Slim v common diameter dental implants for mandibular overdentures

Dental implants are actually in widespread use and all kinds of implant designs can be found various in diameter, size and taper. Mandibular overdentures are thought of to supply benefits over typical dentures. Slim-diameter implants ≤3.5 mm in diameter minimise the necessity for alveolar bone augmentation for some sufferers however could have mechanical and organic limitation in comparisons with common diameter implants (>3.5–4.5 mm in diameter).

The goal of this evaluate was to check using narrow-diameter and common diameter dental implants for supporting mandibular overdentures.

Strategies

Searches have been performed within the Cochrane Central Register of Managed Trials, Embase, Medline, Scopus, Internet of Science, ClinicalTrials.gov and the World Well being Group worldwide medical trials registry platform databases. Randomised managed trials (RCTs) and managed medical trials (CCTs) evaluating stability and useful profit in sufferers with mandibular overdentures supported on slim or common implants have been thought of. Two reviewers independently chosen research, extracted knowledge and assessed examine high quality utilizing the Cochrane Threat of Bias software 2.0  (RoB2) for RCTs and the ROBINS-I software for CCTs. Meta-analyses have been carried out for implant survival charge (ISR), marginal bone loss (MBL), affected person satisfaction, and oral well being associated high quality of life (OHRQoL).

Outcomes

• 8 research (4 RCTs, 4 CCTs) reported in 12 publications have been included.
• Slim implants ranged from 1.8 – 3.3mm in diameter, 10 – 15mm in size.
• Common implants ranges from 3.6 – 4.5mm in diameter, 8.5 – 15mm in size.
• One examine was rated as low threat, one at excessive threat and 6 at reasonable threat of bias.
• Observe-up interval ranged from 1 – 3 years.
• Imply implant survival charge for slim implants 94.88% (vary 86.44%–100%; n = 6) in contrast with 99.02% (vary, 97.14%–100%; n = 6) for normal implants.
• Meta-analysis confirmed: –
  • The relative threat (RR) for implant failure between slim and common implants was not vital RR= 0.98 (95percentCI: 0.94 to 1.02) [6 studies].
  • MBL didn’t considerably differ between slim and common implants, weighted imply distinction (WMD) = 0.03mm (95percentCI: −0.64 to 0.69) [5 studies].
  • Sufferers’ general satisfaction was considerably increased with slim than common implants for mandibular overdentures, WMD = 8.18 (95percentCI: 5.83 to 10.53) [4 studies,250 patients].
  • Slim implants have been related to a major enchancment in OHRQoL in comparison with common implants for mandibular overdentures, WMD = −4.36 (95percentCI: −6.83 to −1.89) [3 studies, 276 patients].
• No examine in contrast useful efficiency for mandibular overdenture between slim and common implants utilizing goal parameters.

Conclusions

The authors concluded: –

Inside short-term follow-up durations, slim dental implants have acceptable remedy outcomes when it comes to implant survival charge, extent of peri-implant marginal bone loss, and PROMs (basic satisfaction and oral health-related high quality of life.

Feedback

No revealed protocol was out there for this evaluate, however the authors searched an excellent vary of databases. Solely 8 research have been included with solely 6 research contributing to the meta-analyses. Solely one of many research was thought of to be at low threat of bias and the out there knowledge is comparatively brief time period with solely two research following up sufferers for greater than 2 years.  Whereas the findings recommend no variations between slim and common implants supporting mandibular overdentures the findings needs to be seen cautiously as the standard of proof is proscribed in high quality and amount and in addition short-term in nature. Prime quality effectively reported randomised trials involving bigger numbers of sufferers and of longer length are wanted to offer higher high quality proof to tell sufferers and clinicians.

Hyperlinks

Major Paper

Park JH, Shin SW, Lee JY. Slim-diameter versus regular-diameter dental implants for mandibular overdentures: A scientific evaluate and meta-analysis. J Prosthodont. 2023 Jun 27. doi: 10.1111/jopr.13726. Epub forward of print. PMID: 37365991.

Different references

Dental Elf – 17^th Jul 2023

Implant diameter and survival charges

Dental Elf – 21^st Mar 2022

Implant-supported overdentures and stuck prostheses in edentulous mandibles

Dental Elf – Overdenture Blogs