| Objective:Meta-analysis was used to collect literatures on the clinical results of mandibular implant-overdenture with different types of attachments,including patient satisfaction and post-repair maintenance,for meta-analysis and systematic evaluation,so as to help clinicians provide better treatment options for patients in future clinical operations.Methods:Computer retrieval in January 1990-December 2019,included in Pubmed,the Cochrane library,web of science,CNKI,WANFANG MED ON LINE,Chinese biomedical literature database published about different types of attachment of clinical randomized controlled trial(RCT)in both English and Chinese literature,retrieve the word for "attachment,implant-supported overdenture,edentulous jaw and satisfaction" for retrieval,and the included references were retrieved manually by two independent researchers.The included references was screened according to the pre-determined criteria(the literature included any one of the clinical results after denture repair,patient satisfaction or post-repair maintenance),then,the quality evaluation data of the literature was extracted and analyzed.If there were any differences,the third researcher would conduct further discussion and arbitration.Meta analysis was performed with Revman5.3 software,and the level of meta-analysis was P=0.05.Results:A total of 29 articles were included in this systematic analysis,and a total of 1052 patients were divided into 5 types of studies.Some of these studies were Meta analyzed.Results: ?Plaque index: the results of the bar group and ball group were [SMD=0.16,95%ci(-0.42,0.75),P=0.59].The result of Locator group and bal group was [SMD=-0.27,95%ci(-0.72,0.17),P=0.22],and the difference was not statistically significant.?Gingival bleeding index: the results of bar group and ball-group were [SMD=-0.16,95%ci(-0.75,0.43),P=0.59],the difference was not statistically significant.? The satisfaction with chewing function of the Locator and ball groups was [SMD=0.16,95%ci(-0.47,0.79),P=0.62],and the difference between the two groups was not statistically significant.?The satisfaction with appearance of Locator and ball group was [SMD=-0.48,95%ci(-1.23,0.27),P=0.21],and the difference was not statistically significant.In addition,studies that could not be analyzed were systematically and comprehensively descriptive analysis,the results showed that: ? Mandibular implant-supported overdenture compared with traditional denture(CCD),after the former repaired with different attachment system,the retention function,chewing efficiency,language and comfort were significantly improved.Patient satisfaction with the denture is also increased significantly,but in terms of chewing satisfaction and retention satisfaction,ball,bar and LOCATOR attachments are better than that of magnetic attachment;?There is no significant difference in the satisfaction of attachment system of Locator and ball group;?In terms of plaque index and gingival bleeding index of the ball group and the bar group,some studies indicated that there were significant differences between the two groups.? Compared with the bal and magnetic attachment system,the Locator attachment has fewer complications,but it needs more post-care to ensure the normal use of the denture.;Compared with ball-cap attachment and magnetic attachment,the stick attachment has better retention effect and less postoperative maintenance,but it has a higher incidence of mucositis and mucosal hyperplasia;The retention force of the ball group was good,but there is higher frequency of postoperative maintenance;More mucosal ulcers occur in magnetic attachments,and more maintenance is required to replace the magnets due to corrosion of the magnets.Conclusion:? Each attachment system has a large degree of satisfaction compared with the original traditional complete denture;? There was no significant difference in plaque index and gingival bleeding index between bar and ball group.The bar attachment has a better retention effect than the ball and magnetic attachment,and the incidence of complications is lower,but it is more likely to cause mucositis and mucosal hyperplasia.?There is no obvious difference between the attachment of Locator and the attachment of ball in the aspects of plaque index,mastication satisfaction and appearance satisfaction.Compared with ball and magnetic attachment system,the attachment system of Locator has a lower incidence of complications,but the nursing frequency after repair is higher.?The retention effect of magnetic attachment is relatively poor,and requires more post-repair maintenance frequency,and is more likely to cause mucosal ulcer.?The ball attachment system requires more maintenance after implantation,and the frequency of visit is high. |
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