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Splinted versus unsplinted overdenture attachment systems - no difference in clinical outcomes
1School of Dentistry and Oral Health, Griffith University, Gold Coast Campus, Queensland, Australia. ebd@nature.com.
Evidence-Based Dentistry
|March 24, 2019
Summary
For mandibular overdentures, splinted and unsplinted attachment systems show similar outcomes. This systematic review found no significant differences in marginal bone loss, complications, or implant survival rates between the two attachment types.
Area of Science:
- Dental Implantology
- Prosthodontics
- Biomaterials Science
Background:
- Mandibular overdentures are commonly retained by attachment systems.
- The choice between splinted and unsplinted attachments may impact long-term outcomes.
- Evidence comparing these systems requires synthesis.
Purpose of the Study:
- To systematically compare the clinical outcomes of splinted versus unsplinted attachment systems for mandibular overdentures.
- To evaluate marginal bone loss, implant survival, and complication rates.
- To provide evidence-based guidance for clinicians.
Main Methods:
- Systematic literature search of PubMed/Medline, Scopus, and Cochrane databases.
- Inclusion of randomized controlled trials and prospective studies with ≥10 participants and ≥6 months follow-up.
- Data extraction and risk of bias assessment using Cochrane Risk of Bias Tool and Newcastle-Ottawa scale.
Main Results:
- Nine studies involving 984 implants in 380 patients were included, with a mean follow-up of five years.
- All studies focused on the mandibular arch.
- No statistically significant differences were observed between splinted and unsplinted systems regarding marginal bone loss, complications, or implant survival.
Conclusions:
- The selection of attachment system (splinted or unsplinted) does not appear to influence key clinical outcomes for mandibular overdentures.
- Clinicians can consider patient-specific factors when choosing between attachment systems.
- Further research may explore patient-reported outcomes and cost-effectiveness.
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