Prosthetic Outcomes of Implant-Assisted Maxillary Restorations in the Edentulous Maxilla: A Systematic Review and Meta-Analysis.

OBJECTIVES

To evaluate the prosthetic outcomes of implant-assisted maxillary full-arch restorations with ≥ 3 years of follow-up.

MATERIALS AND

METHODS

A systematic electronic literature search was conducted in five databases to identify randomised controlled trials and prospective clinical studies involving patients who received full-arch rehabilitation in the maxilla. The primary outcome was prosthesis loss; secondary outcomes included complication-free prosthesis survival, complication-free implant survival, implant loss, technical complications, patient-reported outcome measures (PROMS), and marginal bone loss. Meta-analyses of proportions using random-effects models were performed to estimate pooled rates of prosthetic survival, success, and complications.

RESULTS

A total of 20 studies involving 913 patients were included. Among these, 542 patients received fixed prostheses and 371 received removable prostheses. Most of the studies had an observation period in the range of 3 to 6 years, with only two studies (overdentures) reaching 10 years. Overall prosthesis loss was 4.6% (95% CI: 1.2%-10.1%) and complication-free prosthesis survival was 61.9% (95% CI: 48.4%-74.5%). Overall complication-free implant survival was 46.5% and technical complications were 62.9%. Pooled implant loss was 5.5% after adjusting for clustering effects and mean marginal bone loss was < 0.8 mm. Subgroup analysis of fixed and removable prosthesis over a similar observation period revealed similar outcomes.

CONCLUSIONS

Implant-assisted maxillary full-arch restorations have low rates of prosthesis and implant loss. However, complication-free survival is moderate, underscoring the importance of maintenance and patient education.