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International Journal of Environmental... Apr 2021Mini-dental implants (MDIs) have been used to support and retain overdentures, providing patients with a less invasive placement procedure. Although lucrative, the use... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
Mini-dental implants (MDIs) have been used to support and retain overdentures, providing patients with a less invasive placement procedure. Although lucrative, the use of MDIs to retain a maxillary overdenture is still not an established treatment modality. This systematic review aims to answer the question: Do mini-implant-retained maxillary overdentures provide a satisfactory treatment outcome for complete edentulism?
METHODS
A systematic search for relevant articles was conducted to include articles published until April 2021 in the following electronic databases: CINAHL, Cochrane, EMBASE, PubMed, and Web of Science. All empirical studies evaluating the biological, survival, or patient-reported outcomes after placing mini-implant-retained overdentures in maxilla were considered for inclusion. The risk of bias was assessed by utilizing the Joanna Briggs Institute critical appraisal checklist. Study screening and data extraction were conducted by three reviewers independently.
RESULTS
The electronic search retrieved 1276 titles after omitting duplicates. Twenty articles were considered for full-text review, of which six studies were included in this systematic review. The included studies evaluated a total of 173 participants with a mean age of 66.3 years. The overall mini-implant survival rate was 77.1% (95% CI: 64.7-89.5%) with a mean follow-up time of 1.79 years (range: 6 months to 3 years). Implant survival differed significantly when comparing complete and partial palatal coverage overdentures. Those with complete palatal coverage exhibited less bone loss overall compared to partial coverage overdentures. Participants of all studies reported an increase in the quality of life and in satisfaction after rehabilitation treatment with MDIs.
CONCLUSIONS
The survival rate of mini-implants retaining an overdenture in the maxilla was observed to be lower than the values reported for traditional implants in the literature. Improvements were observed in all aspects in terms of patient satisfaction, quality of life, oromyofunction, and articulation after the treatment.
Topics: Aged; Denture, Overlay; Humans; Jaw, Edentulous; Maxilla; Mouth, Edentulous; Quality of Life
PubMed: 33924167
DOI: 10.3390/ijerph18084377 -
The Journal of Prosthetic Dentistry Dec 2022Prosthetic rehabilitation, especially with removable complete dentures (CDs), can contribute to speech problems, although the prevalence of the problem is unclear. (Review)
Review
STATEMENT OF PROBLEM
Prosthetic rehabilitation, especially with removable complete dentures (CDs), can contribute to speech problems, although the prevalence of the problem is unclear.
PURPOSE
The purpose of this systematic review was to examine the influence of implant-supported fixed complete dentures (FCDs), implant-supported overdentures, and removable CDs on speech articulation disorders in patients with at least 1 completely edentulous jaw.
MATERIAL AND METHODS
This study was prepared according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and registered in the International Prospective Register of Systematic Reviews (CRD42020182705). The PubMed/Medline, Embase, Web of Science, Scopus, Latin American and Caribbean Health Sciences, Brazilian Clinical Trials Registry, and Cochrane Library databases were searched through April 2020 to identify clinical trials comparing maxillary and/or mandibular implant-supported dentures with removable CD use in terms of speech articulation in participants with at least 1 completely edentulous jaw. The risk of bias of selected studies was assessed with the Joanna Briggs Institute critical appraisal tools, and the quality of evidence was tested by using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.
RESULTS
Initially, 2586 articles were identified, and their titles and abstracts were read. Sixteen articles were read in full, and 8 studies (4 paired clinical trials and 4 cross-sectional studies) were included in this review. In total, 290 prosthesis users aged 29 to 90 years, approximately 44 of whom had hearing difficulties, were included. Four studies had a low risk of bias, and 4 studies had a high risk of bias. Distortions of the /s/ phoneme were observed more often in the first 6 months of maxillary FCD use than with removable CD use. Speech articulation did not differ between mandibular FCD and removable CD users. The quality of evidence for speech articulation disorders was low.
CONCLUSIONS
Given the low quality of evidence on speech articulation disorders, further research on speech articulation disorders in prosthesis wearers is needed.
Topics: Humans; Dental Prosthesis, Implant-Supported; Speech; Cross-Sectional Studies; Dental Implants; Denture, Complete; Denture, Overlay; Jaw, Edentulous; Articulation Disorders; Patient Satisfaction
PubMed: 33865562
DOI: 10.1016/j.prosdent.2021.03.006 -
BMC Oral Health Mar 2021Immediate loading has recently been introduced into unsplinted mandibular implant-retained overdentures for the management of edentulous patients due to their increasing... (Meta-Analysis)
Meta-Analysis
Effects of immediate and delayed loading protocols on marginal bone loss around implants in unsplinted mandibular implant-retained overdentures: a systematic review and meta-analysis.
BACKGROUND
Immediate loading has recently been introduced into unsplinted mandibular implant-retained overdentures for the management of edentulous patients due to their increasing demand on immediate aesthetics and function. However, there is still a scarcity of meta-analytical evidence on the efficacy of immediate loading compared to delayed loading in unsplinted mandibular implant-retained overdentures. The purpose of this study was to compare the marginal bone loss (MBL) around implants between immediate and delayed loading of unsplinted mandibular implant-retained overdentures.
METHODS
Randomized controlled trials (RCTs), controlled clinical trials (CCTs), and cohort studies quantitatively comparing the MBL around implants between immediate loading protocol (ILP) and delayed loading protocol (DLP) of unsplinted mandibular overdentures were included. A systematic search was carried out in PubMed, EMBASE, and CENTRAL databases on December 02, 2020. "Grey" literature was also searched. A meta-analysis was conducted to compare the pooled MBL of two different loading protocols of unsplinted mandibular overdentures through weighted mean differences (WMDs) with 95% confidence intervals (95% CIs). The subgroup analysis was performed between different attachment types (i.e. Locator attachment vs. ball anchor). The risk of bias within and across studies were assessed using the Cochrane Collaboration's tool, the Newcastle-Ottawa scale, and Egger's test.
RESULTS
Of 328 records, five RCTs and two cohort studies were included and evaluated, which totally contained 191 participants with 400 implants. The MBL of ILP group showed no significant difference with that of DLP group (WMD 0.04, CI - 0.13 to 0.21, P > .05). The subgroup analysis revealed similar results with Locator attachments or ball anchors (P > .05). Apart from one RCT (20%) with a high risk of bias, four RCTs (80%) showed a moderate risk of bias. Two prospective cohort studies were proved with acceptable quality. Seven included studies have reported 5.03% implant failure rate (10 of 199 implants) in ILP group and 1.00% failure rate (2 of 201 implants) in DLP group in total.
CONCLUSIONS
For unsplinted mandibular implant-retained overdentures, the MBL around implants after ILP seems comparable to that of implants after DLP. Immediate loading may be a promising alternative to delayed loading for the management of unsplinted mandibular implant-retained overdentures. PROSPERO registration number: CRD42020159124.
Topics: Alveolar Bone Loss; Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Overlay; Esthetics, Dental; Humans; Immediate Dental Implant Loading; Jaw, Edentulous; Mandible
PubMed: 33731092
DOI: 10.1186/s12903-021-01486-3 -
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 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 -
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 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 -
Journal of Prosthodontic Research Oct 2021Purpose To clarify the rate of posterior residual ridge resorption (PRRR) in different denture treatments and the factors that can affect PRRR.Study selection A...
Purpose To clarify the rate of posterior residual ridge resorption (PRRR) in different denture treatments and the factors that can affect PRRR.Study selection A bibliographical electronic search was conducted on MeSH, Web of Science, and Ovid databases. Hand searching was also conducted. Longitudinal studies recording the average rate of PRRR in the mandible were included. The effect size was calculated based on the mean rate of PRRR with standard deviation and group size. The random-effects analysis was used to perform meta-analyses across qualified studies.Results A total of 2245 eligible studies were collected from the MeSH, Web of Science, and Ovid databases and hand searching. In the end, 19 studies met the inclusion criteria and were extracted. The average rate of PRRR in different mandibular denture treatments was assessed in this systematic review. The mean combined effect size was -1.05 ± 0.5 (95% confidence interval [CI]: -3.18-1.08) between four-implant overdentures and two-implant overdentures. The combined effect size was -0.01 ± 0.22 (95% CI: -0.93-0.82) between complete dentures and two-implant overdentures. Body mass index, number of dentures used, denture wearing habit, impression technique, artificial tooth material, and peri-implant bone resorption showed no significant effect on the rate of PRRR. Gender, denture material, and relining frequency showed a significant effect on the rate of PRRR.Conclusions This review summarized different average rates of PRRR in mandibular denture treatments. Meta-analyses have reported that four-implant overdenture treatments can lower the rate of PRRR compared to two-implant overdenture treatments. However, there was no significant difference in the treatment effect between the complete denture and two-implant overdenture treatments.
Topics: Bone Resorption; Dental Prosthesis, Implant-Supported; Denture, Complete; Denture, Overlay; Humans; Mandible
PubMed: 33281173
DOI: 10.2186/jpr.JPR_D_20_00075 -
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 -
Clinical and Experimental Dental... Apr 2021The World Health Organization (WHO) recognizes edentulism as a physical impairment that results in a negative impact in the daily activities. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The World Health Organization (WHO) recognizes edentulism as a physical impairment that results in a negative impact in the daily activities.
OBJECTIVE
The study aimed to compare the satisfaction and the quality of life, in patients treated with implant retained overdentures with two mandibular implants (IOD) against those with mandibular conventional complete dentures (CCD).
METHODS
Different search strategies were used to screen for articles in Pubmed/Medline, Cochrane Library and Scielo of the last 17 years (2003-2020). The keywords used were: "quality of life OR satisfaction" AND "complete denture OR conventional denture" AND "overdenture OR implant retained."
RESULTS
Six articles and two more were added by manual search. The population was 400 in the CCD and 412 for IOD. The mean age was 64.3 ± 6.41 years. The group was comprised of 283 men and 427 women. The scores obtained in the visual analog scale (VAS) before and after the treatment were statistically significant in favor of the IOD for overall satisfaction, (WMD: 12.329; 95% CI: 4.873 to 19.784, p-value = 0.001), comfort, speech and stability. For esthetics and chewing there was non-significant improvement while hygiene worsened for the IOD. For the comparison after the treatment between both treatment modalities a statistically significant improvement was found in overall satisfaction (WMD: 14.408; 95% CI: 8.589 to 20.226, p-value < 0.001), comfort, speech, chewing and stability in favor of the IOD but not in esthetics or hygiene.
CONCLUSIONS
This systematic review and meta-analysis show the superiority of the IOD, despite is not achieved in all aspects.
Topics: Aged; Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Complete; Denture, Complete, Lower; Denture, Overlay; Female; Humans; Male; Middle Aged; Patient Satisfaction; Personal Satisfaction; Quality of Life
PubMed: 33205918
DOI: 10.1002/cre2.347