![]() Furthermore, the unsplinted overdentures provide good emergence profile and require simple oral hygiene practice in daily life. Besides low costs, the unsplinted mandibular implant-retained overdentures display a low repair frequency and easy maintenance on isolated attachments, attracting more attention in the clinic. Moreover, when unsplinted anchors are employed, the implant-retained overdentures could cost even less compared to their counterparts with splinted anchors. Little difference was observed between the average annual costs of overdentures retained by two implants and conventional complete dentures. More recently, the York Consensus Statement provided further clinical evidence that the use of no less than two implants could significantly enhance the retention of mandibular overdentures and the EAO consensus conference also indicated that the oral health-related of life outcomes could be improved with overdentures retained by two or four implants. In order to obtain adequate retention at a reasonable cost, the McGill Consensus Statement recommended that the overdenture retained by two implants in anterior area of mandible could be the first-choice standard for edentulous patients. With the wide application of osseointegrated implants, implant-retained overdentures have been introduced as a viable alternative to conventional complete dentures. Conventional complete dentures may present some limitations such as insufficient retention and poor comfort, especially in the severely atrophic mandible. The rehabilitation of edentulism has long been regarded as one of the main challenges for dentists. PROSPERO registration number: CRD42020159124. Immediate loading may be a promising alternative to delayed loading for the management of unsplinted mandibular implant-retained overdentures. Conclusionsįor unsplinted mandibular implant-retained overdentures, the MBL around implants after ILP seems comparable to that of implants after DLP. Seven included studies have reported 5.03% implant failure rate (10 of 199 implants) in ILP group and 1.00% failure rate (2 of 201 implants) in DLP group in total. Two prospective cohort studies were proved with acceptable quality. Apart from one RCT (20%) with a high risk of bias, four RCTs (80%) showed a moderate risk of bias. The subgroup analysis revealed similar results with Locator attachments or ball anchors ( P > .05). The MBL of ILP group showed no significant difference with that of DLP group (WMD 0.04, CI − 0.13 to 0.21, P > .05). Of 328 records, five RCTs and two cohort studies were included and evaluated, which totally contained 191 participants with 400 implants. ![]() The risk of bias within and across studies were assessed using the Cochrane Collaboration’s tool, the Newcastle–Ottawa scale, and Egger’s test. ![]() The subgroup analysis was performed between different attachment types (i.e. A meta-analysis was conducted to compare the pooled MBL of two different loading protocols of unsplinted mandibular overdentures through weighted mean differences (WMDs) with 95% confidence intervals (95% CIs). A systematic search was carried out in PubMed, EMBASE, and CENTRAL databases on December 02, 2020. ![]() Randomized controlled trials (RCTs), controlled clinical trials (CCTs), and cohort studies quantitatively comparing the MBL around implants between immediate loading protocol (ILP) and delayed loading protocol (DLP) of unsplinted mandibular overdentures were included. The purpose of this study was to compare the marginal bone loss (MBL) around implants between immediate and delayed loading of unsplinted mandibular implant-retained overdentures. However, there is still a scarcity of meta-analytical evidence on the efficacy of immediate loading compared to delayed loading in unsplinted mandibular implant-retained overdentures. Immediate loading has recently been introduced into unsplinted mandibular implant-retained overdentures for the management of edentulous patients due to their increasing demand on immediate aesthetics and function. ![]()
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