ABSTRACT
Objective: To evaluate and compare prosthesis and implant survival in case of interim fixed complete dentures reinforced with fiber resin frameworks versus those that were not reinforced with any framework in case of immediately loaded full arch restorations in completely edentulous patients. Material and Methods: Thirty completely edentulous patients were randomly allocated into two parallel arm groups. Non-reinforced control group in which patients received non-reinforced all-on-four immediately loaded fixed complete denture and Fiber reinforced group in which patients received all-on-four fixed complete denture supported with glass-fiber reinforced resin framework. Prosthesis and implant survival were clinically evaluated after 4 months follow up period. Results: A statistically significant difference for prosthesis (p = 0.032) and implant survival (p = 0.031) was found between both groups. The fiber-reinforced group showed 100% prosthesis survival and 95% implant survival. On the other hand, the non-reinforced group showed 73.3% prosthesis survival and 81.1% implant survival. Conclusion: Based on the findings of this study, it can be concluded that strengthening the fixed full arch restorations with fiber reinforced frameworks can help overcoming the problem of interim prosthesis fracture during the osseointegration period when used for immediate loading in completely edentulous patients. It can also improve the survival of the immediately loaded implants. (AU)
Objetivo : Avaliar e comparar a sobrevivência de próteses e implantes no caso de próteses totais fixas provisórias reforçadas com estruturas de resina de fibra versus aquelas que não foram reforçadas com nenhuma estrutura no caso de restaurações de arcada completa com carga imediata em pacientes completamente desdentados. Material e Métodos : Trinta pacientes completamente desdentados foram alocados aleatoriamente em dois grupos de braços paralelos. Grupo controle não reforçado, no qual os pacientes receberam prótese total fixa (all-on-four) não reforçada, com carga imediata e grupo reforçado com fibra, no qual os pacientes receberam prótese total fixa (all-on-four), suportada com estrutura de resina reforçada com fibra de vidro. A sobrevivência da prótese e do implante foi avaliada clinicamente após 4 meses de acompanhamento. Resultados : Foi encontrada diferença estatisticamente significante para prótese (p=0,032) e sobrevivência do implante (p=0,031) entre os dois grupos. O grupo reforçado com fibra apresentou 100% de sobrevivência da prótese e 95% de sobrevivência do implante. Por outro lado, o grupo não reforçado apresentou 73,3% de sobrevivência da prótese e 81,1% de sobrevivência do implante. Conclusão: Com base nos achados deste estudo, pode-se concluir que o fortalecimento das restaurações fixas de arcada completa com estruturas reforçadas com fibras pode ajudar a superar o problema da fratura da prótese provisória durante o período de osteointegração quando usada para carga imediata em pacientes completamente desdentados. Também pode melhorar a sobrevivência dos implantes carregados imediatamente (AU).
Subject(s)
Humans , Male , Female , Dental Implants , Dental Prosthesis , Dental Restoration, Permanent , Denture, CompleteABSTRACT
BACKGROUND: Prosthetic treatment of the posterior edentulous maxilla may require bone augmentation to enable the placement and integration of dental implants. This constitutes a complex healing situation, and resorption of the grafted bone and failure of the implants often occurs. The application of platelet-rich plasma (PRP) has been suggested to improve incorporation and preservation of bone grafts. OBJECTIVE: The objective was to assess the effectiveness of PRP on the implant failure and complication rate, when used as an adjunctive material with bone graft in sinus floor augmentation. METHOD AND MATERIALS: An electronic search of two databases (PubMed and Cochrane) was performed to identify randomized controlled trials (RCTs) in patients requiring sinus augmentation and implant placement in the posterior edentulous maxilla with or without using PRP as an adjunctive material to the bone graft. Data were extracted independently by two reviewers. The Cochrane tool was used for assessing the quality of included studies. Meta-analysis was performed for the included RCTs. RESULTS: Nine RCTs were identified, four of which were included in the study. Three of these trials were judged to be at unclear risk of bias and one was at low risk of bias. The meta-analysis revealed no difference between the PRP versus non-PRP groups regarding implant failure and complication rate. CONCLUSION: The meta-analysis revealed no statistically significant difference regarding implant failure and complication rate of implants placed in the atrophic posterior maxilla with sinus floor augmentation with or without PRP as an adjunctive material to the bone graft. This finding should be interpreted with great caution given the serious numerical limitations of the included studies.
Subject(s)
Bone Transplantation/methods , Dental Implantation, Endosseous , Dental Implants , Platelet-Rich Plasma , Sinus Floor Augmentation/methods , Dental Restoration Failure , Humans , Postoperative Complications/prevention & controlABSTRACT
BACKGROUND: Implant-supported overdenture is one of the most predictable treatment options used in complete edentulism. However, differences have been reported between bar and ball attachments used to retain overdentures in terms of patient satisfaction and prosthesis retention. PURPOSE: The purpose of this study is to compare the effectiveness of bar and ball attachments for conventionally loaded implant-supported overdentures in completely edentulous patients to improve patient satisfaction and prosthesis retention. MATERIALS AND METHODS: We conducted the review according to the Cochrane methods and following MECIR standards. We searched Cochrane Oral Health Group Trial register, Cochrane Central Register of Controlled Trials, MEDLINE, and the WHO ICTRP (March 31, 2017). Two review authors assessed trials for inclusion and risk of bias, extracted data, and checked for accuracy. We have expressed results as risk ratio or mean differences, together with their 95% confidence intervals. RESULTS: We included 10 trials (465 participants). After 5 y, one trial reported higher patient satisfaction when bar attachment was used (MD 1.30, 95% CI 0.20-2.40), and reported no difference between both systems in prosthesis retention (MD -0.90, 95% CI -1.90 to 0.10). Two trials reported no implant failures after 1 and 5 y in both attachments. Downgrading of evidence was based on the unclear risk of bias of included studies and the wide CI crossing the line of no effect. CONCLUSIONS: There is insufficient evidence to support bar or ball attachment to be used with implant-supported overdentures in completely edentulous patients to improve patient satisfaction and prosthesis retention (PROSPERO 2014:CRD42014014594).
Subject(s)
Dental Prosthesis Design , Dental Prosthesis, Implant-Supported , Denture Retention/instrumentation , Denture, Overlay , Denture Retention/methods , Female , Humans , Male , Mouth, Edentulous/rehabilitationABSTRACT
The mandibular implant-retained overdentures (MIRO) are a highly successful prosthetic treatment option. However, an argument still present regarding its design and type of attachment system. This systematic review and meta-analysis aimed to perform a qualitative and quantitative analysis of the scientific literature regarding the telescopic attachments versus other attachment systems retaining mandibular implant overdentures. Manual and electronic database (PubMed and Cochrane) searches were performed to identify randomized controlled trials (RCTs) comparing telescopic versus other attachment systems. Independently, two investigators extracted the trials' data. The Cochrane tool was used for assessing the quality of included studies. Meta-analyses were performed for the included RCTs and reported the same outcome measures. Nine RCTs were identified. Three RCTs (corresponding to four publications) were included in the study. The other five trials were excluded from the study. The meta-analysis revealed no difference between telescopic crowns and ball attachment retaining mandibular implant overdenture as regards prosthodontic maintenance. Regarding peri-implant conditions, ball-retained mandibular overdenture showed statistically significant more probing depth around implants records in ball-retained overdenture when compared to the telescopic group. However, there are no statistically significant differences between two interventions in regard to marginal bone loss, bleeding index, gingival index, and plaque index. In conclusions, no significant differences in prosthodontic maintenance and peri-implant condition between telescopic attachments and ball attachments retaining MIRO. However, this should be considered with caution because of a limited number of included studies.
ABSTRACT
BACKGROUND: As a consensus, the 2-implant supported overdentures (ODs) are considered as the first choice of treatment for the edentulous mandible. In the same context, there is increased evidence supporting the use of single-implant OD. The aim of any design is to preserve the remaining structures and allow the longevity of the treatment. OBJECTIVES: To evaluate the impact of single implant vs 2 implants on the peri-implant marginal bone loss (MBL) and number of implant failures in mandibular implant overdentures. METHODS: A literature search of electronic databases (PubMed and Cochrane) was performed up to March 2016 and complemented by hand search. Randomized clinical trials (RCTs) that evaluated MBL and number of implant failures relative to single-implant mandibular overdenture (MOD) were selected. The review and meta-analysis were performed using meta-analytic statistical package and in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. FINDINGS: Five RCTs met the inclusion criteria for systematic review and qualitative synthesis. The observation period ranged from 12 months to 5 years in the selected RCTs. The comparison included in the meta-analysis is single- vs 2-implant MODs. Pooled data revealed that single-implant MODs significantly decreased the MBL (mean difference: 0.27, 95% confidence interval: 0.20-0.34, P < .0001, I2 = 0%) and number of implant failures (risk ratio: 3.26, 95% confidence interval: 1.18-8.97), P = .02; I2 = 0%). CONCLUSIONS: Single-implant MOD was found to be better than 2-implant MOD in terms of MBL and number of implant failures. However, this result should be interpreted with caution due to limited number of analyzed studies with different loading protocols and short follow-up period.
Subject(s)
Alveolar Bone Loss , Dental Implants , Dental Implantation, Endosseous , Dental Prosthesis, Implant-Supported , Denture, Overlay , Humans , MandibleABSTRACT
PURPOSE: To compare prosthesis and implant failure, patient satisfaction, prosthetic complications and peri-implant marginal bone loss of mandibular overdentures (IOD) supported by a single or two implants. MATERIALS AND METHODS: Manual and electronic database (PubMed and Cochrane) searches were performed to identify randomised controlled trials, without language restriction, comparing single vs two implant supported mandibular overdentures. Two investigators extracted data independently. The Cochrane tool was used for assessing the quality of included studies. Meta-analyses were performed for the included RCTs. RESULTS: Six publications corresponding to four RCTs were identified. Three RCTs (corresponding to five publications) were included and one trial was excluded. Follow-ups in function were 1, 3 and 5 years after loading. All included studies were considered to be at a high risk of bias. The pooled result revealed more prosthesis failures at overdentures supported by two implants at 1 year (three trials) (P = 0.02; Risk Difference: -0.12, 95% CI: -0.22, -0.02), however, there were non-significant differences at 3 years (two trials) (P = 0.22; Risk Difference: -0.32, 95% CI: -0.83, 0.19) and at 5 years (one trial) (P = 0.95; Risk Difference: 0.01, 95% CI: -0.22, 0.24). Regarding implant failures, there were more implant losses in overdentures supported by two implants at 1 year (three trials) (P = 0.02; Risk Difference: -0.12, 95% CI: -0.22, -0.02) and at 5 years (one trial) (P = 0.95; Risk Difference: -0.15, 95% CI: -0.28, -0.02), however, there were non-significant difference at 3 years (two trials) (P = 0.2; Risk Difference: -0.33, 95% CI: -0.84, 0.18). After 5 years in function, meta-analyses revealed that there were non-significant differences regarding overall prosthetic complications when mandibular overdentures supported by a single implant were compared with overdentures supported by two implants (P = 0.43; RD: 0.04, 95% CI: -0.06, 0.15). CONCLUSION: Mandibular overdentures retained by a single implant have comparable results to those retained by two implants. However, this should be interpreted with caution as all the included studies were considered at a high risk of bias.
