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. 2021 Nov 13;7(1):111.
doi: 10.1186/s40729-021-00394-z.

Treatment outcomes of implant-assisted removable partial denture with distal extension based on the Kennedy classification and attachment type: a systematic review

Adityakrisna Yoshi Putra Wigianto  1 , Takaharu Goto  2 , Yuki Iwawaki  1 , Yuichi Ishida  1 , Megumi Watanabe  1 , Tetsuo Ichikawa  1
Affiliations

Treatment outcomes of implant-assisted removable partial denture with distal extension based on the Kennedy classification and attachment type: a systematic review

Adityakrisna Yoshi Putra Wigianto et al. Int J Implant Dent. .

Abstract

Background: Implant-assisted removable partial dentures (IARPDs) have recently become popular, but little information is available on the treatment outcomes based on the Kennedy classification and attachment types.

Objective: The objective of this review was to evaluate the treatment outcomes of IARPD delivered for distal extension edentulous areas based on the differences in the Kennedy classification and attachment type.

Materials and methods: English-language clinical studies on IARPD published between January 1980 and February 2020 were collected from MEDLINE (via PubMed), the Cochrane Library (via the Cochrane Central Register of Controlled Trials), Scopus online database, and manual searching. Two reviewers selected the articles based on pre-determined inclusion and exclusion criteria, followed by data extraction and analysis.

Results: Eighty-one studies were selected after evaluating the titles and abstracts of 2410 papers. Nineteen studies were finally included after the perusal of the full text. Fourteen studies focused on Class I, 4 studies investigated both Class I and II, and only 1 study was conducted on Kennedy's class II. Eight types of attachments were reported. The ball attachment was the most frequently used attachment, which was employed in 8 of the included studies. The implant survival rate ranged from 91 to 100%. The reported marginal bone loss ranged from 0.3 mm to 2.30 mm. The patient satisfaction was higher with IARPD than with conventional RPDs or that before treatment. The results of prosthetic complications were heterogeneous and inconclusive.

Conclusion: IARPD exhibited favorable clinical outcomes when used as a replacement for distal extension edentulous areas. The comparison between the clinical outcomes of Kennedy's class I and II was inconclusive owing to the lack of studies focusing on Kennedy Class II alone. The stud attachment was the most commonly used type in IARPDs. Overall, the different attachment systems did not influence the implant survival rate and patient satisfaction. Further high-quality studies are needed to investigate the attachment systems used in IARPD.

Keywords: Attachment; Dental implant; Implant-assisted removable partial denture; Kennedy classification; Treatment outcomes.

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Conflict of interest statement

All authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Literature review strategy
Fig. 2
Fig. 2
Comparison of the implant survival rate in the included studies based on Kennedy’s classification of the study samples [*Payne et al. reported the survival rates for 3 years and 10 years, separately [30]]
Fig. 3
Fig. 3
Comparison of the mean bone loss between the included studies based on Kennedy classification of the study populations. RA resilient attachment, HA healing abutment, D distal surface, M mesial surface, Conventional conventional sized implant, Mini mini implants
See this image and copyright information in PMC

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