| Objective To provide reliable scientific evidences in clinicaldecision and treatments with comprehensive analysis of clinical results,patient satisfaction and implant maintenance of different attachments formandibular implant-supported overdentures.Methods We searched MEDLINE (1996to Mar.2012), EMbase(1984to Sept.2012), The Cochrane Central Register of Controlled Trials(CENTRAL,1988to Sept.2012), BIOSIS preview (1997to Sept.2012),Chinese biomedical database (CBM,1978to Sept.2012), VIP database(1989to Sept.2012), Wanfang data (1998to Sept.2012), CNKI (1949toSept.2012), and manual searched eleven Chinese Stomatology Journals.According to the inclusion and exclusion criteria, data were extracted, thequality of studies was evaluated by two researchers, and then meta-analysiswith RevMan5.2and qualitative description.Results Eight studies of seventeen articles were included. Among all378patients,188in bar attachment group,166in ball attachment group,and24in magnet attachment group. Two studies with19patients in bar group and28in ball group could use meta-analysis and the results of themshowed that PI (SMD=0.16,95%CI-0.42to0.75, P=0.59) and BI(SMD=0.37,95%CI-0.22to0.96, P=0.22) have no statistically significantdifference between bar-clip and ball-spring attachment groups. Otherqualitative descriptions showed that:1)compared with conventionalcomplete dentures, high overall satisfaction among the three groups but barand ball attachment groups had higher satisfaction in masticatory efficiencyand denture retention;2) bar attachment had a strong retention force andlow repair rate after implantation, but oral mucositis and mucosalhyperplasia occurred frequently;3) ball attachment had a strong retentionforce and less oral mucosa complications, but a higher repair rate;4)magnet attachment had the lowest retention force, more oral ulcers andmore maintenance frequencies after implantation, but had the best implantcondition.Conclusions There is not enough evidence to prove which is best formandibular implant-supported overdentures among bar, ball, and magnetattachment. More randomized controlled trials with rigorous design, largesample size, accurate and objective outcome indicators are required toguide clinicians making decision on the choice of the type of attachment inmandibular implant-supported overdentures. |
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