Kroll Philip, Hou Lisa, Radaideh Hani, Sharifi Nazanin, Han Phuu P, Mulligan Roseann, Enciso Reyes
1 Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, Calif.
2 Division of Dental Public Health and Pediatric Dentistry, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, Calif.
J Oral Implantol. 2018 Aug;44(4):313-324. doi: 10.1563/aaid-joi-D-17-00210. Epub 2018 Feb 19.
The objective of this systematic review was to determine the effect on oral health-related outcomes from mandibular implant-retained dentures opposing maxillary complete dentures in edentulous middle-age and older adults, compared with complete removable dentures in both arches. Randomized controlled trials included participants with an average age of 65 years or older. The Cochrane Library, MEDLINE, and Web of Science were searched. A total of 228 abstracts were reviewed for inclusion criteria, with 14 trials included and analyzed for risk of bias. Eleven of these studies were assessed as being at an unclear risk of bias, and 3 were at high risk. Mandibular implant-retained overdenture therapy showed statistically significant improvements in the patients' general satisfaction ( P = .003), oral health-related quality of life ( P < .001), and chewing ability ( P < .001), over the patients with complete dentures. There were no significant differences in the percentage of patients who were satisfied with their overdentures vs complete dentures for comfort, retention, esthetics, or chewing ability; however, only 2 studies reported these outcomes. In terms of nutritional status 1 year after treatment, vitamin B blood levels increased significantly in the implant-retained group ( P = .003), but not the other nutritional values. Implant-retained mandibular overdentures are an option for middle-aged and elderly edentulous patients as they significantly improve some of the outcomes; however, the quality of the evidence was moderate/low, due to the small number of studies included and the risk of bias. Future research should include objective outcomes such as masticatory performance, chewing efficacy, and muscular coordination.
本系统评价的目的是确定在下颌无牙的中年及老年成年人中，下颌种植体固位义齿对上颌全口义齿的口腔健康相关结局的影响，并与双侧全口可摘义齿进行比较。随机对照试验纳入了平均年龄65岁及以上的参与者。检索了Cochrane图书馆、MEDLINE和科学网。共审查了228篇摘要以确定纳入标准，纳入并分析了14项试验的偏倚风险。其中11项研究的偏倚风险被评估为不明确，3项为高风险。与全口义齿患者相比，下颌种植体固位覆盖义齿治疗在患者总体满意度（P = 0.003）、口腔健康相关生活质量（P < 0.001）和咀嚼能力（P < 0.001）方面有统计学显著改善。在覆盖义齿与全口义齿的舒适度、固位力、美观度或咀嚼能力方面，对义齿满意的患者百分比没有显著差异；然而，只有2项研究报告了这些结局。在治疗后1年的营养状况方面，种植体固位组的维生素B血水平显著升高（P = 0.003），但其他营养指标未升高。种植体固位下颌覆盖义齿是中年和老年无牙患者的一种选择，因为它们显著改善了一些结局；然而，由于纳入研究数量少和存在偏倚风险，证据质量为中/低。未来的研究应包括咀嚼性能、咀嚼效率和肌肉协调性等客观结局。
