Attachment systems for mandibular implant overdentures: a systematic review

Abstract

PURPOSEThe aim of this systematic review was to address treatment outcome according to attachment systems for mandibular implant overdentures in terms of implant survival rate, prosthetic maintenance and complications, and patient satisfaction.MATERIALS AND METHODSA systematic literature search was conducted using PubMed and hand searching of relevant journals considering inclusion and exclusion criteria. Clinical trial studies on mandibular implant overdentures until August, 2010 were selected if more than one type of overdenture attachment was reported. Twenty four studies from 1098 studies were finally included and the data on implant survival rate, prosthetic maintenance and complications, patient satisfaction were analyzed relative to attachment systems.RESULTSFour studies presented implant survival rates (95.8 - 97.5% for bar, 96.2 - 100% for ball, 91.7% for magnet) according to attachment system. Ten other studies presented an implant survival rate ranging from 93.3% to 100% without respect to the attachment groups. Common prosthetic maintenance and complications were replacement of an assay for magnet attachments, and activation of a matrix or clip for ball or bar attachments. Prosthetic maintenance and complications most commonly occurred in the magnet groups. Conflicting findings were found on the rate of prosthetic maintenance and complications comparing ball and bar attachments. Most studies showed no significant differences in patient satisfaction depending upon attachment systems.CONCLUSIONThe implant survival rate of mandibular overdentures seemed to be high regardless attachment systems. The prosthetic maintenance and complications may be influenced by attachment systems. However patient satisfaction may be independent of the attachment system.

Two Implants in a Severely Resorbed Mandible: A Case Report of Early Loading

“…Many studies have reported an overall implant survival rate close to 100% for conventional, early and immediate protocols [12,13] and no differences were either observed as to the attachment system [14]. And the implant survival rate is not depending on the number of implants [15].…”

Evaluation of mini-implant-retained overdentures on the electromyographic activity and patients’ satisfaction in completely edentulous patients (randomized clinical trial)

“…A recent systematic review by Kim et al [17] indicated that the treatment effect with mandibular implant overdenture is not related to attachment system. Cheng et al [18] studied the masticatory efficiency of implant overdentures retained by locator and magnet attachments, and the results showed no difference between both types of the attachments.…”

Precision Attachments: A Review to Guide Clinicians

“…Patients that have severely atrophic mandibles, when rehabilitated with an overdenture, feel a significant improvement in the quality of life, regardless of the different attachment systems used or on the number of implants [5,6,13,16,22]. However, prosthetic maintenance and possible complications may be influenced by the system used [25].…”

“…The minimal height required is 3.7 mm, but by virtue of a larger diameter, this factor is also responsible for increasing its strength [23]. Locators are widely used by clinicians due to their high compatibility with most of the implant systems available [24,25]. The system is composed of two parts, a straight abutment and a male component inside the denture that incorporates a nylon liner, which can solve the problems related to differences in angulation [26].…”