Protocols for the Maxillary Implant Overdenture: A Systematic Review

Purpose: To evaluate patient-related outcomes in restoring the edentulous maxilla with an implant overdenture. Materials and Methods: A comprehensive systematic review of the literature was conducted. Publications reporting patient-based outcomes with concomitant data on implant and/or prosthetic success were selected using predetermined inclusion criteria that were agreed upon by the two reviewers. Results: Twenty-three publications related to 20 study cohorts were identified to meet the inclusion criteria for maxillary implant overdentures: two randomized controlled trials (RCTs), 13 prospective case series including two crossover trials, and five retrospective studies. Conclusion: An implant overdenture offers a stabilized removable solution for the edentulous maxilla, which provides increased patient satisfaction and quality of life improvement. A palateless design supported by four to six implants with a wide anteroposterior span has been successfully applied in some investigations. A higher failure rate was experienced with machined implants, particularly with short implants (length 10 mm). Although both splinted and solitary anchorage systems are advocated, maintenance is higher for solitary attachments and inflammation is increased beneath the bars. Long-term maintenance care is essential for all designs. Well-designed RCTs with larger sample cohorts with longer follow-up periods are required to amplify patient- and clinician-based outcomes. Keywords: implant/prosthetic survival/success, maintenance, maxillary implant overdentures, patient satisfaction