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Meta-Analysis
. 2021 May 8;21(1):247.
doi: 10.1186/s12903-021-01572-6.

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

Fabrizio Di Francesco #  1 , Gennaro De Marco  2 , Estefani B Capcha  3 , Alessandro Lanza  2 , Corina M Cristache  4 , Rolando Vernal  5 , Emilio A Cafferata #  6   7
Affiliations
Meta-Analysis

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

Fabrizio Di Francesco et al. BMC Oral Health. .

Abstract

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.

Keywords: Dental implant; Overdenture; Patient satisfaction; Splinted design; Systematic review.

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Conflict of interest statement

The authors declare that there is no conflict of interest, any suggestion of plagiarism or copyright infringement regarding the publication of this paper.

Figures

Fig. 1
Fig. 1
Data selection flowchart
Fig. 2
Fig. 2
Forest plot of the dental implants survival risk ratios when using 4 versus 6 splinted implants for supporting overdentures
Fig. 3
Fig. 3
Forest plot of the overdentures survival risk diferences when using 4 versus 6 splinted implants for supporting them
Fig. 4
Fig. 4
Dental implants and overdentures survival rates when using 4 or 6 splinted implants
See this image and copyright information in PMC

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