Prosthodontic maintenance and peri-implant tissue conditions for telescopic attachment-retained mandibular implant overdenture: Systematic review and meta-analysis of randomized clinical trials

The mandibular implant-retained overdentures (MIRO) are a highly successful prosthetic treatment option. However, an argument still present regarding its design and type of attachment system. This systematic review and meta-analysis aimed to perform a qualitative and quantitative analysis of the scientific literature regarding the telescopic attachments versus other attachment systems retaining mandibular implant overdentures. Manual and electronic database (PubMed and Cochrane) searches were performed to identify randomized controlled trials (RCTs) comparing telescopic versus other attachment systems. Independently, two investigators extracted the trials' data. The Cochrane tool was used for assessing the quality of included studies. Meta-analyses were performed for the included RCTs and reported the same outcome measures. Nine RCTs were identified. Three RCTs (corresponding to four publications) were included in the study. The other five trials were excluded from the study. The meta-analysis revealed no difference between telescopic crowns and ball attachment retaining mandibular implant overdenture as regards prosthodontic maintenance. Regarding peri-implant conditions, ball-retained mandibular overdenture showed statistically significant more probing depth around implants records in ball-retained overdenture when compared to the telescopic group. However, there are no statistically significant differences between two interventions in regard to marginal bone loss, bleeding index, gingival index, and plaque index. In conclusions, no significant differences in prosthodontic maintenance and peri-implant condition between telescopic attachments and ball attachments retaining MIRO. However, this should be considered with caution because of a limited number of included studies.