The effect of mandibular implant overdentures on masticatory performance: A systematic review and meta-analysis

Abstract

Background

The main objective of this systematic review and meta-analysis was to investigate whether masticatory performance was improved in edentulous patients wearing complete dentures, after the provision of mandibular implant overdentures.

Type of studies reviewed

Electronic search was conducted in three databases (MEDLINE, Scopus, CENTRAL), while handsearching and gray literature assessment were also performed. Risk of bias was assessed via RoB 2 and ROBINS-I tools, according to study type. Meta-analysis was conducted by using inverse variance and random effects model.

Results

Four randomized controlled trials and eight uncontrolled paired before-after studies were considered eligible for meta-analysis. Standardized mean differences between baseline and one, two, three, six and twelve months were -0.97 (95% confidence interval [CI], -1.34 to -0.61; I² = 99%), -1.28 (95% CI, -3.52 to 0.97; I² = 99%), -1.01 (95% CI, -1.58 to -0.43; I² = 99%), -1.09 (95% CI, -1.77 to -0.42; I² = 100%) and -1.31 (95% CI, -2.03 to -0.59; I² = 100%), respectively

Practical implications

In most time intervals the masticatory performance had a statistically significant continuous improvement, demonstrating the functional upgrading of the complete dentures brought by the implants. High heterogeneity was noted, as various variables and evaluation methods were used. Although six of 12 studies were characterized as “Low Risk of Bias”, strength of the evidence was found “Low” in seven studies. Not only more and higher quality studies but also a unique and reliable method for evaluation of masticatory performance are required for producing homogenous and robust results.