OPTIMUM NUMBER OF ORAL IMPLANTS REQUIRED FOR FULL ARCH FIXED PROSTHESIS TO REHABILITATE COMPLETELY EDENTULOUS PATIENTS - A SYSTEMATIC REVIEW AND META-ANALYSIS.

Abstract

Statement of problem: Consensus is lacking regarding the optimal number of implants for supporting complete-arch prostheses with good survival rates and lower prosthetic complications and marginal bone loss.

Purpose: The purpose of this systematic review was to evaluate the influence of the number of implants used for complete-arch prostheses with at least 1 year of follow-up.

Materials and method: An electronic search was conducted for articles in English, listed with PubMed, Medline,

Embase, Cochrane, Google scholar till December 2019. Review articles as well as references from different studies were also used to identify the relevant articles. The search from the electronic databases identified 1025 publications out of which 611 articles were excluded by reading the titles. After evaluation of abstracts, 137 articles were eligible for analysis. After the full text of these articles had been read, 34 studies were excluded for the following reasons: they were retrospective studies, in-vitro studies and animal studies, studies that did not identify the number of implants per jaw per patient, same design and population and inappropriate follow up period and there were insufficient data to rehabilitate completely edentulous patients with optimum number of oral implants. This resulted in a final number of 10 publications for the current systematic review.

Results: The implant survival rate in complete-arch prostheses with fewer than 5 implants was 98.7% for both jaws, 99% for the maxilla and 98.9% for the mandible. The implant survival rate in complete-arches prostheses with more than 4 implants was 96.6% for both jaws, 95.61% for the maxilla and 100% for the mandible.

Conclusion: there is no significant difference in longevity when fewer than 5 implants or more than 4 implants are used for complete-arch implant-supported prosthesis. Thus, the number of implants used in complete-arch prostheses does not influence implant survival rate, prosthesis complications or marginal bone loss in studies with a follow-up period of 5 to 15 years.