A meta-analysis of retention systems for implant-supported prostheses in partially edentulous jaws.

Abstract

STATEMENT OF PROBLEM:

Choosing an appropriate retention system for patients with partial edentulism and dental implants is impeded by a paucity of evidence. The available evidence is extrapolated from either completely edentulous or mixed study populations.

PURPOSE:

The purpose of this systematic review was to assess the effects of different retention systems used for implant-supported prostheses in patients with partially edentulous jaws by measuring the rates of failure, survival, and event-free situations.

MATERIAL AND METHODS:

An electronic database search supplemented by a manual search was conducted to identify the best, good, and fair quality studies reporting at least 10 participants with a 1-year follow-up (PROSPERO-CRD 42015024649). Summary estimates of the survival, failure, and event-free proportions were obtained using a random effects model with a 95% confidence interval.

RESULTS:

Among the 896 citations from 3875 titles identified by the search, 104 studies reporting over 5317 participants with 9568 reconstructions and a total exposure time of 46553.18 years were included in the analysis. Screw-retained single crowns showed twofold minor complication even rates (8.5%; 95% confidence interval [CI]: 5.5-12.9) compared with cement-retained single crowns (4.2%. 95% CI; 3.2-5.4). None of the retention systems were more advantageous than the others in relation to failure and event-free outcomes. However, the summary of the findings suggests that cement-retained single crowns, splinted crowns, and cantilever-fixed partial dentures performed better (with fewer events) than screw-retained restorations in the long term.

CONCLUSIONS:

Results suggest that cement retention may be an appropriate system for implant-supported restorations in partial edentulism. However, high-quality prospective studies and cost evaluation are recommended to confirm the evidence.

Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.