Influenza della riabilitazione orale full-arch sulla salute generale del paziente: una revisione sistematica

Objective: The aim of this systematic review was to evaluate the effects of implant-supported fixed full-arch rehabilitation on patients’ general health, with particular attention to systemic and metabolic outcomes, masticatory function, oral health-related quality of life, patient satisfaction, and clinical implant-related outcomes. Materials and Methods: This systematic review was conducted according to the PRISMA 2020 guidelines and registered in PROSPERO (CRD420261355048). A comprehensive literature search was performed in PubMed/MEDLINE, Scopus, Web of Science, and the Cochrane Library. Clinical studies involving adult edentulous patients or patients with terminal dentition treated with implant-supported fixed full-arch prostheses were considered eligible. Methodological quality and risk of bias were assessed using the National Institutes of Health Study Quality Assessment Tools, while the overall certainty of evidence was evaluated according to the GRADE approach. Results: A total of 340 records were identified, of which 16 studies fulfilled the eligibility criteria and were included in the review. Overall, full-arch implant-supported rehabilitation was consistently associated with improvements in OHRQoL, patient satisfaction, aesthetics, social function, and masticatory ability. Implant and prosthetic survival rates were generally high, frequently exceeding 95%. However, only four studies specifically investigated outcomes directly related to general health. Preliminary evidence suggested potential systemic benefits, including a reduction in gastric emptying time following improved masticatory function and a significant decrease in glycated haemoglobin (HbA1c) in patients with type 2 diabetes. Nevertheless, no included study directly assessed longitudinal changes in the oral or gut microbiome. The overall certainty of evidence was low to very low because of methodological heterogeneity, small sample sizes, lack of control groups, and predominance of observational studies. Conclusions: Implant-supported fixed full-arch rehabilitation provides consistent benefits in oral function, OHRQoL, patient satisfaction, psychological well-being, and functional autonomy. Although preliminary findings suggest possible favourable effects on digestive and metabolic health, current evidence is insufficient to establish a causal relationship between full-arch rehabilitation and improvements in general systemic health. Further well-designed prospective controlled studies using standardized systemic, metabolic, inflammatory, nutritional, and microbiome-related outcomes are required to clarify the broader health effects of full-arch oral rehabilitation.