Splinted and unsplinted overdenture attachment systems: A systematic review and meta‐analysis

Abstract

Splinted and unsplinted overdenture attachment systems have unique advantages and disadvantages. The aim of the present systematic review was to determine the influence of splinted and unsplinted overdenture attachment systems on the marginal bone loss, prosthetic complications and implant survival rate. PubMed/MEDLINE, Scopus and Cochrane databases were searched for articles published up to October 2017, using the following search terms: "overdenture AND attachment OR overdenture AND bar OR overdenture splinted." The PICO question "Do splinted overdenture attachment systems promote better clinical results in comparison to unsplinted systems?" was evaluated. Eligible studies included randomized controlled clinical trials, prospective studies with at least 10 participants and a minimum follow-up of 6 months, and studies published in English that compared splinted and unsplinted attachment systems within the same study. The 95% confidence interval (CI) was considered for all outcomes analysed. After completion of the different steps in the article selection process, nine articles were included in the qualitative and quantitative analyses. A total of 984 implants were placed in 380 patients (mean age: 62.8 years). The meta-analysis demonstrated no statistically significant differences between splinted and unsplinted attachment systems with regard to marginal bone loss (P = .39; MD: -0.11; 95% CI: -0.37 to 0.14), complications (P = .31; RR: 1.26; CI: 0.80-1.99) and implant survival rate (P = .14; RR: 0.37% CI: 0.10-1.36). In addition, splinted and unsplinted overdenture attachment systems achieved similar results with regard to marginal bone loss, prosthetic complications and implant survival rate.

Maxillary Implant-Supported Overdentures: Mechanical Behavior Comparing Individual Axial and Bar Retention Systems. A Cohort Study of Edentulous Patients

“…Regarding the mechanical complications suffered by bar-retained overdentures, a recent systematic review [22] compared differences between overdenture attachments, with and without splinting, describing the following: abutment or abutment screw loosening, relining, dental or resin fractures, and retention clip breakage, the same complications as observed in the present study. Analyzing the incidence of mechanical complications in the present work, the results were similar to Slot et al [32], who found that with bar types of overdenture retention, the most common mechanical event was the fracture of prosthetic teeth or resin [45,46].…”

“…Comparing these results with three recent literature reviews, the present results are clearly worse. In one review by Leao et al [22], mean follow-up of the studies analyzed was five years ranging from nine months to 10 years. The review obtained a mean ISR of 93.3%.…”

“…The retention systems employed in vertical insertion overdentures may use magnetic retainers, ball systems, bars, or stud attachments. However, when it comes to assessing the different retention systems available in terms of success rates, ease of maintenance, patient satisfaction and preferences, and cost to the patient, recent literature has failed to reach definitive conclusions as to which is the best retention system for overdentures [18][19][20][21][22][23][24].…”

Longevity and marginal bone loss of narrow-diameter implants supporting single crowns: A systematic review

“…However, this review also failed to discriminate between implants as to the type of prosthesis supported (single or multiple, fixed or removable). Non-splinted implants are subject to greater overload than those splinted by prosthetic structures [24]. Furthermore, we present a meta-analysis of marginal bone loss.…”

Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry

“…removable prosthodontics, [68][69][70] implant surgery, [71][72][73][74][75][76][77][78][79][80][81][82][83] peri-implant conditions, [84][85][86][87][88] temporomandibular disorders (TMDs) and orofacial pain, [89][90][91][92][93][94] mastication, 95 bruxism, [96][97][98] maintenance, 99,100 pathology and disease, [101][102][103][104][105][106][107][108] oncology 109,110 (including a full issue of the Journal of Dental Research on "precision medicine" 111 ), pharmacology, [112][113][114][115] radiology, [116]…”