Alexei Panfili, Marina Nicoleta Miron, Agop-Forna Doriana, Forna Norina
ABSTRACT
Aim of the study. The objective of this comprehensive review was to evaluate the clinical, biomechanical, and patient-reported outcomes of implant-supported removable partial dentures (ISRPDs) compared to conventional distal extension removable partial dentures (DERPDs) in patients with Kennedy Class I and II mandibular configurations.
Material and methods. A systematic review of current literature was performed across databases including PubMed, Cochrane Library, Embase, and Web of Science. Although multiple clinical trials and comparative papers were initially screened, exactly 3 studies met the strict inclusion parameters perfectly and were retained for final analytical synthesis based on a precise PICO framework. The reviewed sample involved a pooled total of 334 patients and 581 strategic implants. Key parameters extracted included Patient-Reported Outcome Measures (PROMs) via OHIP-14 and Visual Analogue Scales (VAS), maximum occlusal force alterations, marginal bone loss (MBL), and prosthetic maintenance requirements over mid-to-long-term follow-up intervals.
Results. The structural transition from traditional mucosa-borne prostheses to implant-stabilized designs demonstrated a statistically significant global reduction in OHIP scores (30.5 ± 1.8), highlighting a drastic improvement in oral health-related quality of life. Subjective patient satisfaction scales (VAS) exhibited substantial shifts, particularly across prosthesis stability and chewing comfort domains. Objective mechanical assessments showed a mean increase in maximum occlusal force exceeding 120% due to the establishment of a rigid posterior vertical stop. Biologically, the pooled implant survival rate remained highly predictable between 92% and 100%, with a weighted mean marginal bone loss of 0.98 mm, within physiological norms. Prosthetic maintenance, predominantly involving the replacement of retentive nylon inserts every 12 to 18 months, represented the primary technical intervention.
Conclusions. Strategic implant placement under a distal extension removable framework significantly optimizes biomechanical stability, doubles masticatory parameters, and maximizes patient satisfaction, establishing a highly cost-effective and minimally invasive alternative to complex fixed rehabilitation.
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