Outcomes that may affect implant and prosthesis survival and complications in maxillary fixed prosthesis supported by four or six implants: A systematic review and meta-analysis

Mufeed Ahmed Sharaf; Siyuan Wang; Mubarak Ahmed Mashrah; Yangbo Xu; Ohood Haider; Fuming He

doi:10.1016/j.heliyon.2024.e24365

Outcomes that may affect implant and prosthesis survival and complications in maxillary fixed prosthesis supported by four or six implants: A systematic review and meta-analysis

Heliyon. 2024 Jan 20;10(3):e24365. doi: 10.1016/j.heliyon.2024.e24365. eCollection 2024 Feb 15.

Authors

Mufeed Ahmed Sharaf¹, Siyuan Wang², Mubarak Ahmed Mashrah³, Yangbo Xu², Ohood Haider⁴, Fuming He²

Affiliations

¹ Department of Prosthodontics, College of Dentistry, Ibb University, Ibb, Yemen.
² Department of Prosthodontics, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, China.
³ Department of Implantology, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong 510182, China.
⁴ Department of Orthodontics, Medical Center of Stomatology, Second Xiangya Hospital, Central South University, Changsha, China.

Abstract

Objective: To investigate whether the clinical and radiographical outcomes are affected when four or six implants support the maxillary fixed complete denture (FCD).

Materials and methods: This study was registered on PROSPERO (CRD42021226432) and followed the PRISMA guidelines. The focused PICO question was, "For an edentulous maxillary patient rehabilitated with an implant-supported fixed prosthesis, do the clinical and radiographical outcomes differ when four or six implants support the prosthesis ". A thorough search of the relevant studies was designed and performed electronically. The survival rate of implant and prosthesis, marginal bone loss, and complications (mechanical and biological) were the primary outcomes, whereas implant distribution and using the surgical guide, follow-up, and framework material were evaluated as secondary outcomes.

Results: Out of 1099 articles initially retrieved, 53 clearly stated the outcomes of interest and were included in this study. There were no significant differences in implant and prosthesis survival, technical/mechanical complications, and biological complications between the 4-implant group (4-IG) and the 6-implant group (6-IG). However, marginal bone loss (MBL) was significantly higher in the 4-IG (p < 0.01). The surgical guide and follow-up period did not significantly affect implant/prosthesis survival. Additionally, using the CAD/CAM milled framework and anteroposterior implant distribution were associated with significantly higher implant survival in the 6-IG (p < 0.01).

Conclusion: The findings of this study indicated that having a greater number of implants, as seen in the 6-implant group, can lead to a decrease in technical and biological complications and reduce marginal bone loss. It is worth noting that factors such as using CAD/CAM frameworks and the anteroposterior distribution of implants were recognized as important in improving implant survival rates when more implants are present.

Keywords: Complications; Dental implants; Edentulous; Fixed prosthesis; Maxilla.