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Posterior edentulous mandibular bone-height change with implant-supported fixed complete dentures: A systematic
Sieu Yien Chiam1, Han-Pang Liu2, Won-Suk Oh3
1Clinical Assistant Professor, Section of Prosthodontics, School of Dentistry, University of California Los Angeles, Los Angeles, California, USA.
Purpose:
To investigate the amount of bone-height change in the posterior edentulous mandible restored with full-arch implant-supported fixed complete dentures (FCDs).
Methods:
A search was conducted in the Ovid MEDLINE, Embase, Web of Science, and EBSCOhost Dentistry and Oral Sciences databases for clinical studies on bone-height change in the posterior edentulous mandible restored with FCDs. The full-text articles were selected based on inclusion and exclusion criteria by two reviewers. Risk of bias assessment of the included studies was conducted using the methodological index for non-randomized studies (MINORS). Meta-analysis was performed using a random-effects model to estimate bone height change in the posterior mandible with a 95% confidence interval (CI). The statistical significance was defined as p-value (<0.05).
Results:
A total of 7,224 publications were identified through electronic databases and manual search. Twelve cohort studies were selected for qualitative assessment and eight for quantitative analysis. The pooled bone-height change was 0.67 mm (95% CI: 0.29-1.05 mm); p = 0.001) with high heterogeneity based on chi-square and I2 statistics (I2 = 97.63%; τ2 = 0.43). Subgroup analysis based on implant type as covariate demonstrated that endosseous implants were associated with statistically significant (p < 0.001) increase in bone height of the posterior edentulous mandible, but not transosseous implants, although the between-subgroup difference was not significant (Q = 0.284; p = 0.594). MINORS scores were 10-13 of 16 for one-arm studies and 20 of 24 for the single two-arm study.
Conclusion:
Within the limitations of this review and meta-analysis, FCDs were associated with a statistically significant increase in posterior mandibular bone height, although high heterogeneity and a prediction interval spanning bone loss limit the generalizability of this finding. Further standardized prospective studies are needed to clarify the factors underlying this variability.
