Abstract
Statement of problem
Consensus is lacking regarding the influence of the maxillary dentition on the survival
rate of a mandibular metal-resin implant-supported fixed complete denture (MRISFCD)
with distal cantilevers.
Purpose
The purpose of this systematic review was to identify whether an opposing natural
dentition influences the survival rate of mandibular MRISFCDs.
Material and methods
A literature search was performed up to February 2018 from MEDLINE/PubMed, Scopus,
Web of Science, Cochrane Library, BBO/LILACS databases and also in the non–peer-reviewed
literature through Open Grey. Clinical studies regarding natural (ND), removable prostheses
(RP), and complete fixed maxillary implant dentitions (ID) with at least a year of
follow-up were included. The quality of the included studies was analyzed, and the
risk of bias was reported. A meta-analysis comparing the survival rate of ND with
RP and ND with ID was performed with a confidence interval (CI) of 95%, and heterogeneity
was tested by an I2 index. Grading of Recommendations, Assessment, Development, and Evaluation (GRADE)
approach was used to determine the certainty of the evidence.
Results
From a total of 112 ND, 69 ID, and 204 RP in the maxillary dentition, the overall
prevalence of failures was 5.4% (6/112; 95% CI [2.3 to 10.76]) for ND, 13.99% (20/69;
95% CI [0.77 to 39.41]) for ID, and 4.9% (10/204; 95% CI [0.69 to 12.18]) for RP.
No statistical differences were detected in the success rates between ND and RP (risk
difference = 0.00 [−0.06, 0.06]; P=.93; I2=27%) or between ND and ID (risk difference=0.00 [−0.06, 0.07]; P=.97; I2=0%), both with moderate evidence.
Conclusion
With a moderate certainty of evidence, it is suggested that natural maxillary dentitions
do not affect the survival rate of mandibular MRISFCDs differently from other prosthetic
designs.
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Article info
Publication history
Published online: November 18, 2019
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© 2019 by the Editorial Council for The Journal of Prosthetic Dentistry.
