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.

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Background:With continuous debate and lack of consensus regarding which are more eff ective in management of the temporomandibular disorders (TMDs), computer-aided design/computer-assisted manufacture (CAD/CAM) or conventional occlusal splint. Aim: The aim of this systematic review and meta-analysis was to perform a qualitative and quantitative analysis of the scientifi c literature regarding the use of CAD/CAM versus conventional occlusal splint in the management of patient with TMDs. Methodology: Manual and electronic database (PubMed and Cochrane) searches were performed to identify randomized controlled trials (RCTs), without language restriction, comparing CAD/CAM versus conventional occlusal splints. Data were extracted independently by two reviewers. The Cochrane tool was used for assessing the quality of included studies. Meta-analyses were performed for the two included RCTs of similar comparisons reported the same outcome measures. Results: Eight trials were identifi ed. Out of them two RCTs were included and six trials were excluded. The two included RCTs were considered to be at a low risk of bias. The pooled result revealed that the CAD/CAM occlusal splint has statistically signifi cant less pain in jaw joint, face tension, and time needed for adjustment when compared to conventional occlusal splints. Conclusion:The meta-analysis revealed that the CAD/CAM occlusal splint has statistically potential in reduction of pain in jaw joint, face tension, and time needed for adjustment when compared to conventional occlusal splints. Clinical Signifi cance: CAD/CAM occlusal splint may be suggested as an alternative manufacturing modality for TMDs patients who can off er the cost of this treatment modality. This review should be interpreted with caution because of limited number of included studies. Well-designed RCTs should be conducted and the outcome measures evaluation should be standardized between studies to reach potent conclusion.

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