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Analysis of Clinical and Patient-Reported Outcomes Between Single- and Two-Implant Mandibular Overdenture-An Umbrella
Aleksandra Milić Lemić1, Stefan Vulović1, Aleksandar Jakovljević2
1Department of Prosthodontics, School of Dental Medicine, University of Belgrade, Belgrade, Serbia.
Background:
A two-implant mandibular overdenture (TIMO) is considered a viable approach for the rehabilitation of the edentulous mandible, enhancing retention, stability, overall function and patient-reported outcome. Recently, the minimalist strategy of single-implant mandibular overdenture (SIMO) was proposed as an alternative treatment for mandibular edentulism.
Objectives:
To analyse systematic reviews (SRs) and provide a comprehensive overview of clinical and patient-reported outcomes, including implant failure, peri-implant marginal bone loss, overall prosthetic complications and maintenance, patient satisfaction and oral health-related quality of life, in SIMO compared with TIMO.
Methods:
The umbrella review was designed and reported following the PRISMA guidelines, and the protocol was registered in the PROSPERO database (CRD42024599304). Included SRs evaluated the clinical and/or patient-reported outcomes in edentulous patients rehabilitated with SIMO and TIMO. A literature search was conducted without restrictions on the language in Web of Science, ProQuest, SCIELO, KCI, Grants Index, Scopus, PubMed/MEDLINE and the Cochrane Library databases. Critical evaluation of the included SRs was conducted using AMSTAR 2.
Results:
Out of 243 papers suitable for title/abstract screening, 7 SRs were selected. One SR favoured SIMO over TIMO for both implant failure and peri-implant marginal bone loss, whereas in another SR it was shown that TIMO revealed significantly more implant failures after 1 and 5 years, significantly more prosthetic failures after 1 year, and significantly more O-ring replacements after 5 years, compared to SIMO. Regarding the quality assessment of included SRs, two were categorised as 'critically low', two as 'low' and three as 'moderate'.
Conclusions:
SIMO corresponds with the conventional TIMO as a potentially effective treatment for the rehabilitation of the edentulous mandible. Additional studies are warranted to obtain more robust patient evidence and refine clinical guidelines.
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