Nogueira T E, Dias D R, Leles C R
Department of Prevention and Oral Rehabilitation, School of Dentistry, Federal University of Goias, Goiania, Brazil.
J Oral Rehabil. 2017 Dec;44(12):1004-1016. doi: 10.1111/joor.12550. Epub 2017 Sep 4.
The single-implant mandibular overdenture (SIMO) has been proposed as an alternative for edentulous patients who are poorly adapted to their dentures due to low retention and stability of the conventional mandibular complete denture (CD). However, there is a lack of evidence regarding the effectiveness of SIMO, which can be measured by examining patient perception of treatment effects. The aim of this systematic review was to assess the comparative results of CD and SIMO treatments using patient-reported outcome measures. A literature search was carried out in PubMed, Scopus and Cochrane Central databases. The search included studies published up to July 2017. The focus question was: 'Do single-implant mandibular overdentures improve patient-reported outcomes compared to conventional complete dentures in edentulous patients?' Eligible studies were randomised clinical trials (RCT) and prospective studies. After initial screening for eligibility and full-text analysis, 11 studies were included for data extraction and quality assessment (five parallel-group RCTs, two crossover RCTs and four prospective studies). All studies reported marked improvement in satisfaction with the dentures and quality of life measures after SIMO treatment, irrespective of variations in implant treatment protocols and retention systems. Methodological considerations revealed a lack of evidence from RCTs on the comparative effectiveness of the two treatment strategies. Hence, although available evidence suggests considerable improvement in patient-reported outcomes following the insertion of a single implant to retain a mandibular denture, further well-designed comparative studies between SIMO and CD are required to improve the level of evidence and to support the indication of SIMO treatment in routine practice.
单种植体下颌覆盖义齿（SIMO）已被提议作为一种替代方案，用于那些因传统下颌全口义齿（CD）固位和稳定性差而对义齿适应不良的无牙患者。然而，关于SIMO有效性的证据不足，这可以通过检查患者对治疗效果的感知来衡量。本系统评价的目的是使用患者报告的结局指标评估CD和SIMO治疗的比较结果。在PubMed、Scopus和Cochrane Central数据库中进行了文献检索。检索包括截至2017年7月发表的研究。核心问题是：“在无牙患者中，与传统全口义齿相比，单种植体下颌覆盖义齿是否能改善患者报告的结局？”符合条件的研究为随机临床试验（RCT）和前瞻性研究。在初步筛选合格性和进行全文分析后，纳入11项研究进行数据提取和质量评估（5项平行组RCT、2项交叉RCT和4项前瞻性研究）。所有研究均报告，无论种植治疗方案和固位系统如何变化，SIMO治疗后患者对义齿的满意度和生活质量指标均有显著改善。方法学考量显示，RCT缺乏关于这两种治疗策略比较有效性的证据。因此，尽管现有证据表明，在植入单颗种植体以固位下颌义齿后，患者报告的结局有相当大的改善，但仍需要在SIMO和CD之间进行进一步精心设计的比较研究，以提高证据水平，并支持SIMO治疗在常规实践中的应用指征。
