Faculty of Oral and Dental Medicine, Department of Removable Prosthodontics, Cairo University, Egypt; Faculty of Dentistry, Department of Prosthodontics, Modern Science and Arts, University (MSA), Egypt.
Department of Removable Prosthodontics, Cairo University, Egypt.
J Evid Based Dent Pract. 2017 Sep;17(3):216-225. doi: 10.1016/j.jebdp.2017.02.002. Epub 2017 Mar 7.
As a consensus, the 2-implant supported overdentures (ODs) are considered as the first choice of treatment for the edentulous mandible. In the same context, there is increased evidence supporting the use of single-implant OD. The aim of any design is to preserve the remaining structures and allow the longevity of the treatment.
To evaluate the impact of single implant vs 2 implants on the peri-implant marginal bone loss (MBL) and number of implant failures in mandibular implant overdentures.
A literature search of electronic databases (PubMed and Cochrane) was performed up to March 2016 and complemented by hand search. Randomized clinical trials (RCTs) that evaluated MBL and number of implant failures relative to single-implant mandibular overdenture (MOD) were selected. The review and meta-analysis were performed using meta-analytic statistical package and in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
Five RCTs met the inclusion criteria for systematic review and qualitative synthesis. The observation period ranged from 12 months to 5 years in the selected RCTs. The comparison included in the meta-analysis is single- vs 2-implant MODs. Pooled data revealed that single-implant MODs significantly decreased the MBL (mean difference: 0.27, 95% confidence interval: 0.20-0.34, P < .0001, I = 0%) and number of implant failures (risk ratio: 3.26, 95% confidence interval: 1.18-8.97), P = .02; I = 0%).
Single-implant MOD was found to be better than 2-implant MOD in terms of MBL and number of implant failures. However, this result should be interpreted with caution due to limited number of analyzed studies with different loading protocols and short follow-up period.
作为共识，双种植体支持覆盖义齿（OD）被认为是下颌无牙颌的首选治疗方法。同样，越来越多的证据支持使用单种植体 OD。任何设计的目的都是为了保留剩余结构并延长治疗的寿命。
评估单种植体与双种植体对上颌种植体覆盖义齿（MOD）的种植体边缘骨吸收（MBL）和种植体失败数量的影响。
对电子数据库（PubMed 和 Cochrane）进行了文献检索，检索时间截至 2016 年 3 月，并辅以手工检索。选择了评估单种植体下颌 MOD 的 MBL 和种植体失败数量的随机临床试验（RCT）。使用 meta 分析统计软件包并根据系统评价和荟萃分析的首选报告项目（PRISMA）指南进行了综述和荟萃分析。
有 5 项 RCT 符合系统评价和定性综合的纳入标准。所选 RCT 的观察期从 12 个月到 5 年不等。荟萃分析包括的比较是单种植体与双种植体 MOD。汇总数据显示，单种植体 MOD 可显著减少 MBL（平均差异：0.27，95%置信区间：0.20-0.34，P<0.0001，I=0%）和种植体失败数量（风险比：3.26，95%置信区间：1.18-8.97），P=0.02；I=0%）。
单种植体 MOD 在 MBL 和种植体失败数量方面优于双种植体 MOD。然而，由于分析研究数量有限，加载方案不同，随访时间短，因此该结果应谨慎解释。
