25 September 2019

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How many implants do we need for maxillary overdenture?

Lara Figini

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Nowadays patients with fully edentulous maxilla may benefit from different prosthetic rehabilitations. One of them  is the implant-supported overdenture that is a satisfactory and functional prosthetic rehabilitation based on an optimal cost–benefit ratio. The main benefits are an increase of prosthesis retention and a reduction in palatal coverage, resulting in higher patient satisfaction and chewing ability.  

MATERIALS AND METHODS 
In a review published on Journal of Prosthodontic Research January 2019 the authors investigated what was the minimum number of implants required to support a maxillary overdenture in order to obtain optimal treatment outcomes in terms of implant survival, overdenture longevity and patient satisfaction. The authors searched all relevant articles in world literature using the Pubmed and EMBASE databases from 2000 to 2017. The Prism statement and the PICOS approach were adopted. All selected articles provided at least two years follow-up and 10 edentulous patients. Survival rates of implants and overdentures were statistically analyzed according to the number of implants and according to splitting technique, employing non-parametric Fisher Test for unpaired data.         

RESULTS
A total of 28 articles were included in the final review. Analysis of the data from the included studies showed that the implant survival rate was significantly higher in the group in which 4 implants were inserted. Survival rate of overdentures and patient satisfaction were not significantly influenced by the number of implants placed.     

CONCLUSIONS 
From the data of this review, which must be confirmed in other similar revisions, we can concluded that the most frequent tendency is to place at least four implants, splinted or unsplinted, in order to ensure a higher survival rate of implants. However, the relationship between overdenture survival, the patient’s quality of life, and the number of implants required to support a maxillary overdenture has yet to be clarified.      

Clinical implications: based on the data of literature, when dentist have to rehabilitate maxillary edentoulos with an implant-supported overdenture, it is advisable that he  inserts at least 4 supporting implants to ensure a greater implant survival rate.     

For additional informations: 
The number of implants required to support a maxillary overdenture: a systematic review and meta-analysis.

Italian version: http://www.odontoiatria33.it/implantologia/17928/overdenture-mascellare-quanti-impianti-sono-necessari.html