Highlighted review: Attachments for implant dentures

Alan GT Payne, Nabeel HM Alsabeeha, Momen A Atieh, Marco Esposito, Sunyoung Ma, Marwah Anas El‐Wegoud

Plain language summary: Attachments for implant dentures

Review question
The aim of this review was to assess different attachments used for upper or lower jaw implant dentures with respect to their success, wear and tear, patient satisfaction, patient preference and cost.

Background
For adults with complete tooth loss, the modern approach is implant dentures with attachment systems connecting the implants to the undersurface of the dentures. It is important to do the review as the choice of the number of implants and the design of the attachments influences prosthesis success, the amount of wear and tear, patient satisfaction, preference and costs.

Study characteristics
Authors from Cochrane Oral Health carried out this review and the evidence is up to date to 24 January 2018. A total of six trials on adults with complete tooth loss were included with a total of 294 lower jaw dentures (anchored by one or more implants).

The review looked at different attachment systems on the same implant systems. The six trials did not each evaluate the same attachment systems. There were no eligible trials with upper jaw implant dentures.

Key results
There is insufficient evidence to determine any significant differences between lower jaw implant denture attachment systems and an absence of evidence for upper jaw implant denture attachment systems.

Further randomised controlled trials on people with complete tooth loss wearing dentures must pay specific attention to trial design using the same implant system and the same number of implants, but different attachment systems to determine their longevity and patient preferences.

Quality of the evidence
We judged the quality of the evidence to be very low. In all the included trials there were relatively few participants and few events, and there were serious limitations in the trial designs with data missing or not all outcomes reported.

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Citation: Payne  AGT, Alsabeeha  NHM, Atieh  MA, Esposito  M, Ma  S, Anas El‐Wegoud  M. Interventions for replacing missing teeth: attachment systems for implant overdentures in edentulous jaws. Cochrane Database of Systematic Reviews 2018, Issue 10. Art. No.: CD008001. DOI: 10.1002/14651858.CD008001.pub2.