Optimal treatment protocol using dental implants for edentulous maxilla: a review of the literature
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AIM: This systematic review analyzes the impact of factors affecting the rehabilitation of maxillary edentulous patients with implant-supported prosthesis. By identifying these variables we hope to establish standard treatment protocols for the edentulous maxilla. MATERIAL AND METHODS: The electronic data bases PubMed, Science Direct, and Embase were searched for clinical studies of complete maxillary implant supported removable and fixed dental prostheses. The analysis was confined to prospective studies with a mean follow-up of at least 1 year published prior to February 2017. RESULTS: A total of 158 publications were retrieved from the database searches. One additional article was included from manual searches. From these, 12 articles were included in this study for further analysis using PRISMA. The analysis of the selected articles revealed the following findings: 1. It is difficult to report a definite conclusion from the selected articles in the present review because they exhibit a great heterogeneity and differences in methodology. 2. High implant and implant supported fixed prosthesis survival rates can be achieved when five or more implants were placed in edentulous maxilla. 3. Whether implants were placed in healed bone sites or fresh extraction sockets did not significantly affect the implant survival rate. 4. Immediate loading of prosthesis did not show a difference in implant or prosthetic survival rate. 5. Continuing follow up is necessary because in fixed type of restoration fractured components of prostheses is very commonly seen.