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Optimal number of implants for complete-arch implant-supported prostheses with a follow-up of at least 5 years: A systematic review and meta-analysis
Authors:Jéssica Marcela de Luna Gomes  Cleidiel Aparecido Araújo Lemos  Joel Ferreira Santiago Junior  Sandra Lúcia Dantas de Moraes  Marcelo Coelho Goiato  Eduardo Piza Pellizzer
Institution:1. Postgraduate student, Department of Dental Materials and Prosthodontics, Sao Paulo State University (UNESP), Araçatuba, Brazil;2. Postgraduate student, Department of Dental Materials and Prosthodontics, Sao Paulo State University (UNESP), Araçatuba, Brazil;3. Assistant Professor, Pró-Reitoria de Pesquisa e Pós-graduação (PRPPG), Universidade do Sagrado Coração (USC), Bauru, Brazil;4. Adjunct Professor, Faculty of Dentistry, University of Pernambuco (UPE), Camaragibe, Brazil;5. Full Professor, Department of Dental Materials and Prosthodontics, Sao Paulo State University (UNESP), Araçatuba, Brazil;6. Full Professor, Department of Dental Materials and Prosthodontics, Sao Paulo State University (UNESP), Araçatuba, Brazil
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 5 years of follow-up.

Material and methods

A search was performed in the PubMed/MEDLINE, Scopus, and Cochrane Library databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria and was registered in The International Prospective Register of Systematic Reviews (CRD42016048468). The following was the population, intervention, comparison, outcome (PICO) question: Does the number of implants influence the longevity of complete-arch prostheses?

Results

Nineteen studies including 1006 patients with a mean age of 61.44 years were selected for evaluation. The number of implants per jaw ranged between 2 and 9 in the maxilla, mandible, or both jaws. For implant survival rate in complete-arch prostheses with fewer than 5 implants per jaw, the pooled weighted event rate was 1.4% (I2=25.26%; P=.211) and 4.2% (I2=81.35%; P<.001) for complete arches with more than 4 implants per jaw. For the prosthesis survival rate, the pooled weighted event rate for a complete-arch with fewer than 5 implants per jaw was 1.5% (I2=0%; P=.677) and 9% (I2=17.33%; P=.304) for complete arches with more than 4 implants per jaw. For prosthesis complications for complete arches with fewer than 5 implants per jaw, the pooled weighted event rate was 19.9% (I2=93.5%; P<.001) and 24.5% (I2=88.89; P<.001) for complete arches with more than 4 implants per jaw. The mean marginal bone loss for complete arches with fewer than 5 implants per jaw was 1.22 ±0.49 mm (I2=99.46; P<.001) and 1.46 ±0.46 mm (I2=99.6; P <.001) for more than 4 implants per jaw.

Conclusions

The current systematic review indicated no relationship of the number of implants used to support a complete-arch prosthesis with implant survival rate, prosthesis survival rate, prosthesis complications, or marginal bone loss in studies with follow-up periods of between 5 and 15 years.
Keywords:Corresponding author: Dr Jéssica Marcela de Luna Gomes  Department of Dental Materials and Prosthodontics  Aracatuba Dental School  Sao Paulo State University (UNESP)  Jose Bonifacio Street  1153  Vila Mendonca  Aracatuba  Sao Paulo 16015-050  BRAZIL  
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