Patient- and Clinician-Reported Outcomes and the Outcome Measures in Studies Reporting on Rehabilitation of the Edentulous Maxilla With Implant-Supported Fixed Prosthesis Using Short, Standard-Length and/or Zygomatic Implants: A Systematic Review of Clinical Studies Published in the Last 10 Years

Abstract

Objectives To identify patient-reported outcomes (PROs), clinician-reported outcomes (ClinROs) and patient-reported outcome measures (PROMs) in studies evaluating the rehabilitation of the edentulous maxilla with implant-supported fixed prosthesis using short and/or standard-length and/or zygomatic implants.Materials and Methods A systematic search was conducted in MEDLINE/PubMed, EMBASE, Scopus, Web of Science, Cochrane Central Register of Controlled Trials, and National Clinical Trial Register for articles published between January 1, 2014, and March 24, 2024. Studies reporting both PROMs and ClinROs related to implant therapy in patients with fully edentulous maxillae were eligible for inclusion. Study characteristics, PROMs, and ClinROs were extracted from each article. Study quality was appraised using Cochrane's Risk of Bias 2 tool, Newcastle-Ottawa Scale, or the Joanna Briggs Institute Critical Appraisal Tool according to the study design.Results The electronic search identified 1981 titles after removing duplicates. Fourteen publications, reporting both ClinROs and PROMs based on 12 studies (14 publications). These studies evaluated a total of 575 participants and 3367 implants. Eight publications focused exclusively on one type of implant design: seven evaluated standard-length implants and one examined zygomatic implants. The remaining six publications assessed two implant types: four compared zygomatic and standard-length implants, while two compared short and standard-length implants. The most frequently used PROMs among the publications (n = 14) were Oral Health-Related Quality-of-Life using OHIP questionnaires (7/14) and patient satisfaction using unstandardized questionnaires (7/14). The most frequently reported objective ClinROs were complication (14/14), marginal bone loss (10/14) assessed using standardized periapical radiographs, implant mobility/stability/failure (7/14), and implant survival (4/14). Subjective ClinROs related to the clinician's perception were reported in only one study (1/14) and focused on swelling after treatment.Conclusions PROMs and objective ClinROs are often reported together in clinical trials involving short, standard-length or zygomatic implants for implant-supported fixed prostheses in edentulous maxillae. However, the frequent use of unstandardized questionnaires for PROMs hinders sound comparisons across studies. Subjective ClinROs based on clinician perception are rarely reported.