Patient satisfaction and survival of maxillary overdentures supported by four or six splinted implants: a systematic review with meta-analysis

BMC Oral Health

Estefani B. Capcha¹  Corina M. Cristache²  Fabrizio Di Francesco³  Gennaro De Marco³  Alessandro Lanza³  Rolando Vernal⁴  Emilio A. Cafferata⁵ 

[1] Academic Department of Clinical Stomatology, Section of Implant Dentistry, Universidad Peruana Cayetano Heredia, Lima, Peru;Department of Dental Techniques, Faculty of Midwifery and Medical Assisting (FMAM), Carol Davila University of Medicine and Pharmacy, Bucharest, Romania;Multidisciplinary Department of Medical, Surgical and Oral Sciences, School of Dentistry, Campania University Luigi Vanvitelli, Via Luigi De Crecchio 7, 80138, Naples, Italy;Periodontal Biology Laboratory, Faculty of Dentistry, Universidad de Chile, Santiago, Chile;Periodontal Biology Laboratory, Faculty of Dentistry, Universidad de Chile, Santiago, Chile;Department of Periodontology, School of Dentistry, Universidad Científica del Sur, Av. Paseo De La República 5544, Miraflores, Lima, Peru;

关键词: Patient satisfaction;    Overdenture;    Splinted design;    Dental implant;    Systematic review;   

DOI  :  10.1186/s12903-021-01572-6

来源: Springer

【 摘 要 】

BackgroundImplant-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.MethodsCochrane 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.ResultsA 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.ConclusionsWithin 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.

【 授权许可】

CC BY