Friday, January 18, 2013

Implant and Prosthodontic Survival Rates with Implant Fixed Complete Dental Prostheses in the Edentulous Mandible after at Least 5 Years: A Systematic Review.

Papaspyridakos, P., Mokti, M., Chen, C.-J., Benic, G. I., Gallucci, G. O. and Chronopoulos, V. (2013), Implant and Prosthodontic Survival Rates with Implant Fixed Complete Dental Prostheses in the Edentulous Mandible after at Least 5 Years: A Systematic Review. Clinical Implant Dentistry and Related Research. doi: 10.1111/cid.12036

Abstract

Background

The treatment of mandibular edentulism with implant fixed complete dental prostheses (IFCDPs) is a routinely used treatment option.

Purpose

The study aims to report the implant and prosthodontic survival rates associated with IFCDPs for the edentulous mandible after an observation period of a minimum 5 years.

Materials and Methods

An electronic MEDLINE/PubMED search was conducted to identify randomized controlled clinical trials and prospective studies with IFCDPs for the edentulous mandible. Clinical studies with at least 5-year follow-up were selected. Pooled data were statistically analyzed and cumulative implant- and prosthesis survival rates were calculated by meta-analysis, regression, and chi-square statistics. Implant-related and prosthesis-related factors were identified and their impact on survival rates was assessed.

Results

Seventeen prospective studies, including 501 patients and 2,827 implants, were selected for meta-analysis. The majority of the implants (88.5% of all placed implants) had been placed in the interforaminal area. Cumulative implant survival rates for rough surface ranged from 98.42% (95% confidence interval [CI]: 97.98–98.86) (5 years) to 96.86% (95% CI: 96.00–97.73) (10 years); smooth surface implant survival rates ranged from 98.93% (95% CI: 98.38–99.49) (5 years) to 97.88% (95% CI: 96.78–98.98) (10 years). The prosthodontic survival rates for 1-piece IFCDPs ranged from 98.61% (95% CI: 97.80–99.43) (5 years) to 97.25% (95% CI: 95.66–98.86) (10 years).

Conclusion

Treatment with mandibular IFCDPs yields high implant and prosthodontic survival rates (more than 96% after 10 years). Rough surface implants exhibited cumulative survival rates similar to the smooth surface ones (p  > .05) in the edentulous mandible. The number of supporting implants and the antero-posterior implant distribution had no influence (p  > .05) on the implant survival rate. The prosthetic design and veneering material, the retention type, and the loading protocol (delayed, early, and immediate) had no influence (p > .05) on the prosthodontic survival rates.

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