J Adv Prosthodont.  2014 Oct;6(5):325-332. 10.4047/jap.2014.6.5.325.

Standardizing the evaluation criteria on treatment outcomes of mandibular implant overdentures: a systematic review

• Kim HY
• Shin SW
• Lee JY

• KMID: 2284732
• DOI: http://doi.org/10.4047/jap.2014.6.5.325

Abstract

PURPOSE
The aim of this review was to analyze the evaluation criteria on mandibular implant overdentures through a systematic review and suggest standardized evaluation criteria.
MATERIALS AND METHODS
A systematic literature search was conducted by PubMed search strategy and hand-searching of relevant journals from included studies considering inclusion and exclusion criteria. Randomized clinical trials (RCT) and clinical trial studies comparing attachment systems on mandibular implant overdentures until December, 2011 were selected. Twenty nine studies were finally selected and the data about evaluation methods were collected.
RESULTS
Evaluation criteria could be classified into 4 groups (implant survival, peri-implant tissue evaluation, prosthetic evaluation, and patient satisfaction). Among 29 studies, 21 studies presented implant survival rate, while any studies reporting implant failure did not present cumulative implant survival rate. Seventeen studies evaluating peri-implant tissue status presented following items as evaluation criteria; marginal bone level (14), plaque Index (13), probing depth (8), bleeding index (8), attachment gingiva level (8), gingival index (6), amount of keratinized gingiva (1). Eighteen studies evaluating prosthetic maintenance and complication also presented following items as evaluation criteria; loose matrix (17), female detachment (15), denture fracture (15), denture relining (14), abutment fracture (14), abutment screw loosening (11), and occlusal adjustment (9). Atypical questionnaire (9), Visual analog scales (VAS) (4), and Oral Health Impact Profile (OHIP) (1) were used as the format of criteria to evaluate patients satisfaction in 14 studies.
CONCLUSION
For evaluation of implant overdenture, it is necessary to include cumulative survival rate for implant evaluation. It is suggested that peri-implant tissue evaluation criteria include marginal bone level, plaque index, bleeding index, probing depth, and attached gingiva level. It is also suggested that prosthetic evaluation criteria include loose matrix, female detachment, denture fracture, denture relining, abutment fracture, abutment screw loosening, and occlusal adjustment. Finally standardized criteria like OHIP-EDENT or VAS are required for patient satisfaction.

Keyword

Denture; Overlay; Mandibular prosthesis; Dental implants; Outcome assessment; Patient satisfaction

MeSH Terms

Dental Implants
Denture Rebasing
Denture, Overlay*
Dentures
Female
Gingiva
Hemorrhage
Humans
Mandibular Prosthesis
Occlusal Adjustment
Oral Health
Patient Satisfaction
Periodontal Index
Survival Rate
Visual Analog Scale
Surveys and Questionnaires
Dental Implants

Figure

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  Fig. 1 Flowchart of search strategy.

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  Fig. 2 Items in the questionnaires used to evaluate patient satisfaction on implant overdenture.

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