Interventions for replacing missing teeth: attachment systems for implant overdentures in edentulous jaws

Area of Science:

• Dentistry
• Prosthodontics
• Implantology

Background:

• Implant overdentures are a common rehabilitation for edentulous patients.
• Attachment systems are crucial for anchoring overdentures to implants.
• A wide variety of attachment systems necessitates understanding their clinical outcomes.

Purpose of the Study:

• To compare different attachment systems for maxillary and mandibular implant overdentures.
• To assess prosthodontic success, maintenance, patient preference, satisfaction, and costs.
• To provide evidence-based guidance for clinicians selecting attachment systems.

Main Methods:

• Systematic review of randomized controlled trials (RCTs) with at least one year follow-up.
• Searched multiple databases including Cochrane Library, MEDLINE, and Embase.
• Meta-analysis used for dichotomous and continuous outcomes, with GRADE approach for evidence quality assessment.

Main Results:

• Six RCTs on mandibular overdentures were included; no trials on maxillary overdentures.
• Insufficient evidence to compare attachment systems regarding prosthodontic success or maintenance.
• Ball attachments showed higher short-term repair rates compared to bar attachments, but evidence quality was very low.

Conclusions:

• There is insufficient evidence to determine the effectiveness of different attachment systems for mandibular implant overdentures.
• No evidence exists for maxillary implant overdenture attachment systems.
• Further high-quality RCTs are needed, focusing on specific attachment types and patient-centered outcomes.