Professor of Periodontics, Faculty of Dental Medicine, Fernando Pessoa University, Porto, Portugal.
Graduated Dentist, Faculty of Dental Medicine, Fernando Pessoa University, Porto, Portugal.
Eur J Prosthodont Restor Dent. 2022 Aug 30;30(3):169-187. doi: 10.1922/EJPRD_2338deCastro19.
This study aimed to perform a systematic review and meta-analysis to analyze the results obtained clinically for bar-clip versus stud-retainers in overdentures. Three databases (PubMed Central, MEDLINE, and BvSalud) were used beyond a manual search. The study followed strictly the inclusion and exclusion criteria, considering the PICO strategy. For the risk of bias and quality assessment of studies, in the case of RCT, there were six domains of analysis, and for non-RCT studies, the Modified Newcastle-Ottawa Scale was performed. A meta-analysis was developed using the available data for marginal bone loss (MBL) and survival rate. 25 studies were included. The stud-retentor had the lowest implant SR (87.6%) and the greatest MBL (1.96 mm). For the bar-clip system, the mean survival rate was 95.91%, with only 4 studies included for this system, and the mean MBL was 1.13 mm. Only 3 studies directly compared both systems quantitatively, showing a significantly greater MBL toward the stud-retention group. The results may not allow determination of the best system for overdenture (stud retentor or bar-clip). Therefore, most of the studies suggested the stud-retentor as a more preferable system due to better distribution of forces, biological peri-implant behavior, low-cost, and ease for removal facilitating the sanitization and/or repair.
本研究旨在进行系统回顾和荟萃分析,以分析覆盖义齿中夹式固位体和杆卡式固位体的临床结果。除了手动搜索外,还使用了三个数据库(PubMed Central、MEDLINE 和 BvSalud)。研究严格按照纳入和排除标准进行,考虑了 PICO 策略。对于 RCT 研究的风险偏倚和质量评估,有六个分析领域,对于非 RCT 研究,采用了改良的 Newcastle-Ottawa 量表进行评估。对于边缘骨丧失(MBL)和生存率,使用可用数据进行了荟萃分析。共纳入 25 项研究。杆卡式固位体的种植体存留率(SR)最低(87.6%),MBL 最大(1.96mm)。对于夹式固位体系统,平均生存率为 95.91%,仅有 4 项研究纳入该系统,平均 MBL 为 1.13mm。仅有 3 项研究定量比较了两种系统,表明杆卡式固位体组的 MBL 显著更大。结果可能无法确定覆盖义齿的最佳系统(杆卡式固位体或夹式固位体)。因此,由于杆卡式固位体系统具有更好的力分布、生物种植体周围行为、低成本以及易于移除以促进消毒和/或修复等优势,大多数研究都认为杆卡式固位体系统更可取。