Single Implant Retained Overdenture Treatment Protocol: A Systematic Review and Meta‐Analysis

Abstract

Purpose: This systematic review was undertaken to establish the most favourable protocol to treat an edentulous mandible with a single implant-retained overdenture. The formulated PICO question was: "Which surgical and prosthetic protocols result in the highest survival and complication rates of implants and prostheses employed in a single implant retained overdenture for the rehabilitation of a completely edentulous mandibular ridge?" Materials and Methods: A structured literature search was conducted using the following databases; PubMed, ScienceDirect, COCHRANE, LILACS, IndeMED, OVID, EMBASE, NIH Clinical Trials for reports related to the single implant-retained overdenture treatment. Only English articles were included. Publications with a minimum follow up time of 1 year and above were included for meta-analysis. A Poisson regression model was applied to estimate the survival rates of the implant and prosthesis employed. Results: The electronic database search yielded 2083 titles and abstracts; and a total of 17 were selected for the systematic review, of which 11 studies were subjected to meta-analysis. The implants showed high estimated five and 10-year survival rates of 91.93% and 84.62%, respectively. Implants that were delayed loaded showed the greatest survival rates, while immediately loaded implants presented with higher survival rates at five (p = 0.849) and 10 years (p = 0.464) when compared to early loaded implants. The greatest number of fractures were associated with ball abutments with an event rate of 10.8 (95% CI: 10.5-11.09) per 100 prosthesis years, while locator abutments showed a greater number of maintenance events with an event rate of 16.84(95% CI:16.01-17.66) per 100 prosthesis years. Conclusion: Single implant-retained overdenture treatment is a cost-effective, minimally invasive and simple treatment that can be used to restore function and aesthetics to edentulous patients, with relatively high implant and prosthesis success rates and minimal complications.

5‐year randomized multicenter clinical trial on single dental implants placed in the midline of the edentulous mandible

“…Regarding implant survival 5 years after implant loading, there was indeed a statistically significant difference between the two treatment groups and non‐inferiority of the survival rate of the midline implant of the immediate loading protocol could not be shown. Survival rates for conventionally loaded single implants in the edentulous mandible were high after an observation period between 5 and 60 months (Padmanabhan et al., 2020; Passia & Kern, 2014). The implant survival rate in the present investigation for conventionally loaded implants was 96.2% after 5 years.…”

“…The 5‐year results were very promising with an implant survival rate of 100% and remarkable improvements regarding patients’ satisfaction and prosthesis function (Cordioli et al., 1997). The available clinical investigations on this topic show a high variance regarding the study design (Padmanabhan et al., 2020; Passia & Kern, 2014). Implants were loaded either immediately at the day of implant placement (Kronström et al, 2014, 2017) or between seven days and three months after implant placement (Bryant et al., 2015; Cheng et al., 2012; Gonda et al., 2010; Passia et al., 2019).…”

Patient‐reported outcome measures of edentulous patients restored with single‐implant mandibular overdentures: A systematic review

“…A recent meta-analysis showed the 5-and 10-year survival rates of SIMO were 91.93% and 84.62%, respectively, and no significant differences were observed in relative to TIMO. 8 The effect of SIMO from the clinician perspective was well documented in this study, but its effect was not conclusively addressed from patients' perspective.…”

A review of the recent literature on maxillary overdenture with dental implants

“…As indicated previously by the McGill consensus, IOD may be considered the first choice of prosthetic prosthesis for edentulous patients [15]. Among IODs, the mandible IOD is a treatment that has been sufficiently studied both clinically and in literature reviews [16][17][18], and in recent years, main-taining the IOD with only one implant in the mandible has been a clinical approach [19]. Furthermore, since the mandible often has better bone quality than the maxilla, immediate loading may be performed in some cases, and this is known to be very cost-effective with only minimal surgical invasion [20].…”