Patient-reported outcome measures and clinical assessment of implant-supported overdentures and fixed prostheses in mandibular edentulous patients: A systematic review and meta-analysis.

Abstract

STATEMENT OF PROBLEM:

A consensus based on patients' perceptions as to whether to use overdentures or fixed prostheses to rehabilitate mandibular edentulous arches is limited.

PURPOSE:

The purpose of this systematic review and meta-analysis was to compare the patient-reported outcome measures (PROMs) and clinical outcomes associated with implant-supported overdentures and fixed prostheses in edentulous mandibles.

MATERIAL AND METHODS:

Nine electronic databases were searched for randomized clinical trials (RCTs) and nonrandomized clinical trials (N-RCTs). The risk of bias was assessed by the revised Cochrane risk of bias tool for RCTs (RoB 2) and N-RCT (ROBINS-I). Data sets for oral health-related quality of life (OHRQoL), satisfaction, survival rate, implant probing depth, and marginal bone loss were plotted, and the appropriate analyses were applied by using the Rev Man 5.3 software program. Certainty of evidence was also evaluated by means of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.

RESULTS:

Ten eligible trials were included and evaluated quantitatively. For 3 domains of OHRQoL, fixed prostheses showed significantly higher quality of life when compared with overdentures regarding functional limitation (P<.001), physical disability (P=.001), and physical pain (P=.003). Fixed prostheses also improved satisfaction, when compared with overdentures for comfort (P=.02), ease of mastication (P<.001), retention (P<.001), and stability (P<.001). The same pattern was observed for overall OHRQoL (P=.01) and satisfaction (P=.01) in which fixed prostheses improved patient satisfaction. Only ease of cleaning presented greater satisfaction for the overdenture group. Clinical parameters did not differ statistically (P>.05) between both types of prosthesis.

CONCLUSIONS:

Fixed rehabilitations for mandibular edentulous patients seem to be a well-accepted treatment from the patients' oral health perspective. However, mandibular overdentures are no less efficient than fixed prostheses in terms of clinical outcomes.

• Authors: Guilherme Almeida Borges, Thaís Barbin, Caroline Dini, Lucianne Cople Maia, Marcela Baraúna Magno, Valentim Adelino Ricardo Barão, Marcelo Ferraz Mesquita
• Journal: The Journal of prosthetic dentistry (J Prosthet Dent) Vol. 127 Issue 4 Pg. 565-577 (Apr 2022) ISSN: 1097-6841 [Electronic] United States
• PMID: 33390270 (Publication Type: Journal Article, Meta-Analysis, Review, Systematic Review)
• Copyright: Copyright © 2020 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Chemical References

• Dental Implants

Topics

• Dental Implants
• Dental Prosthesis, Implant-Supported
• Denture, Overlay
• Humans
• Jaw, Edentulous
• Mandible
• Mouth, Edentulous
• Patient Reported Outcome Measures
• Patient Satisfaction
• Quality of Life