-
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 -
Journal of Applied Oral Science :... 2023Currently, there is no consensus on the indications and clinical performance of implant-supported overdentures (IODs) involving computer-aided design and manufacturing... (Meta-Analysis)
Meta-Analysis
UNLABELLED
Currently, there is no consensus on the indications and clinical performance of implant-supported overdentures (IODs) involving computer-aided design and manufacturing (CAD-CAM) bars.
OBJECTIVE
To evaluate the performance of IODs involving CAD-CAM bars.
METHODOLOGY
A comprehensive search of studies published until May 2023 was conducted in many databases, including PubMed/MEDLINE, Web of Science, Cochrane Library, and SciELO, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The population, intervention, comparison, outcome (PICO) question was: "How do IODs retained by bars fabricated by CAD-CAM technology perform in daily clinical practice?" The meta-analysis included clinical studies based on effect size and a two-tailed null test with a 95% confidence interval (CI).
RESULTS
Ten studies were included in the meta-analysis. Among them, nine reported a 100% implant survival rate for all CAD-CAM milled bars. Complications were reported in two studies with CAD/CAM-milled titanium bars, and one study reported more fractures in soldered gold bars used in maxillary rehabilitation. However, no fractures were observed in IODs retained by PEEK and zirconia bars. According to six studies, biological complications, including peri-implantitis, were minimal in the BioHPP and PEEK bar groups, while no cases were reported in the titanium or zirconia bar groups. CAD-CAM-milled zirconia bars had higher plaque and bleeding indices compared with titanium bars, as evidenced by findings from five studies. All four studies that evaluated Oral Health Impact Profile (OHIP) scores showed a positive effect of IODs retained by CAD-CAM milled titanium bars on quality of life. Patient satisfaction and acceptance by prosthodontists were significantly high, according to the results of five studies.
CONCLUSION
Overdentures retained with CAD-CAM milled titanium bars show great potential for use in daily clinical practice. Moreover, patient and practitioner satisfaction was very high when this method was used.
Topics: Humans; Denture, Overlay; Quality of Life; Titanium; Computer-Aided Design
PubMed: 37646715
DOI: 10.1590/1678-7757-2023-0054 -
Stomatologija 2008Implant loading time is considered to influence the treatment outcomes. Number of experimental studies have shown that implant loading up to 3 months can produce equally... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
Implant loading time is considered to influence the treatment outcomes. Number of experimental studies have shown that implant loading up to 3 months can produce equally satisfactory results. However, research results in this area are not consistent. The purpose of the study was to investigate the influence of conventional and early loading of two-implant supported mandibular overdentures on treatment outcomes.
METHODS
The articles from 1985 to 2007 in English related to the topic were identified. Totally 221 (214 online and 7 printed) primary articles were detected. Eight articles were selected for data extraction. Implant survival and success rates, periimplant parameters, prosthetic maintenance and patient satisfaction were considered.
RESULTS
Implant success rate ranged from 83% to 100% in conventional loading group and from 71% to 100% in early loading group. During the first year in conventional group, the marginal bone loss ranged from 0.35 to 0.91 mm, during the second year--from zero to 0.2 mm, whereas in early loading group these intervals were 0.12-1 mm and 0-0.15 mm, respectively. Comparing averaged probing depth values at different time periods, it could be noticed that around conventionally loaded implants probing depth slightly decreased (from 1.62 mm to 1.56 mm), while around early loaded implants--increased from 1.7 mm to 1.82 mm.
CONCLUSIONS
Considering implant success rates and peri-implant parameters early loading protocol produces equal outcomes as with conventional loading. More well designed studies are needed to further substantiate the early loading protocol.
Topics: Dental Abutments; Dental Implantation, Endosseous; Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Complete, Lower; Denture, Overlay; Humans; Mandible; Patient Satisfaction; Periodontal Diseases; Survival Analysis; Treatment Outcome
PubMed: 18708737
DOI: No ID Found -
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 -
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 -
Brazilian Oral Research 2014This systematic review evaluated the influence played by the number of implants on the results of rehabilitation treatment with mandibular overdentures on 2 or 4... (Review)
Review
This systematic review evaluated the influence played by the number of implants on the results of rehabilitation treatment with mandibular overdentures on 2 or 4 implants. The literature search was conducted using PubMed, Embase and Cochrane databases. Specific terms were used in performing a search from January 1980 to January 2013. The search strategy was applied by two reviewers who extracted the data and compared the results. Discrepancies were resolved by discussion. Great heterogeneity was seen among the selected studies, in regard to survival rates, prosthesis failure and function rates. A medium degree of quality and methodological consistency was found in one study, and no studies showed a high degree. When considering the prosthesis success rate for 2 implants, there was a variation of 23% to 100%. However, when considering the survival rate, the result was 92% to 100%. For 4 implants, prosthesis survival rates showed less variation, i.e., 97.7% to 100%. Ball attachments were the most common type of abutment for 2 implants; however, there was a higher prevalence of bar abutments for 4 implants. Rehabilitations with 2 implants showed more complications and required more maintenance according to the connection type. Given the limitations of this review, mandibular overdentures with 4 implants showed better results with respect to survival and success rates, especially those with a bar connection. Further studies comparing these two treatment types are necessary to improve the scientific evidence in this area.
Topics: Dental Implantation, Endosseous; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Denture, Complete, Lower; Denture, Overlay; Humans; Jaw, Edentulous; Treatment Outcome
PubMed: 24402059
DOI: 10.1590/S1806-83242013000600012 -
Journal of Prosthodontic Research Jul 2022To evaluate the effect of overdenture (OD) attachment type and the number of implants supporting mandibular ODs on peri-implant health. (Meta-Analysis)
Meta-Analysis
PURPOSE
To evaluate the effect of overdenture (OD) attachment type and the number of implants supporting mandibular ODs on peri-implant health.
STUDY SELECTION
From inception to October 2020, electronic databases (Medline/PubMed, Embase, Cochrane Library, and Scopus) were systematically searched. The outcomes of interest were marginal bone loss (MBL), pocket probing depth (PPD), plaque index, bleeding index, and implant survival rate. Bayesian network meta-analysis was performed using the GeMTC package supported by R. The weighted mean difference and 95% credible interval were estimated.
RESULTS
Twenty-eight studies with a total of 1166 participants who received 2666 dental implants were included. Except for 4 bar and 4 telescopic, which showed a statistically lower MBL than the 2 locator, all other interventions showed insignificant differences in MBL (P > 0.05). The difference in periodontal probing depth was not statistically significant when comparing the different groups. The pooled implant survival rates of the different interventions ranged from 88.9% to 100%. The rank probability test showed that 4 bar and 4 telescopic had the lowest MBL, 2 magnet and 2 bar had the highest PI, whereas 4 locator showed the least PPD.
CONCLUSION
Except for 4 implants+bar, or telescopic, and 4 locator that, respectively, showed less MBL and PPD compared to some interventions, it seemed that different attachment types and number of implants supporting mandibular ODs have no clear superiority over the other in terms of peri-implant health outcomes.
Topics: Bayes Theorem; Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Overlay; Humans; Jaw, Edentulous; Mandible; Network Meta-Analysis
PubMed: 34588403
DOI: 10.2186/jpr.JPR_D_21_00073 -
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 -
Dento Maxillo Facial Radiology 2014The objectives for this systematic review were to determine if the pre-operative availability of cross-sectional imaging, such as cone beam CT, has a diagnostic impact,... (Review)
Review
The objectives for this systematic review were to determine if the pre-operative availability of cross-sectional imaging, such as cone beam CT, has a diagnostic impact, therapeutic impact or impact on patients' outcome when placing two dental implants in the anterior mandible to support an overdenture. The Cochrane Oral Health Group's Trials Register (CENTRAL), MEDLINE® and Embase were searched up to, and including, February 2013. Studies were considered eligible for inclusion if they compared the impact of conventional and cross-sectional imaging when placing dental implants in sites including the anterior mandible. An adapted quality assessment tool was used for the assessment of the risk of bias in included studies. Pooled quantitative analysis was not possible and, therefore, synthesis was qualitative. Of 2374 potentially eligible papers, 5 studies were included. Little can be determined from a synthesis of these studies because of their small number, clinical diversity and high risks of bias. Notwithstanding, it may be tentatively inferred that cross-sectional imaging has a therapeutic impact in the more challenging cases. In terms of impact, this review has found no evidence to support any specific imaging modality when planning dental implant placement in any region of the mouth. Therefore, those who argue that cross-sectional imaging should be used for the assessment of all dental implant sites are unsupported by evidence.
Topics: Dental Implantation, Endosseous; Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Overlay; Humans; Imaging, Three-Dimensional; Jaw, Edentulous; Mandible; Patient Care Planning; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 24271462
DOI: 10.1259/dmfr.20130321 -
The Journal of Advanced Prosthodontics Nov 2012The aim of this systematic review was to address treatment outcome according to attachment systems for mandibular implant overdentures in terms of implant survival rate,...
PURPOSE
The aim of this systematic review was to address treatment outcome according to attachment systems for mandibular implant overdentures in terms of implant survival rate, prosthetic maintenance and complications, and patient satisfaction.
MATERIALS AND METHODS
A systematic literature search was conducted using PubMed and hand searching of relevant journals considering inclusion and exclusion criteria. Clinical trial studies on mandibular implant overdentures until August, 2010 were selected if more than one type of overdenture attachment was reported. Twenty four studies from 1098 studies were finally included and the data on implant survival rate, prosthetic maintenance and complications, patient satisfaction were analyzed relative to attachment systems.
RESULTS
Four studies presented implant survival rates (95.8 - 97.5% for bar, 96.2 - 100% for ball, 91.7% for magnet) according to attachment system. Ten other studies presented an implant survival rate ranging from 93.3% to 100% without respect to the attachment groups. Common prosthetic maintenance and complications were replacement of an assay for magnet attachments, and activation of a matrix or clip for ball or bar attachments. Prosthetic maintenance and complications most commonly occurred in the magnet groups. Conflicting findings were found on the rate of prosthetic maintenance and complications comparing ball and bar attachments. Most studies showed no significant differences in patient satisfaction depending upon attachment systems.
CONCLUSION
The implant survival rate of mandibular overdentures seemed to be high regardless attachment systems. The prosthetic maintenance and complications may be influenced by attachment systems. However patient satisfaction may be independent of the attachment system.
PubMed: 23236571
DOI: 10.4047/jap.2012.4.4.197