Prosthodontic maintenance and peri-implant tissue conditions for telescopic attachment-retained mandibular implant overdenture: Systematic review and meta-analysis of randomized clinical trials

Abstract

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.

Five years follow‐up of mandibular 2‐implant overdentures on locator or ball abutments: Implant results, patient‐related outcome, and prosthetic aftercare

“…To connect the mandibular overdenture with the 2 implants, different systems are available: the bar/clip construction with splinted implants and the nonsplinted system using ball, magnetic, telescopic, or stud abutments. The implant outcome and marginal bone loss is not significantly affected by the attachment choice . Comparing Locator (Zest Anchors LLC) stud abutments, and ball abutments, more marginal bone loss was observed after 3 year with the locator system .…”

“…Studies comparing balls and bars are inconclusive on the maintenance need . Comparing maintenance of ball and telescopic systems, the difference is less prominent but both systems are susceptible to maintenance . Research on the complications on ball 2IOD reports a high level of aftercare .…”

“…The implant outcome and marginal bone loss is not significantly affected by the attachment choice. [10][11][12][13][14] Comparing…”

“…7,20,22,25,26 Comparing maintenance of ball and telescopic systems, the difference is less prominent but both systems are susceptible to maintenance. 13,14,19 Research on the complications on ball 2IOD reports a high level of aftercare. 18 Comparing the prosthetic complications between 2IOD with ball and the stud abutment (locator), earlier studies report inconsistent outcomes.…”

Peri‐implant mucosal response to implant‐supported overdentures: A systematic review and meta‐analysis

“…Nevertheless, changes in PD and other soft‐tissue peri‐implant parameters serve as an useful indication to further probe with follow‐up radiographs to aid in the diagnosis of peri‐implantitis, which has been shown to affect the overall implant survival in ISODs 58 . The clinical relevance of peri‐implant pocket depths on ISOD maintenance requirement needs has to be investigated further, as only one previous study attempted to analyze the relationship between the peri‐implant mucosal health and prosthodontic maintenance requirement with different types of ISODs, 59 and evidence is still unclear on the association.…”