Effect of bar designs on peri implant tissues health in implant-supported removable prostheses: a systematic review

Abstract

Different characteristics of bars (cross-sectional shape, diameter, distal extension etc.) lead to different biomechanical behavior (retention and stress) with implants and peri-implant tissues. Aim: To evaluate the impact of implant-supported removable prostheses bar designs in fully edentulous arch (in the maxilla and/or mandibula), with 4 implants or more, on the peri-implant soft and hard tissues. Two reviewers searched for observational studies, RCT and in vitro studies, published on five main databases and three from the grey literature, without restrictions on November 2023. Of the 3049 selected articles, four met the inclusion criteria. Four RCT evaluated peri-implant health tissues in full edentulous arches with 4 or 6 implants rehabilitated with implant bar overdentures. One prospective study with 5 years follow-up evaluated the success/survival rate of implants and implant bar overdentures. Overall, 261 subjects were enrolled in our systematic review with 1176 implants. Overdentures’ survival rate was 100%. There was a trend that plaque indices and gingival indices were low in all of the studies, however no statistical analysis was done due to the lack of information. Due to the lack of information in the included studies, we cannot confirm if bar characteristics affect the peri-implant tissues health.