Patient-reported outcome measures and clinical assessment of implant-supported overdentures and fixed prostheses in mandibular edentulous patients: A systematic review and meta-analysis.

Abstract Statement of problem A consensus based on patients’ perceptions as to whether to use overdentures or fixed prostheses to rehabilitate mandibular edentulous arches is limited. Purpose The purpose of this systematic review and meta-analysis was to compare the patient-reported outcome measures (PROMs) and clinical outcomes associated with implant-supported overdentures and fixed prostheses in edentulous mandibles. Material and methods Nine electronic databases were searched for randomized clinical trials (RCTs) and nonrandomized clinical trials (N-RCTs). The risk of bias was assessed by the revised Cochrane risk of bias tool for RCTs (RoB 2) and N-RCT (ROBINS-I). Data sets for oral health–related quality of life (OHRQoL), satisfaction, survival rate, implant probing depth, and marginal bone loss were plotted, and the appropriate analyses were applied by using the Rev Man 5.3 software program. Certainty of evidence was also evaluated by means of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Results Ten eligible trials were included and evaluated quantitatively. For 3 domains of OHRQoL, fixed prostheses showed significantly higher quality of life when compared with overdentures regarding functional limitation (P .05) between both types of prosthesis. Conclusions Fixed rehabilitations for mandibular edentulous patients seem to be a well-accepted treatment from the patients’ oral health perspective. However, mandibular overdentures are no less efficient than fixed prostheses in terms of clinical outcomes.