Comparative study of splinted and unsplinted implant-retained maxillary overdentures without palatal coverage: A literature review

Abstract

<p>The palatal coverage is considered as an auxiliary element in the distribution of tensile strains on implant maxillary total prosthesis (implant overdentures) bases, either implant-supported or retained. However, complaints in some patients due to palate and phonetic impairment are constant. The palatal coverage removal would allow the improvement of these issues as well as pharyngeal control, salivary flow and hygiene. Thus, this literature review proposed to analyze the survival rates of dental implants retaining an implant maxillary overdenture without palatal coverage in edentulous maxilla. The review was conducted in Medline database, via PubMed between 2000 to 2016 period, and limited to English language publications. The search strategy took the following key-words, referencing title and / or abstract: dental implants; maxilla; maxillary; overdenture; and palatal coverage. According the data, the rehabilitation of the maxillary edentulous with four implant-supported overdentures with bar attachments and implant-retained with ball attachments has shown great survival rates of dental implants, but there are a few studies reporting the survival rate of implant overdentures. It was concluded that the prosthetic rehabilitation of total maxillary edentulous patients is viable through palateless implant overdentures when a minimum of four to six implants were used with careful planning and execution.</p><p> </p><p><strong>Keywords</strong></p><p>Dental Implants; Maxilla; Overdenture and Palatal coverage.</p>

Patient satisfaction and survival of maxillary overdentures supported by four or six splinted implants: a systematic review with meta-analysis

“…Implants initially placed that were still present at follow-up were included and analyzed. The outcomes of included studies showed 18 lost implants on a total of 1164 implants in 291 patients rehabilitated with MIODs on four splinted implants [ 10 , 19 – 22 , 24 – 31 ] and 12 lost implants on a total of 1158 implants in 193 patients rehabilitated with MIODs on six splinted implants [ 10 , 19 – 22 , 24 , 28 , 33 ]. The pooled risk ratio for implant survival (RR = 0.71; CI = [0.34, 1.45]) showed no statistical differences between using 4 versus 6 splinted implants for supporting maxilla overdentures ( P = 0.34) (Fig.…”

“…Patients usually require an overdenture without palatal coverage in order to increase comfort, taste, phonation, pharyngeal control, salivary flow, and hygiene. Another issue of discussion was the number of dental implants recommended to be installed to support a maxillary overdenture [ 33 ]. In the literature, it seems that the minimum favorable number to support a MIOD without palate coverage is four or six splinted implants [ 4 – 6 , 33 – 36 ].…”

“…Another issue of discussion was the number of dental implants recommended to be installed to support a maxillary overdenture [ 33 ]. In the literature, it seems that the minimum favorable number to support a MIOD without palate coverage is four or six splinted implants [ 4 – 6 , 33 – 36 ]. This concept is in line with several included studies in this review, reporting a survival rate of implants greater than or equal to 97%, both for palateless MIOD on 4 splinted implants [ 19 – 23 , 25 , 27 – 29 ] and palateless MIOD on 6 splinted implants [ 20 , 21 , 25 , 26 , 28 , 29 , 32 ].…”