay
PubMed: 37605296
DOI: 10.1111/joor.13564 -
The Journal of Prosthetic Dentistry Feb 2024Evidence regarding the retention system for a mandibular overdenture is important for treatment planning. However, the clinical performance of stud and ball attachments... (Meta-Analysis)
Meta-Analysis Review
Patient-reported outcome measures and clinical performance of implant-retained mandibular overdentures with stud and ball attachments: A systematic review and meta-analysis.
STATEMENT OF PROBLEM
Evidence regarding the retention system for a mandibular overdenture is important for treatment planning. However, the clinical performance of stud and ball attachments for mandibular overdenture retainers is unclear.
PURPOSE
The purpose of this systematic review and meta-analysis was to compare the clinical performance and self-reported patient outcomes of ball and stud attachments as mandibular overdenture retainers.
MATERIAL AND METHODS
Randomized (RCTs) and nonrandomized (N-RCTs) controlled clinical trials were selected based on the eligibility criteria. The risk of bias was assessed by using the Cochrane Collaboration Tools, and the certainty of the evidence (COE) by using the grades of recommendation, assessment, development, and evaluation (GRADE) workshop approach. Meta-analyses according to the follow-up period were performed for implant survival, prosthetic maintenance and complications, bleeding on probing (BoP), marginal bone loss (MBL), satisfaction, and oral health-related quality of life (OHRQoL).
RESULTS
Thirteen RCTs and 4 N-RCTs were included. Twelve studies presented a high risk of bias. The stud demonstrated a lower risk ratio (RR) (P<.001) for maintenance and complications concerning the need for matrix activation (RR 7.12 [2.65, 19.15]) (very low COE) and new overdentures (RR 2.47 [1.02, 5.96]) (moderate COE), ranging from 1 to 5 years of follow-up. Mean difference (MD) for MBL after 1 (MD 0.40 [0.28, 0.52]; P<.001) and 5 years (MD 0.18 [0.16, 0.20]; P<.001) was higher for ball attachments than that for stud (very low COE) attachments. Stud attachments also improved satisfaction (P<.001) when compared with ball attachments (very low COE). Implant survival rate (high COE), BoP (very low COE), and OHRQoL (low COE) were similar for the attachments.
CONCLUSIONS
Stud and ball attachments are clinically appropriate options as mandibular overdenture retainers and are capable of restoring OHRQoL. Nevertheless, the stud showed greater improvement in satisfaction and less prosthetic aftercare and MBL.
Topics: Humans; Denture, Overlay; Quality of Life; Dental Prosthesis, Implant-Supported; Denture Retention; Dental Implants; Mandible; Patient Reported Outcome Measures
PubMed: 35931572
DOI: 10.1016/j.prosdent.2022.02.006 -
Quintessence International (Berlin,... Jun 2024This systematic review compares the impact of ball and locator attachments on marginal bone loss in implant-retained overdentures in completely edentulous patients. (Meta-Analysis)
Meta-Analysis
OBJECTIVES
This systematic review compares the impact of ball and locator attachments on marginal bone loss in implant-retained overdentures in completely edentulous patients.
METHOD AND MATERIALS
Following PRISMA guidelines, health science librarians completed literature searches from inception to 17 March 2023 in seven databases. There were 15,686 items exported to EndNote from Embase.com, CINAHL (EBSCO), Cochrane Library, Ovid MEDLINE-ALL, PubMed, Scopus, and Web of Science. Hand-searching added four more articles. After deduplication, 6,756 items were screened for eligibility. Twenty-nine studies were assessed by full text, of which ten studies, involving 424 subjects, were included in the review. Risk of bias assessment was conducted using the Cochrane risk-of-bias tool and the Newcastle-Ottawa scale. A meta-analysis was performed to synthesize and analyze the collective data from the selected studies.
RESULTS
The included studies used diverse methodologies, implant systems, and loading protocols. Most studies reported no significant difference in marginal bone loss between ball and locator attachments. The meta-analysis revealed high heterogeneity.
CONCLUSION
The results of this systematic review suggest that ball and locator attachments exhibit similar performance in terms of marginal bone loss in implant-retained overdentures. However, the limited number, risk of bias, and heterogeneity of studies highlight the need for standardized research designs and larger sample sizes in future investigations to draw more definitive conclusions.
Topics: Humans; Denture, Overlay; Dental Prosthesis, Implant-Supported; Alveolar Bone Loss; Denture Retention
PubMed: 38619260
DOI: 10.3290/j.qi.b5213685 -
Journal of Prosthodontics : Official... Apr 2020This systematic review was undertaken to establish the most favourable protocol to treat an edentulous mandible with a single implant-retained overdenture. The... (Meta-Analysis)
Meta-Analysis
PURPOSE
This systematic review was undertaken to establish the most favourable protocol to treat an edentulous mandible with a single implant-retained overdenture. The formulated PICO question was: "Which surgical and prosthetic protocols result in the highest survival and complication rates of implants and prostheses employed in a single implant retained overdenture for the rehabilitation of a completely edentulous mandibular ridge?"
MATERIALS AND METHODS
A structured literature search was conducted using the following databases; PubMed, ScienceDirect, COCHRANE, LILACS, IndeMED, OVID, EMBASE, NIH Clinical Trials for reports related to the single implant-retained overdenture treatment. Only English articles were included. Publications with a minimum follow up time of 1 year and above were included for meta-analysis. A Poisson regression model was applied to estimate the survival rates of the implant and prosthesis employed.
RESULTS
The electronic database search yielded 2083 titles and abstracts; and a total of 17 were selected for the systematic review, of which 11 studies were subjected to meta-analysis. The implants showed high estimated five and 10-year survival rates of 91.93% and 84.62%, respectively. Implants that were delayed loaded showed the greatest survival rates, while immediately loaded implants presented with higher survival rates at five (p = 0.849) and 10 years (p = 0.464) when compared to early loaded implants. The greatest number of fractures were associated with ball abutments with an event rate of 10.8 (95% CI: 10.5-11.09) per 100 prosthesis years, while locator abutments showed a greater number of maintenance events with an event rate of 16.84(95% CI:16.01-17.66) per 100 prosthesis years.
CONCLUSION
Single implant-retained overdenture treatment is a cost-effective, minimally invasive and simple treatment that can be used to restore function and aesthetics to edentulous patients, with relatively high implant and prosthesis success rates and minimal complications.
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Overlay; Esthetics, Dental; Humans; Jaw, Edentulous; Mandible
PubMed: 31849146
DOI: 10.1111/jopr.13133 -
The Journal of Prosthetic Dentistry Dec 2022Healing abutments and attachments have been used for implant-supported removable partial dentures (ISRPDs). However, the effects of these abutments and attachments on... (Review)
Review
STATEMENT OF PROBLEM
Healing abutments and attachments have been used for implant-supported removable partial dentures (ISRPDs). However, the effects of these abutments and attachments on the clinical outcomes of the implants and prostheses are elusive because of the lack of standardized research protocols.
PURPOSE
The purpose of this systematic review was to determine the clinical outcomes of mandibular distal extension ISRPDs with healing abutments and attachments by analyzing qualified studies.
MATERIAL AND METHODS
An electronic and manual literature search was conducted on PubMed, Web of Science, Scopus, Embase, and Cochrane Library databases including articles published in English from 1980 to 2020. Publications of clinical outcome studies on the mandibular distal extension ISRPDs with healing abutments or attachments were screened by inclusion and exclusion criteria. Clinical outcomes of removable partial dentures (RPDs) and ISRPDs with different types of abutments or attachments were compared by using patient-reported outcome measures, implant survival rate, masticatory performance, and implant- or prosthesis-related complications. Study designs and clinical outcome data were extracted and analyzed. The evidence of the selected studies and degree of recommendation were made according to the Oxford Centre for Evidence-based Medicine, and the risk of bias of the studies was assessed based on Newcastle-Ottawa criteria.
RESULTS
Of 541 articles initially identified after removing duplicate records, 11 articles were selected by applying the inclusion and exclusion criteria, by inter-viewer agreement, and by hand searching. Nine prospective cohort studies, 1 retrospective cohort study, and 1 randomized controlled trial were included with evidence levels assessed at 1b, 2b, and 2c. The risk of bias varied from 5 to 8 out of 9. Patient overall satisfaction, oral health-related quality of life (OHRQoL) scores, and masticatory ability were significantly improved for ISRPDs with either healing abutments, ball, or LOCATOR attachments when compared with RPDs. The implant survival rate varied from 92% to 97% at 2 to 10 years for ball attachment and was 100% at 1 year for LOCATOR attachment-supported ISRPDs. Marginal bone loss (MBL) varied from 0 to 1 mm in all studies, although LOCATOR attachments had significantly less MBL compared with ball attachments. The maximal pocket depth and bleeding on probing index around implants at 1 year were 1.7 to 1.8 mm and 0.1 to 0.3. Loose healing caps were the main mechanical complication of implants. There were more prosthetic complications in ISRPDs with ball attachments than RPDs at 10-year follow-up, including gold matrix loosening, loss of retention, and denture base fractures. No direct comparisons were made of patient-reported outcomes or prosthetic complications between ball and LOCATOR attachment-supported ISRPDs.
CONCLUSIONS
Healing abutments and attachments (ball or LOCATOR) improved patient-reported outcomes and the masticatory function of mandibular distal extension ISRPDs. However, insufficient evidence was found to determine the relative effectiveness of different attachment systems on the clinical outcomes of mandibular distal extension ISRPDs. Abutment loosening was the most frequent mechanical complication for healing abutments. More prosthetic complications were associated with ball attachment-supported ISRPDs than RPDs. The major weaknesses of this systematic review were the relatively moderate level of evidence and the publication language, since implant attachments are used in many non-English speaking countries.
Topics: Humans; Denture, Partial, Removable; Denture Retention; Dental Prosthesis, Implant-Supported; Dental Implants; Quality of Life; Prospective Studies; Retrospective Studies; Mandible; Denture, Overlay
PubMed: 34301416
DOI: 10.1016/j.prosdent.2021.04.008