Single Implant Retained Overdenture Treatment Protocol: A Systematic Review and Meta‐Analysis

Abstract

This systematic review was undertaken to establish the most favourable protocol to treat an edentulous mandible with a single implant-retained overdenture. The formulated PICO question was: "Which surgical and prosthetic protocols result in the highest survival and complication rates of implants and prostheses employed in a single implant retained overdenture for the rehabilitation of a completely edentulous mandibular ridge?" A structured literature search was conducted using the following databases; PubMed, ScienceDirect, COCHRANE, LILACS, IndeMED, OVID, EMBASE, NIH Clinical Trials for reports related to the single implant-retained overdenture treatment. Only English articles were included. Publications with a minimum follow up time of one year and above were included for meta-analysis. A Poisson regression model was applied to estimate the survival rates of the implant and prosthesis employed. The electronic database search yielded 2083 titles and abstracts; and a total of 17 were selected for the systematic review, of which 11 studies were subjected to meta-analysis. The implants showed high estimated five and 10-year survival rates of 91.93% and 84.62% respectively. Implants that were delayed loaded showed the greatest survival rates, while immediately loaded implants presented with higher survival rates at five (p = 0.849) and 10 years (p = 0.464) when compared to early loaded implants. The greatest number of fractures were associated with ball abutments with an event rate of 10.8 (95% CI: 10.5-11.09) per 100 prosthesis years, while locator abutments showed a greater number of maintenance events with an event rate of 16.84(95%CI:16.01-17.66) per 100 prosthesis years. Single implant-retained overdenture treatment is a cost-effective, minimally invasive and simple treatment that can be used to restore function and aesthetics to edentulous patients, with relatively high implant and prosthesis success rates and minimal complications. This article is protected by copyright. All rights reserved.