Prognosis of removable complete dentures considering the level of mandibular residual ridge resorption: a systematic review and meta-analysis
摘要
To compare clinical outcomes in atrophic (AM) and non-atrophic (NAM) mandibles of edentulous patients rehabilitated with mandibular removable complete dentures (CD) or implant mandibular overdentures (IMO).
Materials and methodsNon-randomized clinical studies were searched in 8 databases. Articles were assessed by the risk of bias in non-randomized studies of interventions. Datasets for CDs comparing AM and NAM were plotted [masticatory function, maximum occlusal biting force (MOBF), oral health-related quality of life (OHRQoL)]. Residual ridge (AM and NAM) data (masticatory function, OHRQoL, implant survival, marginal bone loss, and maintenance events) in IMO were also combined.
Results23 studies were included. Only 1 was classified as low risk of bias. Superior masticatory performance was observed in the NAM group rehabilitated with CD (P <.001). NAM group rehabilitated with CD exhibited increased MOBF (P <.05). Once patients were treated with IMO, improvements were observed in swallowing threshold (number of cycles and time) in the NAM group (P <.05). Comparable results of OHRQoL were noted for both groups (AM and NAM) and rehabilitations (CD and IMO). Similar peri-implant outcomes were displayed for IMO rehabilitation in AM and NAM patients. Most common event for IMO wearers (AM and NAM) was replacement of retention insert.
ConclusionAM patients presented suboptimum masticatory function whether using CD or IMO. CD wearers with AM also had a reduced MOBF compared with NAM patients.
Clinical relevanceClinicians should carefully monitor residual ridge resorption to guide treatment planning and prognosis, particularly in cases of AMs. Our findings indicate that AMs may negatively impact the clinical performance of both CD and IMO rehabilitations.