METHODS: In January 2022, Medline, Embase, CINAHL, Cochrane Library, PubMed Central, Web of Science, and ClinicalTrials.gov were screened for prospective clinical studies on completely edentulous patients treated with IFCDs and/or IODs, reporting pre-treatment and follow-up dPROs. Hedges\' g effect sizes (ES) with corresponding 95% confidence intervals (CI) were calculated. Afterward, meta-analyses were conducted using random effect models.
RESULTS: A total number of 1608 records was initially identified. Of those, 28 studies reporting dPROs from 1457 patients were finally included. The applied dental patient-reported outcome measures (dPROMs) included several versions of the Oral Health Impact Profile (OHIP) or specific items assessing satisfaction with Visual Analogue Scales (VAS). The overall ES was large for rehabilitation with IFCDs (1.68 [CI: 1.15, 2.20]) and IODs (1.26 [CI: 0.99, 1.52]) with no significant difference (p = .165) between the two. Denture stability was the only factor rated significantly higher for IFCDs (ES difference: 2.37 [CI: 0.21, 4.54]; p = .032). Subgroup analyses revealed moderately higher ES for IODs on two implants relative to one implant (ES difference: 0.73 [CI: 0.34, 1.12]; p < .001).
CONCLUSIONS: There is a strong positive effect of implant treatment in edentulous patients, independent of the type of prosthetic rehabilitation. In patients seeking high stability, IFCDs may be preferable. In mandibular IODs on a single implant, there was a significantly positive effect of an additional implant on dPROs.
方法:2022年1月,Medline,Embase,CINAHL,科克伦图书馆,PubMedCentral,WebofScience,和ClinicalTrials.gov筛选了对使用IFCD和/或IOD治疗的完全无牙患者的前瞻性临床研究,报告治疗前和随访dPRO。计算对冲效应大小(ES)和相应的95%置信区间(CI)。之后,使用随机效应模型进行meta分析.
结果:最初确定的记录总数为1608条。其中,最终纳入了来自1457名患者的28项报告dPROs的研究。应用的牙科患者报告的结果指标(dPROM)包括口腔健康影响概况(OHIP)的几个版本或评估对视觉模拟量表(VAS)满意度的特定项目。对于IFCD(1.68[CI:1.15,2.20])和IOD(1.26[CI:0.99,1.52])的康复,总体ES很大,两者之间没有显着差异(p=.165)。义齿稳定性是IFCD评价显著较高的唯一因素(ES差异:2.37[CI:0.21,4.54];p=.032)。亚组分析显示,相对于一个植入物,两个植入物的IOD的ES稍高(ES差异:0.73[CI:0.34,1.12];p<.001)。
结论:种植体治疗无牙患者有很强的积极作用,独立于假肢康复的类型。在寻求高稳定性的患者中,IFCD可能是优选的。在单个植入物上的下颌IOD中,额外的植入物对dPRO有显著的积极作用.