Skip to main content

Table.1 Treatment outcomes of IARPD reported by the included studies

From: Treatment outcomes of implant-assisted removable partial denture with distal extension based on the Kennedy classification and attachment type: a systematic review

Implant survival rate  
Author Year Research design Follow-up period Number of patients Number of implants Kennedy classification Attachment design Results
Bellia E, et al. 2020 Prospective 4 years Total: 20
U: –, L: –
U: 7, L: 28 I&II Locator 94.3%
Threeburuth W, et al. 2018 RCT 12 months L: 30 L: 60 I Equator on mini implant 93.3%
Jensen C, et al. 2017 RCT 3 months L: 30 L: 120 I Locator 100%
Jensen C, et al. 2017 Retrospective 3–16 years
Mean: 8 years
L: 23 L: 46 I Ball 91.7%
Payne AG, et al. 2017 Prospective 3 and 10 years L: 36 L: 72 I Ball Survival after 3 years: 100%
Survival after 10 years: 92%
Ortiz-Puigpelat O, et al. 2014 Case report Mean: 28.6 months U: 6, L: 6 U: 12, L: 12 I&II Locator 91.6%
Grageda E, et al. 2014 Case report 3 years L: 1 L: 2 I ERA 100%
Gates WD 3rd, et al. 2014 Prospective 6 and 12 weeks L: 17 L: 30 I&II Ball with Clix 96.7%
Turkyilmaz I 2009 Case Report 18 months L: 1 L: 2 II Locator 100%
Mitrani R, et al. 2003 Retrospective 1 to 4.5 years
Mean: 2.52 years
U: 4, L: 6 U: 5, L: 6 I&II Healing abutment, resilient attachment 100%
Mean bone loss
Bellia E, et al. 2020 Prospective 4 years Total: 20
U: –, L: –
U: 7, L: 28 I&II Locator 1.04 ± 1.88 mm
Threeburuth W, et al. 2018 RCT 12 months L: 30 L: 60 I Equator on mini implant Mini implant: 0.47 ± 0.42 mm, Conventional implant: 1.03 ± 1.07 mm
Mini vs. conventional implant*
Jensen C, et al. 2017 RCT 3 months L: 30 L: 120 I Locator Molar (M) Implant: 1.10 ± 0.53, Premolar (PM) Implant: 1.06 ± 0.59
M vs. PM(−)
Jensen C, et al. 2017 Retrospective 3–16 years
Mean: 8 years
L: 23 L: 46 I Ball Mean: 0.9 ± 1.0 mm; Anterior: 1.0 ± 1.1 mm; Posterior: 0.8 ± 1.0 mm
Anterior vs. posterior (−)
Payne AG, et al. 2017 Prospective 3 and 10 years L: 36 L: 72 I Ball 2.20 ± 0.81 mm
Turkyilmaz I 2009 Case report 18 months L: 1 L: 2 II Locator 0.3 ± 0.1 mm
Mitrani R, et al. 2003 Retrospective 1–4.5 years
Mean: 2.52 years
U: 4, L: 6 U: 5, L: 11 I&II Healing abutment,
Resilient attachment
Mesial (total: 0.61 ± 0.62):
Healing abutment (0.32 ± 0.47) vs. Resilient attachment (0.93 ± 0.64) (−)
Distal (total: 0.64 ± 0.45):
Healing abutment (0.44 ± 0.45) vs. Resilient attachment (0.88 ± 0.34) (−)
Occlusal contact area
Suzuki Y, et al. 2017 Randomized crossover 2–3 weeks L: 10 L: 20 I Stress Breaking Ball (SBB) CRPD: around 4 mm2, Healing abutment: around 7.8 mm2,
SBB: around 7.8 mm2
CRPD vs. healing abutment & SBB*
Ohkubo C, et al. 2008 Single-blinded randomized crossover 2–3 weeks L: 5 L: 10 I Healing abutment ISRPD on RPD area: around 6 mm2, CRPD on RPD area: around 3 mm2, ISRPD on full dental arch: 10 mm2, CRPD on full dental arch: 8 mm2
ISRPD vs. CRPD*
Occlusal force
Suzuki Y, et al. 2017 Randomized crossover 2–3 weeks L: 10 L: 20 I Stress Breaking Ball (SBB) Conventional RPD: around 200 N, Healing abutment: around 400 N
SBB: 400 N
CRPD vs. healing abutment & SBB*
Ohkubo C, et al. 2008 Crossover 2–3 weeks L: 5 L: 10 I Healing abutment ISRPD on RPD area: around 300 N, CRPD on RPD area: around 50 N
ISRPD on full dental arch: around 550 N, CRPD on full dental arch: around 400 N
ISRPD vs. CRPD* (ISRPD had significant greater force)
Patient satisfaction
Threeburuth W, et al. 2018 RCT 12 months L: 30 L: 60 I Equator on mini implant Comfort, Retention, Chewing performance
Before vs. after treatment*; mini-implant vs. conventional implant(−)
Jensen C, et al. 2016 RCT 3 and 6 months L: 30 L: 120 I Locator OHIP/total (Max score: 196): Old RPD = 49.6, New RPD = 40.3, ISRPD(M) 17.6, ISRPD(PM) = 21.2
ISRPD vs. RPD*
Campos CH, et al. 2015 Prospective 2 months L: 12 L: 24 I Ball QoL assessment using OHIP indicators & other indicators, such as chewing difficulty, pronunciation, appearance, self-consciousness
ISRPD with Ball abutment vs. CRPD*
Ortiz-Puigpelat O, et al. 2014 Case Report Mean: 28.6 months U; 6, L: 6 U: 12, L: 12 I&II Locator VAS Score Before = 1.19 ± 0.64, After = 4.55 ± 0.35
IARPD vs. RPD*
Goncalves TM, et al. 2014 Prospective 2 months Total: 12
U: -, L: -
Total: 24
U: -, L: -
I Ball VAS Score on retention, comfort, masticatory capacity, speaking ability
ISRPD vs. CRPD*
Wismeijer D, et al. 2013 Prospective 3 years L; 48 L: 72 I Ball OHIP, OHIQ, VAS
IARPD vs. CRPD*
Ohkubo C, et al. 2008 Crossover 2–3 weeks L: 5 L: 10 I Healing abutment VAS Score on stability, chewing, retention, and comfort
ISRPD vs. CRPD*
Mitrani R, et al.. 2003 Retrospective 1–4.5 years
Mean: 2.52 years
U: 4, L: 6 U: 5, L: 11 I&II Healing abutment,
Resilient attachment
Questionnaire (1–5 scale, 1 was least favorable): before (1.2), after (5.0)
Before vs. after IARPD Treatment*
Technical/prosthetic complication
Jensen C, et al. 2017 Retrospective 3–16 years
Mean: 8 years
L: 23 L: 46 I Ball No complications: 4 Anterior(A), 11 Posterior(P) = 15 (65.21%)
Minor repair: 2 (1A, 1P) (8.68%), Replaced: 3 (2A, 1P) (13%), Not in function: 1 (A) (4.34%)
Reverted into a full arch denture: 2 (P) (8.68%)
Anterior vs. Posterior* (anterior implant had significantly higher complications)
Ortiz-Puigpelat O, et al. 2014 Case Report Mean: 28.6 months U; 6, L: 6 U: 12, L: 12 I&II Locator Attachment (Locator) loosening: 0 (0%), Retentive cap mobility: 6 (50%)
Plastic retentive male change: all patients at 12th-month visit (100%)
Denture teeth wear: 7 (1 requires change) (58.33%), Metal framework: 1 broken after 15 months (8.33%)
Gates WD 3rd, et al. 2014 Prospective 6 and 12 weeks L: 17 L: 30 I&II Ball with Clix Clasp adjustments: 5 (29.41%), Denture base relining: 2 (11.76%), Fracture on denture tooth: 2 (11.76%), Abutment loosening: 1 (5.88%), Attachments replacement: 1 (5.88%), RPD reprocessing: 1 (5.88%)
Bleeding on probing
Bellia E, et al. 2020 Prospective 4 years Total: 20
U: –, L: –
U: 7, L: 28 I&II Locator BOP rate at 1 year: 20%, BOP rate at 4 years: 36.36%
Jensen C, et al. 2017 RCT 3 months L: 30 L: 120 I Locator Molar support: 0.26 ± 0.29, Premolar support: 0.11 ± 0.11
Molar vs. Premolar*
Jensen C, et al. 2017 Retrospective 3–16 years
Mean: 8 years
L: 23 L: 46 I Ball Anterior: 0.5(0.6), Posterior: 0.8(0.6)
Anterior vs. Posterior(−)
Implant mobility
Bellia E, et al. 2020 Prospective 4 years Total: 20
U: –, L: –
U: 7, L: 28 I&II Locator Mobility rate on 1 year: 0%, Mobility rate on 4 years: 3.03%
Masticatory performance
Goncalves TM, et al. 2014 Prospective 2 months L: 12 L: 25 I Ball VAS Score
RPD vs. IRPD & IFPD*
Mucosal health
Jensen C, et al. 2017 Retrospective 3–16 years
Mean: 8 years
L: 23 L: 46 I Ball Gingiva Index: Anterior: 0.1 ± 0.3, Posterior: 1.1 ± 0.7, Anterior vs. Posterior*
Probing depth: Anterior: 3.3(1.4); Posterior: 3.3(1.2), Anterior vs. Posterior(−)
Plaque score
Jensen C, et al. 2017 Retrospective 3–16 years
Mean: 8 years
L: 23 L: 46 I Ball Plaque Index (total: 0.9 ± 0.7): Anterior: 0.6 ± 0.7; Posterior: 1.1 ± 0.7
Anterior vs. Posterior*
Maximum bite force
Goncalves TM, et al. 2013 Clinical trial 2 months L: 12 L: 48 I Ball RDP: 178.1 ± 36.4 N, IRDP: 318.4 ± 47.1 N, IFDP: 483.9 ± 50.5 N
RDP vs. IRDP* (140 N gain, 79%), RDP vs. IFDP* (306 N gain, 172%)
Food comminution index
Goncalves TM, et al. 2013 Clinical trial 2 months L: 12 L: 48 I Ball RDP: 19.9 ± 5.3%, IRDP: 38 ± 7.7%, IFDP: 61.6 ± 10.6%
RDP vs. IRDP* (91% increase), RDP vs. IFDP* (209% increase)
Swallowing threshold
Campos CH, et al. 2014 Prospective 2 months L: 8 L: 16 I Ball Masticatory cycles don’t differ significantly between prosthesis treatments
X50: CRPD = 3.64; IARPD = 2.92
IARPD vs. CRPD*
Energy intake
Campos CH, et al. 2014 Prospective 2 months L: 8 L: 16 I Ball Parameters: Energy (kcal), Carbohydrate (g/day), Protein (g/day), Calcium (mg/day), Fiber (mg/day), Iron (mg/day)
ISRPD vs. IARPD*
  1. RPD Removable partial denture, IARPD Implant-assisted removable partial denture, ISRPD Implant-supported removable partial denture, CRPD Conventional removable partial denture, IFPD Implant fixed partial denture, IRPD Implant-retained partial denture, ERA Extracoronal resilient attachment, RCT Randomized controlled trial. OHIP Oral health impact profile, OHIQ Oral health impact questionnaire, VAS Visual analog scale, STTI Swallowing threshold test index, *significant difference, (−)no significant difference