title: Impact of implant support for mandibular dentures on satisfaction, oral and general health-related quality of life: a meta-analysis of randomized-controlled trials.
abstract: OBJECTIVE
  The aim of this study was to examine systematically the data published on the efficacy of mandibular implant-retained overdentures from the patient's perspective.
  
  
  METHODS
  Medline, Embase, The Cochrane Central Register of Controlled Trials and The Cochrane Systematic Reviews Database were searched and complemented by hand searching. All randomized-controlled trials published in English or French up to April 2007 were included, in which conventional dentures and mandibular implant overdentures in adult edentulous individuals were compared. The outcomes of interest were patient satisfaction, oral and general health-related quality of life. Random effects models were used to pool the effect sizes (ES) of all included studies.
  
  
  RESULTS
  Ten publications of seven randomized-controlled trials were identified and eight were included in the meta-analysis. When compared with mandibular conventional dentures, implant overdentures were rated to be more satisfactory at a clinically relevant level [pooled ES 0.80, z=3.56, 95% confidence intervals (CI) 0.36-1.24, P=0.0004], but a statistical heterogeneity was found (chi(2)=31.63, df=5, P<0.00001, I(2)=84%). The pooled ES for oral health quality of life was -0.41 (z=1.31, 95% CI, -1.02 to 0.20; P=0.19, chi(2)=11.53, df=2, P<0.003, I(2)=83%). There was a lack of evidence to show the impact of mandibular implant overdenture on perceived general health.
  
  
  CONCLUSIONS
  Our findings suggest that, although mandibular implant-retained overdentures may be more satisfying for edentulous patients than new conventional dentures, the magnitude of the effect is still uncertain. There is a need for additional evidence including cost-effectiveness analyses on the impact of mandibular implant overdentures and conventional dentures.
authors.affiliation: Départment de Dentisterie et de Restauration, Faculté de Médecine Dentaire, Université de Montréal, Montréal, QC, Canada.
authors.forename: Elham
authors.initials: E
authors.lastname: Emami
authors.forename: Guido
authors.initials: G
authors.lastname: Heydecke
authors.forename: Pierre H
authors.initials: PH
authors.lastname: Rompré
authors.forename: Pierre
authors.initials: P
authors.lastname: de Grandmont
authors.forename: Jocelyne S
authors.initials: JS
authors.lastname: Feine
mesh_terms: D000328:Adult; D015921:Dental Implants / Q000523:psychology*; D019094:Dental Prosthesis, Implant-Supported / Q000523:psychology*; D003826:Denture, Complete, Lower / Q000523:psychology*; D003828:Denture, Overlay; D055094:Evidence-Based Dentistry; D006304:Health Status; D006801:Humans; D007575:Jaw, Edentulous / Q000523:psychology / Q000534:rehabilitation*; D008334:Mandible; D015233:Models, Statistical; D009909:Oral Health; D017060:Patient Satisfaction; D011788:Quality of Life / Q000523:psychology; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
chemical_list: D015921:Dental Implants