Alqutaibi, A.YElawady, D.M.A2020-05-022020-05-022020-03Alqutaibi, A.Y., Esposito, M., Algabri, R., Alfahad, A., Kaddah, A.F., Farouk, M., Alsourori, A. Single vs two implant-retained overdentures for edentulous mandibles: A systematic review (2017) European Journal of Oral Implantology, 10 (3), pp. 243-261. Cited 5 times. https://ejoi.quintessenz.de/f5d4/ejoi_2017_03_s0243.pdf 2 Alqutaibi, A.Y., Aboalrejal, A. There is no evidence that recommends a specific optimum number of implants for an overdenture (2016) Journal of Evidence-Based Dental Practice, 16 (3), pp. 184-186. Cited 3 times. http://www.elsevier.com/inca/publications/store/6/2/3/2/3/4/index.htt doi: 10.1016/j.jebdp.2016.09.006 View at Publisher 3 Feine, J.S., Carlsson, G.E., Awad, M.A., Chehade, A., Duncan, W.J., Gizani, S., Head, T., (...), Wismeijer, D. The McGill consensus statement on overdentures. Mandibular two-implant overdentures as first choice standard of care for edentulous patients. (2002) Gerodontology, 19 (1), pp. 3-4. Cited 175 times. doi: 10.1111/j.1741-2358.2002.00003.x View at Publisher 4 Thomason, J.M., Kelly, S.A.M., Bendkowski, A., Ellis, J.S. Two implant retained overdentures - A review of the literature supporting the McGill and York consensus statements (2012) Journal of Dentistry, 40 (1), pp. 22-34. Cited 132 times. doi: 10.1016/j.jdent.2011.08.017 View at Publisher 5 Çiftçi, Y., Canay, Ş. The Effect of Veneering Materials on Stress Distribution in Implant-Supported Fixed Prosthetic Restorations (2000) International Journal of Oral and Maxillofacial Implants, 15 (4), pp. 571-582. Cited 87 times. 6 Naert, I., Alsaadi, G., Van Steenberghe, D., Quirynen, M. A 10-year randomized clinical trial on the influence of splinted and unsplinted oral implants retaining mandibular overdentures: Peri-implant outcome (2004) International Journal of Oral and Maxillofacial Implants, 19 (5), pp. 695-702. Cited 151 times. 7 Sadowsky, S.J. Mandibular implant-retained overdentures: A literature review (2001) Journal of Prosthetic Dentistry, 86 (5), pp. 468-473. Cited 128 times. http://www.sciencedirect.com/science/journal/00223913 doi: 10.1067/mpr.2001.119921 View at Publisher 8 Stoumpis, C., Kohal, R.-J. To splint or not to splint oral implants in the implant-supported overdenture therapy? A systematic literature review (2011) Journal of Oral Rehabilitation, 38 (11), pp. 857-869. Cited 60 times. doi: 10.1111/j.1365-2842.2011.02220.x View at Publisher 9 Van Kampen, F.M.C., Van der Bilt, A., Cune, M.S., Bosman, F. The influence of various attachment types in mandibular implant-retained overdentures on maximum bite force and EMG (2002) Journal of Dental Research, 81 (3), pp. 170-173. Cited 95 times. View at Publisher 10 Feine, J.S., Maskawi, K., de Grandmont, P., Donohue, W., Tanguay, R., Lund, J.P. Within-subject Comparisons of Implant-supported Mandibular Prostheses: Evaluation of Masticatory Function (1994) Journal of Dental Research, 73 (10), pp. 1646-1656. Cited 124 times. doi: 10.1177/00220345940730101001 View at Publisher 11 Fontijn-Tekamp, F.A., Slagter, A.P., Van't Hof, M.A., Geertman, M.E., Kalk, W. Bite forces with mandibular implant-retained overdentures (1998) Journal of Dental Research, 77 (10), pp. 1832-1839. Cited 116 times. View at Publisher 12 Tang, L., Lund, J.P., Taché, R., Clokie, C.M.L., Feine, J.S. A within-subject comparison of mandibular long-bar and hybrid implant-supported prostheses: evaluation of masticatory function (1999) Journal of Dental Research, 78 (9), pp. 1544-1553. Cited 49 times. http://jdr.sagepub.com/content/by/year doi: 10.1177/00220345990780090901 View at Publisher 13 Stoker, G., Van Waas, R., Wismeijer, D. Long-term outcomes of three types of implant-supported mandibular overdentures in smokers (2012) Clinical Oral Implants Research, 23 (8), pp. 925-929. Cited 46 times. doi: 10.1111/j.1600-0501.2011.02237.x View at Publisher 14 Burns, D.R., Unger, J.W., Coffey, J.P., Waldrop, T.C., Elswick Jr., R.K. Randomized, prospective, clinical evaluation of prosthodontic modalities for mandibular implant overdenture treatment (2011) Journal of Prosthetic Dentistry, 106 (1), pp. 12-22. Cited 39 times. doi: 10.1016/S0022-3913(11)60088-7 View at Publisher 15 Moher, D., Liberati, A., Tetzlaff, J., Altman, D.G., Altman, D., Antes, G., Atkins, D., (...), Tugwell, P. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement (Open Access) (2009) Annals of Internal Medicine, 151 (4), pp. 264-269. Cited 10436 times. http://www.annals.org/cgi/reprint/151/4/264.pdf doi: 10.7326/0003-4819-151-4-200908180-00135 View at Publisher 16 Batenburg, R.H.K., Raghoebar, G.M., Van Oort, R.P., Heijdenrijk, K., Boering, G. Mandibular overdentures supported by two or four endosteal implants: A prospective, comparative study (1998) International Journal of Oral and Maxillofacial Surgery, 27 (6), pp. 435-439. Cited 80 times. http://www.elsevier-international.com/journals/ijom/ doi: 10.1016/S0901-5027(98)80032-5 View at Publisher 17 de Jong, M.H.M., Wright, P.S., Meijer, H.J.A., Tymstra, N. Posterior mandibular residual ridge resorption in patients with overdentures supported by two or four endosseous implants in a 10-year prospective comparative study (2010) International Journal of Oral and Maxillofacial Implants, 25 (6), pp. 1168-1174. Cited 20 times. 18 Gotfredsen, K., Holm, B. Implant-Supported Mandibular Overdentures Retained with Ball or Bar Attachments: A Randomized Prospective 5-Year Study (2000) International Journal of Prosthodontics, 13 (2), pp. 125-130. Cited 190 times. 19 Meijer, H.J.A., Raghoebar, G.M., Batenburg, R.H.K., Visser, A., Vissink, A. Mandibular overdentures supported by two or four endosseous implants: A 10-year clinical trial (2009) Clinical Oral Implants Research, 20 (7), pp. 722-728. Cited 109 times. doi: 10.1111/j.1600-0501.2009.01710.x View at Publisher 20 Naert, I., Gizani, S., Vuylsteke, M., Van Steenberghe, D. A 5-year prospective randomized clinical trial on the influence of splinted and unsplinted oral implants retaining a mandibular overdenture: Prosthetic aspects and patient satisfaction (1999) Journal of Oral Rehabilitation, 26 (3), pp. 195-202. Cited 214 times. www.blackwellpublishing.com/journal.asp?ref=0305-182X doi: 10.1046/j.1365-2842.1999.00369.x View at Publisher 21 Spiekermann, H., Jansen, V.K., Richter, E.-J. A 10-year follow-up study of IMZ and TPS implants in the edentulous mandible using bar-retained overdentures (1995) International Journal of Oral and Maxillofacial Implants, 10 (2), pp. 231-243. Cited 171 times. http://jomi.quintessenz.de/2f81/jomi_1995_02_s0231.pdf 22 Bergendal, T., Engquist, B. Implant-Supported Overdentures: A Longitudinal Prospective Study (1998) International Journal of Oral and Maxillofacial Implants, 13 (2), pp. 253-262. Cited 214 times. 23 Närhi, T.O., Hevinga, M., Voorsmit, R.A.C.A., Kalk, W. Maxillary Overdentures Retained by Splinted and Unsplinted Implants: A Retrospective Study (2001) International Journal of Oral and Maxillofacial Implants, 16 (2), pp. 259-266. Cited 60 times. 24 Kiener, P., Oetterli, M., Mericske, E., Mericske-Stern, R. Effectiveness of Maxillary Overdentures Supported by Implants: Maintenance and Prosthetic Complications (2001) International Journal of Prosthodontics, 14 (2), pp. 133-140. Cited 101 times. 25 Oetterli, M., Kiener, P., Mericske-Stern, R. A Longitudinal Study on Mandibular Implants Supporting an Overdenture: The Influence of Retention Mechanism and Anatomic-Prosthetic Variables on Periimplant Parameters (2001) International Journal of Prosthodontics, 14 (6), pp. 536-542. Cited 54 times. 26 Karabuda, C., Tosun, T., Ermis, E., Ozdemir, T. Comparison of 2 retentive systems for implant-supported overdentures: Soft tissue management and evaluation of patient satisfaction (2002) Journal of Periodontology, 73 (9), pp. 1067-1070. Cited 30 times. doi: 10.1902/jop.2002.73.9.1067 View at Publisher 27 Walton, J.N. A randomized clinical trial comparing two mandibular implant overdenture designs: 3-Year prosthetic outcomes using a six-field protocol (2003) International Journal of Prosthodontics, 16 (3), pp. 255-260. Cited 52 times. 28 Chung, K.-H., Chung, C.-Y., Cagna, D.R., Cronin Jr., R.J. Retention characteristics of attachment systems for implant overdentures (2004) Journal of Prosthodontics, 13 (4), pp. 221-226. Cited 121 times. doi: 10.1111/j.1532-849X.2004.04042.x View at Publisher 29 Timmerman, R., Stoker, G.T., Wismeijer, D., Oosterveld, P., Vermeeren, J.I.J.F., Van Waas, M.A.J. An eight-year follow-up to a randomized clinical trial of participant satisfaction with three types of mandibular implant-retained overdentures (2004) Journal of Dental Research, 83 (8), pp. 630-633. Cited 136 times. http://jdr.sagepub.com/content/by/year doi: 10.1177/154405910408300809 View at Publisher 30 MacEntee, M.I., Walton, J.N., Glick, N. A clinical trial of patient satisfaction and prosthodontic needs with ball and bar attachments for implant-retained complete overdentures: Three-year results (2005) Journal of Prosthetic Dentistry, 93 (1), pp. 28-37. Cited 170 times. doi: 10.1016/j.prosdent.2004.10.013 View at Publisher 31 Lachmann, S., Kimmerle-Müller, E., Gehring, K., Axmann, D., Gomez-Roman, G., Watzek, G., Weber, H. A comparison of implant-supported, bar- Or ball-retained mandibular overdentures: A retrospective clinical, microbiologic, and immunologic study of 10 edentulous patients attending a recall visit (2007) International Journal of Prosthodontics, 20 (1), pp. 37-42. Cited 17 times. 32 Al-Zubeidi, M.I., Alsabeeha, N.H., Thomson, W.M., Payne, A.G. Patient Satisfaction and Dissatisfaction with Mandibular Two-Implant Overdentures Using Different Attachment Systems: 5-Year Outcomes (2012) Clinical Implant Dentistry and Related Research, 14 (5), pp. 696-707. Cited 17 times. http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1708-8208 doi: 10.1111/j.1708-8208.2010.00306.x View at Publisher 33 Visser, A., Raghoebar, G.M., Meijer, H.J.A., Batenburg, R.H.K., Vissink, A. Mandibular overdentures supported by two or four endosseous implants: A 5-year prospective study (2005) Clinical Oral Implants Research, 16 (1), pp. 19-25. Cited 121 times. doi: 10.1111/j.1600-0501.2004.01085.x View at Publisher 34 Wismeijer, D., Van Waas, M.A.J., Vermeeren, J.I.J.F., Kalk, W. Patients' perception of sensory disturbances of the mental nerve before and after implant surgery: A prospective study of 110 patients (1997) British Journal of Oral and Maxillofacial Surgery, 35 (4), pp. 254-259. Cited 135 times. http://www.elsevier-international.com/journals/bjom/ doi: 10.1016/S0266-4356(97)90043-7 View at Publisher 35 Wismeijer, D., Van Waas, M.A.J., Mulder, J., Vermeeren, J.I.J.F., Kalk, W. Clinical and radiological results of patients treated with three treatment modalities for overdentures on implants of the ITI® Dental Implant System: A randomized controlled clinical trial (1999) Clinical Oral Implants Research, 10 (4), pp. 297-306. Cited 94 times. www.blackwellpublishing.com/journal.asp?ref=0905-7161 doi: 10.1034/j.1600-0501.1999.100406.x View at Publisher 36 De Bruyn, H., Besseler, J., Raes, F., Vaneker, M. Clinical outcome of overdenture treatment on two nonsubmerged and nonsplinted astra tech microthread™ Implants (2009) Clinical Implant Dentistry and Related Research, 11 (2), pp. 81-89. Cited 23 times. doi: 10.1111/j.1708-8208.2008.00103.x View at Publisher 37 Stoker, G.T., Wismeijer, D., Van Waas, M.A.J. An eight-year follow-up to a randomized clinical trial of aftercare and cost-analysis with three types of mandibular implant-retained overdentures (2007) Journal of Dental Research, 86 (3), pp. 276-280. Cited 103 times. http://jdr.sagepub.com/content/by/year doi: 10.1177/154405910708600315 View at Publisher 38 Mau, J., Behneke, A., Behneke, N., Fritzemeier, C.U., Gomez-Roman, G., D'Hoedt, B., Spiekermann, H., (...), Yong, M. Randomized Multicenter Comparison of 2 IMZ and 4 TPS Screw Implants Supporting Bar-Retained Overdentures in 425 Edentulous Mandibles (2003) International Journal of Oral and Maxillofacial Implants, 18 (6), pp. 835-847. Cited 34 times. 39 Alqutaibi, A.Y., Kaddah, A.F., Farouk, M. Randomized study on the effect of single-implant versus two-implant retained overdentures on implant loss and muscle activity: a 12-month follow-up report (2017) International Journal of Oral and Maxillofacial Surgery, 46 (6), pp. 789-797. Cited 6 times. http://www.elsevier-international.com/journals/ijom/ doi: 10.1016/j.ijom.2017.02.001 View at Publisher 40 Helmy, M.H.E.-D., Alqutaibi, A.Y., El-Ella, A.A., Shawky, A.F. Effect of implant loading protocols on failure and marginal bone loss with unsplinted two-implant-supported mandibular overdentures: systematic review and meta-analysis (2018) International Journal of Oral and Maxillofacial Surgery, 47 (5), pp. 642-650. Cited 6 times. http://www.elsevier-international.com/journals/ijom/ doi: 10.1016/j.ijom.2017.10.018 View at Publisher 41 Ali, R.M.M., Alqutaibi, A.Y., El-din Gomaa, A.S., Abdallah, M.F. Effect of submerged vs nonsubmerged implant placement protocols on implant failure and marginal bone loss: A systematic review and meta-analysis (2018) International Journal of Prosthodontics, 31 (1), pp. 15-22. Cited 4 times. http://www.quintpub.com/journals/ijp/fulltext.php?article_id=17987 doi: 10.11607/ijp.5315 View at Publisher336572https://doi.org/10.3290/j.qi.a44144https://t.ly/oZtPhttps://t.ly/ACbcScopusObjectives: To evaluate the influence of implant splinting on peri-implant marginal bone level and implant failures in com pletely edentulous patients who have been rehabilitated with mandibular implant overdentures. Method and materials: A literature search of electronic databases (PubMed and Cochrane Central Register of Controlled Trials [CENTRAL]) was performed, with the last search conducted in July 2019. Randomized con trolled trials with at least a 12-month follow-up period were selected. The review and meta-analysis were performed in ac cordance with PRISMA guidelines. Two comparisons were in cluded in the meta-analysis: (1) Two-implant supported ball versus two-implant supported bar mandibular overdenture; (2): Two- versus four-implant supported bar mandibular overden ture. Results: Six randomized controlled trials fulfilled the inclu sion criteria and were included in a quality assessment and me ta-analysis. Pooled data revealed a nonsignificant difference in marginal bone level (I2 = 0%; P = 1; mean difference = 0.00; 95% CI −0.37 to 0.37) and implant failures (P = .24; risk ratio = 6.07; 95% CI 0.30 to 121.33) when two-implant ball overdentures were compared to two-implant bar overdentures. Similarly, there was no significant difference in marginal bone level (I2 = 59%; P = .59; mean difference = −0.16; 95% CI −0.73 to 0.41) or implant failures (I2 = 0%; P = .36; risk ratio = 2.03; 95% CI 0.45 to 9.16) when two- versus four-implant bar overdentures were compared. Conclusion: Based on the findings of the meta-ana lysis, there is no influence of implant splinting on peri-implant marginal bone level and implant failures for completely edentu lous patients rehabilitated with mandibular implant overden tures. However, this result should be interpreted with caution due to the limited number of analyzed studies, most of them considered at unclear risk of bias. Well-designed randomized controlled trials with follow-up periods of at least 5 years are highly recommended to establish evidence with regard to the influence of implant splinting on mandibular overdentures. © 2020 Quintessence Publishing Co., Ltd.en-USDental implantsImplant failureMandibular overdentureMarginal bone lossSplintingedentulousnesshumanimplant-supported dentureDental ImplantsDental Prosthesis, Implant-SupportedImplant splinting in mandibular overdentures: A systematic review with meta-analysis of randomized clinical trials(Review)Articlehttps://doi.org/10.3290/j.qi.a44144