A Systematic Review of Clinical Outcomes on Patients Rehabilitated with Complete‐Arch Fixed Implant‐Supported Prostheses According to the Time of Loading

Abstract

Purpose:To perform a systematic review on studies assessing clinical outcomes in patients rehabilitated with complete-arch fixed implant-supported prostheses according to the time of loading. Materials and Methods: Data obtained from patient and clinical outcomes, as implant failure, success rate, survival rate, biological complications, technical complications, mechanical complications, and marginal bone loss, were included on this review. The search was performed on databases PubMed, Scopus, and Cochrane. Cochrane Collaboration tool was used to assess the risk of bias of randomized controlled studies, and an adapted version of Newcastle-Ottawa scale was used for observational studies. All data were tabulated according to the time of loading: (1) immediate restoration/loading, (2) early loading, and (3) conventional loading. Results: From a total of 4027 studies identified through the three databases, six of them were randomized controlled trials, five of them were prospective observational studies, and another five were retrospective observational studies. In total, 5954 implants, 1294 patients and 1305 full-arch fixed implant-supported prostheses were included in this review. There was a wide heterogeneity among clinical studies regarding the study design and treatment procedures. Thus, pooled estimates were not performed in order to avoid potential biases. The methodological assessment by the Modified Newcastle-Ottawa scale showed a moderate quality of observational studies. Regarding the RCTs studies, all of them presented at least one element of bias according to the Cochrane Collaboration tool for assessing risk of bias. Conclusion: There is evidence of high survival-success implant rate (95-100%) for either loading protocols (immediate restoration/loading, early loading, and conventional loading). However, careful attention must be taken by clinician when interpreting the results reported in clinical studies. Future studies should be performed using standardized methodology in order to determine the true predictability regarding immediate, early, and conventional loading protocols.

A parallel 3‐group randomised clinical trial comparing different implant treatment options for the edentulous mandible: 1‐year effects on dental patient‐reported outcomes and chewing function

“…Another traditional option for the rehabilitation of the edentulous mandible is the use of multiple implants in the interforaminal region of the mandible to retain a fixed prosthesis—implant‐supported fixed complete denture (IFCD). The use of four implants ‘ad modum’ Branemark with a permanent fixed rigid cross‐arch suprastructure has been successfully used since the earliest introduction of osseointegrated implants, with high success rates and predictability regarding implant survival 10 and favourable patient‐related outcomes (dPROs) 11 . However, many patients may be reluctant to be submitted to this type of treatment, due to the more complex and invasive surgical procedures, and since this treatment modality generates an additional cost due to the more extensive surgical procedure with a higher number of implants, prosthetic components, aftercare and laboratory steps, as well as the need for additional measures for oral hygiene 12 …”

Clinical retrospective study of dental implant removal: do patients who require implant removal desire implant prosthesis again?

“…Dental implants have several important advantages such as improved mastication efficiency and restoration of aesthetics and have become common prosthetic methods for dental treatment. Furthermore, several studies have reported high implant success and survival rates ( 13 ). Dental implant treatment is a highly reliable treatment; however, despite the low incidence of implant failure, failures occur occasionally, even with expert dentists.…”

Methodological quality and risk of bias of systematic reviews about loading time of multiple dental implants in totally or partially edentulous patients: An umbrella systematic review

“…In addition, seven did not make clear how many reviewers participated in the study selection and data collection [ [8] , [9] , [10] , [11] , [12] , [13] , [14] ]. Only eight reviews did not make any restrictions on the language [ 3 , 9 , 10 , 12 , [15] , [16] , [17] , [18] ], and the rest included practically only articles in English. Virtually all systematic reviews included randomized or non-randomized clinical trials, but some prospective studies were also included [ 10 , [18] , [19] , [20] , [21] , [22] ].…”