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Quintessence International (Berlin,... 2020To investigate bone loss in the anterior edentulous maxilla restored with maxillary complete dentures and opposed by mandibular two-implant-supported overdentures... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To investigate bone loss in the anterior edentulous maxilla restored with maxillary complete dentures and opposed by mandibular two-implant-supported overdentures (2-IODs) or complete dentures.
METHOD AND MATERIALS
A systematic search was conducted using the Ovid MEDLINE, Embase, Web of Science, CINAHL, and Cochrane databases for studies investigating bone loss in the anterior edentulous maxilla with mandibular 2-IODs or complete dentures. Two reviewers assessed the eligibility of studies and risk of bias assessment was conducted according to the Newcastle-Ottawa Scale. A meta-analysis was performed using statistical software to estimate weighted mean difference in bone loss with 95% confidence interval (CI). The level of significance was defined as P value (< .05).
RESULTS
A total of 2,510 studies were identified through electronic and manual searching. Six studies were selected and compounded for quantitative synthesis of 163 patients. Bone loss in the anterior edentulous maxilla was greater with 2-IODs than with complete dentures. The total estimate of weighted mean difference between 2-IODs and complete dentures was -1.40 (95% CI -3.12 to 0.31). However, the difference was not statistically significant (P = .11). The data were heterogenous across the studies based on chi-square statistics (χ2 [df = 7] = 52.75, P < .0001; τ2 = 5.53, I2 = 95.21%). In addition, the impact of implant splinting on bone loss was not significant (P > .29). None of the included studies were considered to be at high risk of bias.
CONCLUSION
Within the limitations of the current systematic review and meta-analysis, the estimate of bone loss in the anterior edentulous maxilla was greater with 2-IODs than with complete dentures. However, the difference was not statistically significant. A well-designed randomized clinical study needs to be conducted to validate the results of this systematic review.
Topics: Dental Prosthesis, Implant-Supported; Denture, Complete; Denture, Overlay; Humans; Jaw, Edentulous; Mandible; Maxilla
PubMed: 32696032
DOI: 10.3290/j.qi.a44928 -
The Journal of Prosthetic Dentistry May 2021Evidence provided by implant-supported mandibular overdenture research on different loading protocols is important. However, methodological inconsistency, as well as... (Meta-Analysis)
Meta-Analysis
STATEMENT OF PROBLEM
Evidence provided by implant-supported mandibular overdenture research on different loading protocols is important. However, methodological inconsistency, as well as inadequate reporting of results, hampers a consistent decision in terms of clinical applicability.
PURPOSE
The purpose of this systematic review and meta-analysis was to evaluate whether immediate or early loading protocols can achieve comparable clinical outcomes when compared with a conventional loading protocol in edentulous patients rehabilitated with mandibular overdentures.
MATERIAL AND METHODS
In accordance with the Participant, Intervention, Comparison, Outcome strategy, prospective clinical studies without restrictions as to language or follow-up period were included. The Cochrane collaboration and ROBINS-I tools were used for quality assessment and risk-of-bias evaluation. The follow-up for the different outcomes ranged from 3 to 168 months, with the focus on implant success and survival rates, marginal bone loss, bleeding on probing, probing depth, plaque index, and the implant stability quotient. Statistical analyses in which standard mean differences were applied with a 95% confidence interval when continuous data were included were performed. For dichotomous data, risk difference was adopted.
RESULTS
The search strategy resulted in 14 234 references. Twenty-three studies fulfilled the inclusion criteria. Meta-analysis showed statistically significant differences for plaque index at 12 months (standard mean difference=0.284 [0.022, 0.545], P=.033, I=35%), probing depth at 36 months (standard mean difference=0.460 [0.098, 0.823], P=.013, I=0%), and on pooled results for plaque index (standard mean difference=0.157 [0.031, 0.284], P=.015, I=18%) in which the conventional loading protocol presented lower indices than those of immediate loading protocol or early loading protocol. Implant stability quotient presented a statistically significant difference only at 3 months (standard mean difference=0.602 [0.309, 0.895], P<.001, I=0%) with higher values for the conventional loading protocol. For the other parameters, statistically significant differences (P>.05) were not found.
CONCLUSIONS
Immediate loading protocol or early loading protocolfor mandibular overdentures has been determined to be a well-established treatment and worthy of consideration in clinical practice.
Topics: Dental Implantation, Endosseous; Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Overlay; Humans; Immediate Dental Implant Loading; Jaw, Edentulous; Mandible; Prospective Studies; Treatment Outcome
PubMed: 32684353
DOI: 10.1016/j.prosdent.2020.04.017 -
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 -
Quintessence International (Berlin,... 2020To evaluate the influence of implant splinting on peri-implant marginal bone level and implant failures in completely edentulous patients who have been rehabilitated... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
To evaluate the influence of implant splinting on peri-implant marginal bone level and implant failures in completely edentulous patients who have been rehabilitated with mandibular implant overdentures.
METHOD AND MATERIALS
A literature search of electronic databases (PubMed and Cochrane Central Register of Controlled Trials [CENTRAL]) was performed, with the last search conducted in July 2019. Randomized controlled trials with at least a 12-month follow-up period were selected. The review and meta-analysis were performed in accordance with PRISMA guidelines. Two comparisons were included in the meta-analysis: (1) Two-implant supported ball versus two-implant supported bar mandibular overdenture; (2): Two- versus four-implant supported bar mandibular overdenture.
RESULTS
Six randomized controlled trials fulfilled the inclusion criteria and were included in a quality assessment and meta-analysis. Pooled data revealed a nonsignificant difference in marginal bone level (I2 = 0%; P = 1; mean difference = 0.00; 95% CI -0.37 to 0.37) and implant failures (P = .24; risk ratio = 6.07; 95% CI 0.30 to 121.33) when two-implant ball overdentures were compared to two-implant bar overdentures. Similarly, there was no significant difference in marginal bone level (I2 = 59%; P = .59; mean difference = -0.16; 95% CI -0.73 to 0.41) or implant failures (I2 = 0%; P = .36; risk ratio = 2.03; 95% CI 0.45 to 9.16) when two- versus four-implant bar overdentures were compared.
CONCLUSION
Based on the findings of the meta-analysis, there is no influence of implant splinting on peri-implant marginal bone level and implant failures for completely edentulous patients rehabilitated with mandibular implant overdentures. However, this result should be interpreted with caution due to the limited number of analyzed studies, most of them considered at unclear risk of bias. Well-designed randomized controlled trials with follow-up periods of at least 5 years are highly recommended to establish evidence with regard to the influence of implant splinting on mandibular overdentures.
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Overlay; Humans; Jaw, Edentulous; Mandible; Mouth, Edentulous; Randomized Controlled Trials as Topic
PubMed: 32080685
DOI: 10.3290/j.qi.a44144 -
Clinical Oral Implants Research Apr 2020This review evaluated the change in treatment outcomes after conversion from conventional removable partial denture (RPD) to implant-assisted removable partial denture... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
This review evaluated the change in treatment outcomes after conversion from conventional removable partial denture (RPD) to implant-assisted removable partial denture (IARPD). The patient-reported outcome measures (PROMs), objective parameters for evaluation of functional performance, and biological and mechanical complication were evaluated.
MATERIALS AND METHODS
This systematic review was based on the Cochrane review methodology and followed the criteria of the preferred reporting items for systematic reviews and meta-analyses (PRISMA). We searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, Web of Science, and Scopus up to April 3, 2019. After the initial search, additional electronic and hand searches were performed to identify further studies, ongoing studies, and gray literature, without restrictions on language, year of publication, or publication type.
RESULTS
In total, 6,544 non-duplicate articles were identified, and 31 were eligible for full-text search. Finally, 19 publications based on 13 independent studies were selected. In the meta-analysis, general patient satisfaction was significantly increased (p < .05), and the improved mastication was remarkable oral function. In oral health-related quality of life, the oral health impact profile score was significantly improved, and improvements of physical pain and psychological disability were prominent (p < .05). Masticatory performance was improved in terms of maximum bite force, active occlusal contact area, and mandibular jaw movement (p < .05). The weighted mean survival rate of implants was 96.60%.
CONCLUSIONS
After conversion from conventional RPD to IARPD, the PROMs and masticatory performance significantly improved in partially edentulous patients under mandibular Kennedy classification I.
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Partial, Removable; Humans; Mandible; Mastication; Patient Satisfaction; Quality of Life
PubMed: 31945212
DOI: 10.1111/clr.13574 -
Clinical Oral Investigations Mar 2020The aim of this systematic review was to investigate the predictability of the sandwich osteotomy technique to provide sufficient alveolar bone height for dental implant...
OBJECTIVES
The aim of this systematic review was to investigate the predictability of the sandwich osteotomy technique to provide sufficient alveolar bone height for dental implant therapy in vertically atrophic jaws.
MATERIAL AND METHODS
A MEDLINE (Pubmed), EMBASE and Cochrane Library electronic search and a manual search were performed until July 2018. Any clinical study published in English, reporting data on at least 10 patients rehabilitated with implant-supported dental prostheses after vertical ridge augmentation by means of the sandwich osteotomy technique and followed for at least 12 months after loading, was included. Data on study and patients' characteristics, interventions provided, implant and prostheses survival rates and complications were extracted from the included studies. Each study design was evaluated using the Cochrane Collaboration's tool for assessing risk of bias.
RESULTS
Initially, 415 records were identified, from which 10 full-text articles could be included in the final qualitative analysis. Implant survival rate after a mean follow-up of 3.7 years (median: 3 years; range: 1-7 years) was 94% (median: 93%; range: 91-100%). Peri-implant mean marginal bone resorption was 1.6 mm (median: 1.4 mm; range: 0.6-4.7 mm). The calculated mean alveolar bone height available at the time of implant placement was 11.3 mm (median: 11.5 mm; range: 7.8-16 mm). A temporary sensory disturbance of the inferior alveolar nerve was the most commonly reported complication following the sandwich osteotomy.
CONCLUSIONS
The present systematic review documents that implant survival rate after mandibular vertical ridge augmentation using the sandwich osteotomy technique is high after up to 5 years of loading. The complication rate can be considered moderate and has predominantly a transient nature. Data on the long-term behavior of the augmented bone and inserted implants are missing.
CLINICAL RELEVANCE
The present technique can be considered a reliable treatment option in cases of moderate vertical bone deficiency of the posterior mandible to provide suitable conditions for later implant placement. Intra- and post-operative complications do not seem to jeopardize the final outcome.
Topics: Alveolar Bone Loss; Alveolar Ridge Augmentation; Bone Transplantation; Dental Implantation, Endosseous; Dental Implants; Dental Prosthesis Design; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Humans; Osteotomy; Treatment Outcome
PubMed: 31927693
DOI: 10.1007/s00784-019-03183-6 -
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 Jul 2020Consensus is lacking regarding the influence of the maxillary dentition on the survival rate of a mandibular metal-resin implant-supported fixed complete denture... (Meta-Analysis)
Meta-Analysis
Does the natural maxillary dentition influence the survival rate of mandibular metal-resin implant-supported fixed complete dentures? A systematic review and meta-analysis.
STATEMENT OF PROBLEM
Consensus is lacking regarding the influence of the maxillary dentition on the survival rate of a mandibular metal-resin implant-supported fixed complete denture (MRISFCD) with distal cantilevers.
PURPOSE
The purpose of this systematic review was to identify whether an opposing natural dentition influences the survival rate of mandibular MRISFCDs.
MATERIAL AND METHODS
A literature search was performed up to February 2018 from MEDLINE/PubMed, Scopus, Web of Science, Cochrane Library, BBO/LILACS databases and also in the non-peer-reviewed literature through Open Grey. Clinical studies regarding natural (ND), removable prostheses (RP), and complete fixed maxillary implant dentitions (ID) with at least a year of follow-up were included. The quality of the included studies was analyzed, and the risk of bias was reported. A meta-analysis comparing the survival rate of ND with RP and ND with ID was performed with a confidence interval (CI) of 95%, and heterogeneity was tested by an I index. Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach was used to determine the certainty of the evidence.
RESULTS
From a total of 112 ND, 69 ID, and 204 RP in the maxillary dentition, the overall prevalence of failures was 5.4% (6/112; 95% CI [2.3 to 10.76]) for ND, 13.99% (20/69; 95% CI [0.77 to 39.41]) for ID, and 4.9% (10/204; 95% CI [0.69 to 12.18]) for RP. No statistical differences were detected in the success rates between ND and RP (risk difference = 0.00 [-0.06, 0.06]; P=.93; I=27%) or between ND and ID (risk difference=0.00 [-0.06, 0.07]; P=.97; I=0%), both with moderate evidence.
CONCLUSION
With a moderate certainty of evidence, it is suggested that natural maxillary dentitions do not affect the survival rate of mandibular MRISFCDs differently from other prosthetic designs.
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Dentition; Denture, Complete; Metals; Survival Rate
PubMed: 31753454
DOI: 10.1016/j.prosdent.2019.06.018 -
The British Journal of Oral &... Jun 2019The aim of this systematic review (for which we followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines) was to provide an overview of...
The aim of this systematic review (for which we followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines) was to provide an overview of the protocols and clinical outcomes of dental implants placed in growing jaws. We searched the MEDLINE/PubMed, Embase, Scopus, and Science Direct databases in October and November, 2017. A total of 3492 studies were identified, and all the studies reporting the outcomes of dental implants placed during the growth phase were included in the study. After duplicates had been removed, 2133 studies were screened based on their titles and abstracts, and 162 were selected for reading. Finally, 28 studies were included in the review. Overall, 493 dental implants were placed in 147 patients aged from 3-18 years old with follow-up being from 1-20 years. The most common disorders seen that were associated with missing teeth were ectodermal dysplasia and dental trauma. The main complications reported were the infraocclusion positioning of dental implants in the maxillary arch and the rotation of dental implants in the mandibular arch. Dental implants were indicated for the anterior regions of the maxilla and mandible in patients over 10 years old, and placement of maxillary implants in a more coronal position was recommended. Consultations and adjustments to prostheses were required until growth had ceased. In growing jaws, dental implants require positional modifications, and they should be considered only under special circumstances.
Topics: Adolescent; Anodontia; Child; Child, Preschool; Dental Implantation, Endosseous; Dental Implants; Dental Prosthesis, Implant-Supported; Humans; Mandible; Maxilla; Maxillofacial Development
PubMed: 31076220
DOI: 10.1016/j.bjoms.2019.04.011 -
Survival of Mini Dental Implants Used to Retain Mandibular Complete Overdentures: Systematic Review.The International Journal of Oral &... 2019To evaluate the survival rate of mini implants used to retain mandibular overdentures.
PURPOSE
To evaluate the survival rate of mini implants used to retain mandibular overdentures.
MATERIALS AND METHODS
An electronic search, supplemented by hand searching of the references, was conducted with no time or language restriction in October 2016 and updated in October 2017. The results were reviewed independently by the two authors. All randomized controlled trials, clinical trials, observational studies, and case series were included. The primary outcome measure was implant survival (months).
RESULTS
The search retrieved a combined total of 391 articles. Following screening, 17 articles were included. A total of 1,715 mini implants were assessed in 475 patients. Follow-up periods ranged from 6 to 84 months (mean: 28.24 months). There were 75 failures in total. The overall survival rate was 95.63%. The majority of patients received four implants to retain their prostheses. Most studies used a flapless surgical technique, but there were vast differences in loading protocols and retention methods. Formal meta-analysis was not conducted due to the heterogeneity between studies.
CONCLUSION
Based on the findings of this systematic review, mini dental implants exhibit excellent survival rates in the short to medium term. They appear to be a reasonable alternative treatment modality to retain mandibular complete overdentures from the available evidence.
Topics: Dental Implantation, Endosseous; Dental Implants; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Denture, Overlay; Humans; Mandible; Mouth, Edentulous; Prosthesis Fitting
PubMed: 30883617
DOI: 10.11607/jomi.6991