Chaware Sachin Haribhau, Thakkar Smruti Tushar
Department of Prosthodontics, MGV's KBH Dental College and Hospital, Nasik, Maharashtra, India.
J Indian Prosthodont Soc. 2020 Jul-Sep;20(3):255-268. doi: 10.4103/jips.jips_368_19. Epub 2020 Jul 17.
To evaluate the survival rate, tissue response, and patient satisfaction of different attachments used in implant overdenture.
Systematic Review and Meta-analysis.
Electronic search of peer-review articles published between 2001 and 2019 assessing the attachments used for implant-supported overdentures was done according to PRISMA Guidelies. The review evaluated sixteen articles related to survival of the attachments, the reaction of the soft and hard tissues along with repair and maintenance of the attachments, and overall performance of the overdenture attachments.
There is statistically significant heterogeneity (Q =374.7403, df = 15, and < 0.0001). The statistics of fixed-effect model reported an MD of - 0.0880 (95% CI = -0.1536; 0.0225).
The review evaluated the 16 articles that met with the inclusion and search criteria. The studies were the combination of bar and ball attachments and their subtypes, magnetic and bar attachments, and locator in combination with other attachments. The meta-analysis of combined 16 studies reported acceptable heterogeneity among 16 studies (I 2 = 96%) and reported to be statistically significant ( < 0.01).
The survival rate of attachments was in the range of 95.8%-97.5% for bar, 96.2%-100% for ball, 90%-92% for magnet and locator attachments were in the range of 97% after a mean follow-up period of 3 years. The bar attachments reported moderate tissue reaction in the form of mucosal changes, gingival inflammation, and bone resorption. The locator attachments require higher maintenance and repair. The magnetic attachments produce higher bone resorption and readily displace under functional force. Patient satisfaction and compliance was higher for ball, locator, and bar attachments as well as low for magnetic attachment. Thus, the ball and locator attachments excellently perform in terms of survival rate, tissue response, and patient satisfaction.
评估种植覆盖义齿中不同附着体的存活率、组织反应及患者满意度。
系统评价和荟萃分析。
根据PRISMA指南，对2001年至2019年间发表的评估种植支持覆盖义齿所用附着体的同行评议文章进行电子检索。该综述评估了16篇与附着体存活率、软硬组织反应以及附着体的修复和维护，以及覆盖义齿附着体的整体性能相关的文章。
存在统计学显著异质性（Q = 374.7403，自由度 = 15，P < 0.0001）。固定效应模型统计报告的MD为 - 0.0880（95%置信区间 = -0.1536；0.0225）。
该综述评估了16篇符合纳入和检索标准的文章。这些研究包括杆卡式附着体及其亚型、磁性附着体与杆式附着体的组合，以及定位器与其他附着体的组合。对16项研究进行的荟萃分析显示，16项研究之间存在可接受的异质性（I² = 96%），且具有统计学显著性（P < 0.01）。
在平均3年的随访期后，杆式附着体的存活率在95.8% - 97.5%之间，球帽式附着体为96.2% - 100%，磁性附着体为90% - 92%，定位器附着体为97%左右。杆式附着体表现出中度组织反应，形式为黏膜改变、牙龈炎症和骨吸收。定位器附着体需要更高的维护和修复。磁性附着体导致更高的骨吸收，并且在功能力作用下容易移位。球帽式、定位器和杆式附着体的患者满意度和依从性较高，而磁性附着体较低。因此，球帽式和定位器附着体在存活率、组织反应和患者满意度方面表现出色。
