A meta-analysis of effectiveness of an implant-supported mandibular overdenture retained with a ball attachment

doi:10.3969/j.issn.2095-4344.2014.47.028

Abstract

Abstract:

BACKGROUND: There is no design that can completely rule out the intermittent impact damage to implants, therefore, a new ball attachment-retained implant system is constantly updated and developed.
OBJECTIVE: To evaluate the clinical effectiveness of an implant-supported mandibular overdenture retained with a ball attachment.
METHODS: We searched the Cochrane Library, PubMed, Medline, EM-base, WanFang Data, CNKI, VIP and other databases by computer to collect randomized controlled trials addressing the implant-supported mandibular overdenture retained with a ball attachment and other control methods for dentures. The time limit was from database creation to February 2014. Two researchers independently completed literature screening according to inclusion and exclusion criteria, data extraction and quality assessment. RevMan 5.1 software was used for meta-analysis.
RESULTS AND CONCLUSION: There were 10 studies included in result analysis, including 7 from China and 3 from other countries. Analysis results showed that statistical heterogeneity was remarkable in included studies, and there was no significant difference in patient’s satisfaction, clinical and objective indicators, and complications, suggesting that this approach continues to be explored in clinic. The implant-supported ball attachment-retained mandibular overdenture is relatively expensive, which is identical with the current research progress that is in the exploration stage worldwide. Due to the limited quantity and quality of included studies, the conclusions of this systematic review only provide references for clinical practice and research. The implant-supported ball attachment-retained mandibular overdenture still needs further exploration and improvement.

中国组织工程研究杂志出版内容重点：生物材料；骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性；组织工程

全文链接：

Key words: dental implants, dentures, denture precision attachment

CLC Number:

R318

Huang Yan, Guo Na. A meta-analysis of effectiveness of an implant-supported mandibular overdenture retained with a ball attachment[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(47): 7702-7708.

Figures/Tables 4

2.3 Meta分析结果 2.3.1 种植体支持球帽附着体固位下颌覆盖全口义齿与对照组患者义齿固性良好率的Meta分析纳入的10个文献中，9个独立研究均报告了义齿的固性状态，各研究间具有异质性(P=0.000 3，I2=72%)，故采用随机效应模型进行Meta分析。结果显示种植体支持球帽附着体固位下颌覆盖全口义齿组和对照组相比，两组义齿固性良好的报告率差异无显著性意义[RR=0.76，95%CI(0.33，1.72)，P=0.51]。见图1。从漏斗图分析可见，Meta分析计算所得合并效应基本不受发表偏倚的影响。见图2。 2.3.2 种植体支持球帽附着体固位下颌覆盖全口义齿与对照组患者义齿美观性满意率的Meta分析纳入的10个文献中，9个独立研究均报告了义齿的美观性状态，各研究间具有异质性(P < 0.000 1，I2=78%)，故采用随机效应模型进行Meta分析。结果显示种植体支持球帽附着体固位下颌覆盖全口义齿组和对照组相比，两组义齿美观性的满意率差异无显著性意义[RR=1.75，95%CI(0.59，5.24)，P=0.32]。见图3。从漏斗图分析可见，Meta分析计算所得合并效应基本不受发表偏倚的影响。见图4。 2.3.3 种植体支持球帽附着体固位下颌覆盖全口义齿与对照组患者义齿舒适性满意率的Meta分析纳入的10个文献中，9个独立研究均报告了义齿的舒适性状态，各研究间具有异质性(P=0.01，I2=58%)，故采用随机效应模型进行Meta分析。结果显示种植体支持球帽附着体固位下颌覆盖全口义齿组和对照组相比，两组义齿舒适性的满意率差异无显著性意义[RR=1.01，95%CI(0.53，1.93)，P=0.97]。见图5。从漏斗图分析可见，Meta分析计算所得合并效应基本不受发表偏倚的影响。见图6。 2.3.4 种植体支持球帽附着体固位下颌覆盖全口义齿与对照组患者义齿咀嚼功能满意率的Meta分析纳入的10个文献中，9个独立研究均报告了义齿的咀嚼功能满意状态，各研究间具有异质性(P < 0.000 1，I2=78%)，故采用随机效应模型进行Meta分析。结果显示种植体支持球帽附着体固位下颌覆盖全口义齿组和对照组相比，两组义齿咀嚼功能的满意率差异无显著性意义[RR=1.71，95%CI(0.40，7.28)，P=0.47]。见图7。从漏斗图分析可见，Meta分析计算所得合并效应基本不受发表偏倚的影响。见图8。 2.3.5 种植体支持球帽附着体固位下颌覆盖全口义齿与对照组患者义齿舒牙槽骨高度的Meta分析纳入的10个文献中，5个独立研究报告了义齿的牙槽骨高度，各研究间有异质性(P < 0.000 1，I2=100%)，故采用随机效应模型进行Meta 分析。结果显示种植体支持球帽附着体固位下颌覆盖全口义齿组和对照组相比，两组义齿牙槽骨高度差异无显著性意义[SD=0.32，95%CI(-0.61，1.25)，P=0.50]。见图9。从漏斗图分析可见，Meta分析计算所得合并效应量不受发表偏倚的影响。见图10。 2.3.6 种植体支持球帽附着体固位下颌覆盖全口义齿与对照组患者义齿牙周袋深度的Meta分析纳入的10个文献中，5个独立研究报告了义齿的牙周袋深度，各研究间有异质性(P < 0.000 1，I2=96%)，故采用随机效应模型进行Meta分析。结果显示种植体支持球帽附着体固位下颌覆盖全口义齿组和对照组相比，两组义齿牙周袋深度差异无显著性意义[SD=-0.71，95%CI(-1.62，0.19)，P=0.12]。见图11。从漏斗图分析可见，Meta分析计算所得合并效应量基本不受发表偏倚的影响。见图12。 2.3.7 种植体支持球帽附着体固位下颌覆盖全口义齿与对照组患者义齿并发症发生率的Meta分析纳入的10个研究中，3个研究报告了并发症的发生率，各研究间具有异质性 (P < 0.000 1，I2=91%)，故采用随机效应模型进行Meta分析。结果显示种植体支持球帽附着体固位下颌覆盖全口义齿组和对照组相比，两组义齿并发症发生率差异无显著性意义[RR=0.64，95%CI(0.04，9.71)，P=0.75]。见图13。由于纳入研究仅为3个，未进行漏斗图分析。"

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