title: Treatment of adult patients with edentulous arches: a systematic review.
abstract: OBJECTIVE
  This study aimed to evaluate the outcomes of treatment methods used to rehabilitate adult patients with maxillary and/or mandibular edentulism after at least 5 years of follow-up. The risks, adverse effects, and cost effectiveness of these methods were also evaluated.
  
  
  METHODS
  Three databases as well as the reference lists of included publications were searched using specified indexing terms. Publications that met the inclusion criteria were read and interpreted using pre-established protocols. Quality of evidence was classified according to the GRADE system (high, moderate, low, or very low).
  
  
  RESULTS
  The search yielded 2,130 titles and abstracts. Of these, the full-text versions of 488 publications were obtained. After data extraction and interpretation, 10 studies with moderate study quality of evidence and 1 study with low quality of evidence regarding outcomes, risks, and adverse effects remained. Three studies on the economic aspects of treatment were also included (1 with moderate quality and 2 with low quality). Low-quality evidence showed that the survival rate of implant-supported fixed prostheses is 95% after 5 years in patients with maxillary edentulism and 97% after 10 years in patients with mandibular edentulism. The survival rate of implant-supported overdentures is 93% after 5 years (low-quality evidence). In implant-supported fixed prostheses, 70 of every 1,000 implants are at risk of failing in the maxilla after 5 years and 17 of every 1,000 implants in the mandible are at risk after 10 years. Regarding economic aspects, the evidence was insufficient to provide reliable results.
  
  
  CONCLUSIONS
  Due to the low quality of evidence found in the included studies, further research with a higher quality of evidence is recommended to better understand the outcomes of treatment for patients with maxillary and/or mandibular edentulism.
authors.affiliation: Malmo University, Malmo, Sweden. madeleine.rohlin@mah.se
authors.forename: Madeleine
authors.initials: M
authors.lastname: Rohlin
authors.forename: Krister
authors.initials: K
authors.lastname: Nilner
authors.forename: Thomas
authors.initials: T
authors.lastname: Davidson
authors.forename: Goran
authors.initials: G
authors.lastname: Gynther
authors.forename: Margareta
authors.initials: M
authors.lastname: Hultin
authors.forename: Torsten
authors.initials: T
authors.lastname: Jemt
authors.forename: Ulf
authors.initials: U
authors.lastname: Lekholm
authors.forename: Gunilla
authors.initials: G
authors.lastname: Nordenram
authors.forename: Anders
authors.initials: A
authors.lastname: Norlund
authors.forename: Karin
authors.initials: K
authors.lastname: Sunnegardh-Gronberg
authors.forename: Sofia
authors.initials: S
authors.lastname: Tranaeus
mesh_terms: D000328:Adult; D055094:Evidence-Based Dentistry; D006801:Humans; D007575:Jaw, Edentulous / Q000628:therapy*