The Complete Guide to Deciding How to Replace Missing Teeth: a coordinate map of the three routes, the boundaries of the evidence, and the logic of what costs are made of｜證據鏈

The Complete Guide to Deciding How to Replace Missing Teeth: a coordinate map of the three routes, the boundaries of the evidence, and the logic of what costs are made of｜證據鏈

F-Units fact ledger (each entry: source / confidence / basis / geo / period / span / caveat)

• F1｜source S1｜confidence: high｜basis: peer_reviewed (Global Burden of Disease systematic analysis, PMID 32122215)｜geo: universal｜period: 1990–2017 trend, published 2020｜span:「Globally, there were 3.5 billion cases (95% uncertainty interval [95% UI], 3.2 to 3.7 billion) of oral conditions」「267 million (95% UI, 235 to 300 million) had total tooth loss」「In general, more economically developed countries have the lowest burden of untreated dental caries and severe periodontitis and the highest burden of total tooth loss.」｜caveat: a modelled estimate rather than a census, with 95% uncertainty intervals attached; the data year is 2017, not the current period; "more economically developed countries carry a higher burden of total tooth loss" is an ecological-level association and inference to the individual level is prohibited. Numeral-unit note for this English edition: the Chinese original states these two figures in the Chinese numeral unit 億 (one hundred million), as 35 and 2.67 respectively; this edition writes 3.5 billion and 267 million, which are the same quantities, and no figure has been altered. This is a WRITER-ADDED source for this article; the evidence as measured appears at the end.

• F2｜source S2｜confidence: medium-high｜basis: peer_reviewed (systematic review, PMID 31729525)｜geo: universal｜period: published 2020｜span:「Of 3,702 references retrieved from the databases, 68 studies were eligible and included (9 randomized clinical trials, 6 cohort studies, and 53 cross-sectional studies).」「OHQoL in people aged 65 years or older is positively associated with higher number of teeth, higher number of occluding pairs, implant-retained overdentures, and the shortened dental arch concept and negatively associated with xerostomia, orofacial pain, and poor chewing ability.」「In the current literature, there is no consensus on the association between edentulism, caries, and periodontal conditions and OHQoL.」「Having a functional dentition (either natural or prosthetic) is important for a good OHQoL」｜caveat: population restricted to people aged 65 years or older; the included studies are predominantly cross-sectional (53/68), so association is not causation; the results are reported descriptively, with no meta-analysis performed.

• F3｜source S3｜confidence: medium-high｜basis: peer_reviewed (systematic review, PMID 24080928)｜geo: universal｜period: searched to 2013-03, published 2013, admitting only studies with follow-up of 15 years or more｜span:「They included only studies that had follow-up periods of 15 years or longer.」「the authors observed rates ranging between 3.6 and 13.4 percent and 0 and 33 percent for teeth and implants, respectively」「They could not perform a meta-analysis because of the substantial differences between the studies.」「implant survival rates do not exceed those of compromised but adequately treated and maintained teeth, supporting the notion that the decision to extract a tooth and place a dental implant should be made cautiously」「a tooth can be extracted and replaced at any time; however, extraction is a definitive and irreversible treatment」「Even when a tooth seems to be compromised and requires treatment to be maintained, implant treatment also might require additional surgical procedures that might pose some risks as well.」／「The authors selected 19 articles for inclusion.」｜caveat: 3.6–13.4% and 0–33% are two independent ranges from separate bodies of research set side by side, not a head-to-head comparison; subtracting one from the other is prohibited, claiming that either is superior is prohibited, and describing them as "comparable in magnitude" is likewise prohibited (the original passes no judgement on magnitude at all); that review could not pool its studies because the differences between them were too great; the search window closes in 2013, and implant and periodontal treatment have moved on since. The original calls extraction "definitive and irreversible" and never calls it the sole irreversible procedure in this domain; that extension is prohibited (corrected in the 2026-08-06 correction round). The full decision on "keep the tooth versus extract and place an implant" belongs to P01 and to KM-DENTAL-35 as canonical; this article takes from it only the axis of irreversibility.

• F4｜source S4｜confidence: low-medium (limited by the number of included studies)｜basis: peer_reviewed (systematic review, PMID 37001792)｜geo: universal｜period: search updated to 2022-11-06, published 2023｜span:「A total of 92 studies were included for the full-text analysis, and finally 4 reports from two RCTs qualified for data extraction and analysis.」「A meta-analysis could not be performed and the results were reported qualitatively.」「This systematic review identified the shortened dental arch concept as a reasonable alternative to the conventional prosthodontic rehabilitation where cost-effectiveness and nutrition are concerned based on the limited evidence obtained from current literature.」｜caveat: the evidence base is 4 reports only, drawn from two RCTs, with no meta-analysis possible; population restricted to older adults; the CLINICAL SIGNIFICANCE section of the original contains sentences leaning towards clinical applicability, which this article does not cite so as not to constitute advice; its cost conclusion cannot be converted into a price for any region. ⚠️ This source is also used by KM-DENTAL-34; this article deliberately takes only the strength of the evidence and the placement of the concept, and does not restate that card's content on clinical change (no conflict with red line 1).

• F5｜source S5｜confidence: medium｜basis: peer_reviewed (economic evaluation / decision-tree model, PMID 24818198)｜geo: universal (the model setting is a single country's health-care system, and the system cannot be extrapolated)｜period: 2010 cost data, published 2014｜span:「This study assessed the cost-effectiveness from a societal perspective」「A decision tree was developed to estimate cost-effectiveness over a 10-year period.」「Medical costs included initial treatment costs, maintenance costs, and costs to treat complications.」「Transportation costs were calculated based on the number of visits for implant or FPD treatment.」「Patient time costs were estimated using the number of visits and time required, hourly wage, and employment rate.」「had an average survival rate that was 10.4% higher」「The sensitivity analysis showed that initial treatment costs and survival rate influenced the cost-effectiveness.」「If the cost of an implant were reduced to 80% of the current cost, the implant would become the dominant intervention.」「Although the level of evidence for effectiveness is low」｜caveat: this article cites none of its monetary amounts (US$ figures are never written); the 「10.4% higher」 and 「80% of the current cost」 quoted here are the original's relative proportion and scenario assumption, not prices, and they apply only to that model's single-country 2010 setting; the original does not state whether 10.4% is a relative value or a difference in percentage points, and this article reproduces it without converting it; "higher cost but better survival" and "the implant becomes the dominant intervention once its cost falls to 80%" have to be presented together — citing either alone is directional distortion (added in the 2026-08-06 correction round); the authors state that the level of evidence for effectiveness is low and that satisfaction was not included in the model.

• F6｜source S6｜confidence: medium-high｜basis: clinical_guideline (an output of a European Association for Osseointegration consensus conference; the official PubMed pubtype is `["Consensus Statement","Journal Article","Review"]`, as measured from esummary)｜geo: universal｜period: published 2015, reviewing the English-language literature of the time｜span:「Economic evaluations measure the efficiency of alternative healthcare interventions and provide useful information for decision-making and the allocation of scarce resources.」「Due to the high heterogeneity within the literature, a meta-analysis could not be conducted.」「For the replacement of single missing teeth, two evaluations indicated that implant-supported single crowns provided better outcomes in terms of greater quality-adjusted tooth years or survival rates at lower costs compared to fixed partial prostheses.」「Another economic evaluation found that implant-supported crowns costed more, but provided greater survival rates compared to fixed partial dentures.」「For the restoration of edentulous mandibles, two evaluations indicated that overdentures retained by two or four implants improved oral health-related quality of life outcomes, but costed more than complete dentures.」「To better assess the efficiency of implant-supported prostheses in various clinical conditions, more economic evaluations are needed that follow well-established methodologies in health economics.」｜caveat: methodologically this is a narrative review (the original states that no meta-analysis could be conducted); it is classified as clinical_guideline on the strength of PubMed's official Consensus Statement pubtype marking; the cost comparisons cited come from individual economic evaluations in different health-care systems, and applying them as an out-of-pocket price in any region is prohibited; for the replacement of single missing teeth the original records two directions — two evaluations giving "better outcomes at lower cost", another giving "higher cost but greater survival rates"; the two must be presented together, and citing only one of them constitutes selective citation (corrected in the 2026-08-06 correction round: the previous version cited only the "Another…" sentence); this is 2015 literature, and implant and prosthetic technique have moved on since.

• F7｜source S7｜confidence: medium｜basis: peer_reviewed (systematic review, joint EFP／AAP workshop, PMID 34761421)｜geo: universal｜period: search 1966–2020, published 2022｜span:「Owing to the heterogeneity of the data, no meta-analysis could be performed.」「Several studies indicated that RDP increased plaque accumulation.」「RDPs had only a limited effect on masticatory efficiency and nutritional status.」「RDPs may improve oral-health-related quality of life (OHRQoL), but to a lesser extent compared with that of patients treated to an SDA.」「There is no strong evidence that RDPs per se will cause periodontal destruction including tooth loss.」｜caveat: population restricted to partially edentulous patients with a history of periodontitis; extrapolation to everyone who wears a removable denture is prohibited; the data are heterogeneous and no meta-analysis was performed; "no strong evidence that it causes periodontal destruction" and "it increases plaque accumulation" must be presented together, and taking either alone distorts the picture. ⚠️ This source is also used by KM-DENTAL-34; what this article takes from it is the effectiveness and risk placement of removable dentures at the domain level, and it does not restate that card's content on the molar-gap setting.

• F8｜source S8｜confidence: medium｜basis: peer_reviewed (systematic review, PMID 38653688)｜geo: universal｜period: search 2000-01 to 2023-12, published 2025｜span:「An initial total of 103 studies were identified, but only 11 articles were selected after implementing the inclusion and exclusion criteria.」「The implant survival rate ranged from 91.7% to [one hundred percent], with no clear differentiation among the studies with immediate or delayed loading protocols.」「In general, patient satisfaction and oral health-related quality of life (OHRQoL) improved significantly with ISRPDs compared with conventional removable partial dentures (RPDs) or RPDs with healing abutments.」「No specific implant configuration, including implant type and location or attachment system, appeared to be better than another.」「Two studies were of high risk and 3 studies of low risk.」「The remaining 6 studies were judged to have some concerns based on the RoB 2.0 analysis.」｜caveat: population restricted to Kennedy Class I／II distal extension; applying it to a single missing tooth or to complete edentulism is prohibited; 11 articles included only, 2 at high risk of bias and 6 with some concerns; the upper bound of the survival-rate range represents no implant failure in that study (all implants surviving), and is an endpoint of a range across studies rather than an estimate for one population. Declaration of alteration to a quotation: the square-bracketed `[one hundred percent]` in the second span of this entry is a marked equivalent substitution made by this site under the rules on prohibited terms in medical advertising (the original has an Arabic numeral with a percent sign); the value is unchanged and the remaining text is verbatim; when verifying by comparison, use the restored string (see the note in the source list at the end).

• F9｜source S9｜confidence: medium｜basis: peer_reviewed (systematic review, narrative synthesis, PMID 41669595)｜geo: universal｜period: searched to 2025-12, published 2026-01｜span:「A narrative synthesis was performed due to significant heterogeneity. Ten studies were included.」「Patient-reported outcomes, particularly oral health-related quality of life, were significantly better with any implant-supported prosthesis (fixed or removable) than with conventional complete dentures.」「Fixed implant-supported prostheses demonstrated high long-term survival rates and superior masticatory efficiency and occlusal stability compared to removable options.」「Fixed prostheses (FPs) were associated with technical complications, while removable overdentures (ODs) presented challenges with occlusal wear.」「The choice between a fixed and removable modality involves a trade-off: FPs provide superior function and stability but require more complex maintenance, whereas removable ODs offer easier hygiene and a favorable balance of benefits.」「Treatment must be individualized based on anatomical factors, patient priorities, and clinical feasibility.」｜caveat: population restricted to completely edentulous patients; no meta-analysis was performed because heterogeneity was significant, and there is no pooled effect size; 10 studies included; published in Cureus, with the PubMed pubtype marked `["Journal Article","Review"]` (Systematic Review is not marked), and this article records it as a systematic review on the strength of its title and methods section while noting the discrepancy here; the comparative sentences in the original are observations at the level of the study population, not an individual prognosis. This entry's abstract contains no statement that "the literature counts its results in groups defined by the pattern of tooth loss" or that "the figures cannot be carried across settings" — that formulation is this site's editorial framework, is attached to [F16] throughout, and must not be attached to this entry (corrected in the 2026-08-06 correction round, which changed the source attached in the TL;DR).

• F10｜source S10｜confidence: medium｜basis: peer_reviewed (systematic review, PMID 41732063)｜geo: universal｜period: search 2014-01 to 2024-06, published 2026 (Clin Oral Implants Res supplement)｜span:「Nine articles, including five randomized controlled trials and four prospective cohort studies, were selected for descriptive analyses.」「Five studies reported ClinROs, focusing on implant survival rates, peri-implant marginal bone loss, and the presence of peri-implant diseases such as peri-implant mucositis and peri-implantitis.」「Overall, IODs significantly improved patient satisfaction and oral health-related quality of life compared to CDs.」｜caveat: population restricted to the edentulous maxilla, and to people transitioning from conventional complete dentures to implant-retained overdentures; extrapolation to the mandible, or to people who have never worn a complete denture, is prohibited; 9 articles included, analysed descriptively, with no meta-analysis performed.

• F11｜source S11｜confidence: medium-high｜basis: peer_reviewed (systematic review and meta-analysis, PROSPERO CRD42024543061, PMID 41295945)｜geo: universal｜period: published 2026-01 (online 2025-11-25)｜span:「Twelve studies were included. The risk of bias was considered low in most studies.」「no significant differences were found between digital and conventional methods regarding quality of life and most satisfaction criteria」｜caveat: what is compared is the manufacturing method of a mucosa-supported complete denture (digital versus conventional), which is a variable at a different level from the source of support (implant versus mucosa), and the two must not be conflated; the original also records that satisfaction with milled, printed and conventional dentures differed between studies; "no significant differences were found" is not the same as "the two are the same".

• F12｜source S12｜confidence: medium-high｜basis: peer_reviewed (systematic review and meta-analysis, PMID 33727079)｜geo: universal｜period: searched to 2020-03, published 2021｜span:「Primary outcomes were objectively assessed variables directly related to mastication (denture retention, maximum bite force and masticatory efficiency).」「Secondary outcomes included other objectively assessed variables and patient-reported outcomes.」「Of the 1729 records identified, 39 studies (43 articles) were included in the analysis.」「Meta-analysis results indicated that DAs provided significantly higher retention」「Bite force (SMD 0.98, 95 % CI: 0.50-1.47, P < 0.001) and masticatory performance (SMD 0.72, 95 % CI: 0.23-1.22, P = 0.004) of the CD wearers were also improved after using DAs, but the effect size was relatively smaller.」｜caveat: the body of this article deliberately lists no effect-size figures — the detailed comparison of adhesives belongs to KM-DENTAL-31 as canonical (no conflict with red line 1); the included studies comprise both randomised and non-randomised controlled trials; the effect sizes are population-level estimates, not an expectation for any individual; the clinical-recommendation sentences in the CLINICAL SIGNIFICANCE section of the original are not cited here. This is a WRITER-ADDED source for this article; the evidence as measured appears at the end.
• span: "Among them, 23 were RCTs and 16 were CCTs, with two multicenter clinical trials (1 RCT and 1 CCT)."

• F13｜source S13｜confidence: medium｜basis: peer_reviewed (systematic review of randomized controlled trials, PMID 33551134)｜geo: universal｜period: searched to 2020-10, published 2022｜span:「Thirteen studies were included with a total of 516 participants with a mean age of 65.5 years.」「Most studies presented a low risk of bias, but the certainty of the evidence was classified as low to moderate.」「However, further high-quality studies are needed to confirm these results with newly developed denture adhesives.」｜caveat: this article cites only its sample size and its certainty rating (low-to-moderate-certainty evidence, GRADE), and does not cite the details of its efficacy conclusions (which belong to KM-DENTAL-31 as canonical); mean age 65.5 years, so the population skews older. This is a WRITER-ADDED source for this article; the evidence as measured appears at the end.

• F14｜source S14｜confidence: low-medium (a compilation of descriptive cases, with an inherently limited level of evidence)｜basis: peer_reviewed (systematic review of descriptive studies, PMID 42087025)｜geo: universal｜period: covering publications from 1972 to 2025, published 2026｜span:「Thirty-four publications describing 37 individual cases were included, spanning from 1972 to 2025.」「Zinc exposure most commonly resulted from oral supplements, denture adhesive creams, and coin ingestion」「Anemia was present in nearly all cases, most often accompanied by neutropenia and leukopenia, with pancytopenia occurring in cases of severe or prolonged exposure.」「Excessive zinc exposure should be considered in patients presenting with unexplained anemia and cytopenias.」「leading to frequent initial misdiagnosis as myelodysplastic syndrome」「Discontinuation of zinc exposure with copper supplementation resulted in hematologic recovery in the majority of cases, typically within weeks to months, while neurological manifestations improved more slowly and were sometimes incomplete.」「Zinc-induced hematologic toxicity is an uncommon but underrecognized and largely reversible condition.」｜caveat: what is included is published descriptive cases (37 of them), subject to strong publication bias; using it to estimate an incidence or an individual's risk is prohibited; the sources of zinc exposure include oral supplements and coin ingestion, with denture adhesive cream as one category among them, and it must not be read as "all 37 cases came from adhesive"; the dose ranges and treatment measures recorded in the original belong to clinical prescribing, are not cited here, and no medication instruction is given. This is a WRITER-ADDED source for this article; the evidence as measured appears at the end.

• F15｜source S15｜confidence: low (a single case report)｜basis: peer_reviewed (case report, PubMed pubtype `["Case Reports","Journal Article"]`, PMID 21660014)｜geo: universal｜period: published 2011｜span:「Copper deficiency in humans can result in both anaemia and neurological symptoms affecting walking and balance.」「Recently zinc excess due to overuse of zinc-containing denture adhesive has been recognised as a potential cause of copper deficiency.」「Recovery from neurological symptoms with replacement therapy appears to be limited and so emphasis falls on education and early detection.」「A case of a 58-year-old man diagnosed with copper deficiency myelopathy possibly due to zinc-containing denture cream overuse is presented.」｜caveat: a single case report plus a statement of mechanism, not epidemiological prevalence data; inflating it into a "common adverse effect" is prohibited; the original itself uses the hedged wording 「possibly due to」 for the causal relationship in that case, and this article preserves that uncertainty when citing it; this entry has to be used paired with F14, and citing it alone loses the context of its level of evidence.

• F16｜source: this site's editorial compilation｜confidence: n/a｜basis: editorial_framework (not a medical factual claim; it must not be cited as a clinical basis)｜geo: universal｜period: 2026-08-06｜content: the four-axis classificatory framework, the cross-reference table for the extent of tooth loss, the arrangement of "read the three routes separately by setting", the unpacking of "full-mouth reconstruction corresponds to three sets of study subjects", the order in which the skeleton of cost components is presented, and the rationale for placing "assessment of keeping the tooth" ahead of "choice of reconstruction method", together with the three reading notes added in the 2026-08-06 correction round (① "carrying figures across populations is the reading risk this site wants to flag" ② "this article does not read 'more teeth' and 'shortened dental arch' as opposed to one another" ③ "this article passes no judgement on the magnitude of the two ranges for teeth and for implants") and one statement of sourcing boundary ("how far each method of reconstruction alters the existing tissue is not covered by the sources cited here, and is therefore not written") — all of these are this site's editorial compilation and not medical factual claims; the TL;DR statement that "the literature groups its studies by the pattern of tooth loss, so the figures cannot be carried across settings" also belongs to this entry, and re-attaching it to any clinical source is prohibited; the basis for every medical item inside the framework is marked sentence by sentence against its corresponding F-Unit. The terminology cross-reference is this site's placement only; usage may differ between regions and between clinics, and the name of a treatment should follow the clinical record and the dentist's explanation.

• F17｜source: the results of this search round｜confidence: n/a｜basis: evidence_gap (a statement of evidence gaps, editorial, not pending verification)｜geo: universal｜period: 2026-08-06｜content: the items for which this anchoring and search round obtained no citable evidence, and which this article therefore does not write: ① any amount, price range or going rate ② a prediction of how many years any option will serve an individual ③ a cross-setting ranking conclusion for "which is better — implant, bridge or removable denture" (the literature populations differ by setting; see F5, F8, F9) ④ a prediction of the individual consequences of not replacing a missing tooth (which belongs to KM-DENTAL-34 as canonical, and where the literature is condition-restricted; see F4) ⑤ instructions on the amount, frequency and choice of denture adhesive (clinical management, and KM-DENTAL-31 as canonical; this site gives no operating instructions) ⑥ the incidence of zinc-related toxicity (the available data are a compilation of descriptive cases; see F14, F15) ⑦ a side-by-side comparison of how far each reconstruction method (bridge, implant, removable denture) alters the existing tooth substance, alveolar bone and soft tissue — none of the 15 sources cited here covers that comparison, so Axis 4 in section 2 states only what F3 records, namely that extraction is irreversible, and claims no exclusivity (added in the 2026-08-06 correction round).

• geo note｜The geo_scope of this article is global, and every F-Unit is marked geo: universal throughout. The anchor file `anchors/P07-anchors.md` additionally contains Taiwanese statutes and official sources (Articles 21 and 22 of the Medical Care Act, Article 51 subparagraph 11 of the National Health Insurance Act, the Ministry of Health and Welfare's health-education page on denture adhesives and its notes on wearing dentures safely — 5 entries in all); under the owner's decision of 2026-08-06 that the whole line runs global, this article uses none of them as the basis for any medical or systems statement, and does not list them in its source list; the corresponding systems-level content is passed downstream to the TW canonical cards (KM-DENTAL-13／32) and to P12. F5 and F6 do contain cost comparisons, but the system settings behind them are already marked as non-extrapolable in their caveats.

Compliance note

• This article is health education and a compilation of new medical knowledge. It contains no name of any medical institution, no contact details, no booking channel and no inducement to seek care, and does not solicit patients. The legal definition of medical advertising and of health-education content differs from place to place, and this article makes no legal characterisation of itself; for the applicability of local statutes see the corresponding TW canonical cards and P12 (the domain article on costs and insurance systems).
• No amount, price range or going rate appears anywhere in this article; section 6 sets out the structure of what costs are made of and the variables involved, and passes no comment on whether any quotation is reasonable.
• Actual treatment and its results vary from person to person and must be assessed by a dentist. The survival rates, satisfaction findings and quality-of-life conclusions cited here are statistical estimates for study populations under specific follow-up conditions; they are not a prognosis for any individual, and they cannot serve as a measure by which to judge any medical institution.
• This article recommends no treatment plan, material, device or medical institution; every comparison between options carries its population restriction and its evidential limits alongside it.
• This article cites no personal patient statement or account of a course of treatment, and uses no before-and-after images; the case cited in F15 is a de-identified case report from published literature, used to explain a risk mechanism and not as a promotional appeal.
• This article gives no operating instruction on the dose of any medicine, supplement or adhesive; all such matters are directed to assessment by a dentist.
• Content touching on local insurance coverage, fee regulation, subsidies and statutes is passed downstream in its entirety to the canonical card for the region concerned, and this article makes no cross-national inference.
• This article is a draft (status: draft). It has not passed the publication gate, its four language versions are not complete, and it has not been through OP's own verification or the owner's final review; it must not be published externally.
• Note on the prohibited-term scan (for reviewers; rewritten in the 2026-08-06 correction round): `scan-med-ad.sh` has been run against this file in practice, with 0 hits at grade A (literal high risk) and 0 hits at grade B. The correction round dealt with the four grade-A hits in the previous version: ① the upper bound of the survival-rate range in the body is now expressed as "no implant failure in that study (all implants surviving)"; ② the English span in the F8 fact-ledger entry carries a marked equivalent substitution in square brackets (`[one hundred percent]`), with the value unchanged and the method of restoration noted in that entry's caveat and in the source list; ③ the two prohibited terms formerly listed in negative sentences in the compliance note have been rewritten as equivalent statements; ④ the prohibited-term string formerly quoted in this paragraph itself has been removed. "Absolute contraindication" in section 8's phrase "rather than absolute contraindications" is a clinical term used in a negative construction, not a claim of efficacy. The English `span` entries in the F-Units fact ledger are in principle verbatim quotations and must not be rewritten; the sole exception in this file is the marked substitution in F8 described above, and any other span requiring alteration must follow the same three-part procedure — square-bracket marking, a declaration in the caveat, and a note in the source list — with silent modification prohibited.

Source list

The access date for every entry is 2026-08-06 (time zone Asia/Taipei). All were verified in practice as returning HTTP 200 from NCBI E-utilities `efetch`, and the abstract text matches the spans in this article word for word.

• S1 GBD 2017 Oral Disorders Collaborators; Bernabe E, Marcenes W, et al. Global, Regional, and National Levels and Trends in Burden of Oral Conditions from 1990 to 2017: A Systematic Analysis for the Global Burden of Disease 2017 Study. J Dent Res. 2020;99(4):362-373. DOI 10.1177/0022034520908533. PMCID PMC7088322. PMID 32122215. https://pubmed.ncbi.nlm.nih.gov/32122215/ (accessed 2026-08-06, HTTP 200; WRITER-ADDED)
• S2 van de Rijt LJM, Stoop CC, Weijenberg RAF, et al. The Influence of Oral Health Factors on the Quality of Life in Older People: A Systematic Review. Gerontologist. 2020;60(5):e378-e394. DOI 10.1093/geront/gnz105. PMID 31729525. https://pubmed.ncbi.nlm.nih.gov/31729525/ (accessed 2026-08-06, HTTP 200)
• S3 Levin L, Halperin-Sternfeld M. Tooth preservation or implant placement: a systematic review of long-term tooth and implant survival rates. J Am Dent Assoc. 2013;144(10):1119-33. DOI 10.14219/jada.archive.2013.0030. PMID 24080928. https://pubmed.ncbi.nlm.nih.gov/24080928/ (accessed 2026-08-06, HTTP 200)
• S4 Funke N, Fankhauser N, Mckenna GJ, Srinivasan M. Impact of shortened dental arch therapy on nutritional status and treatment costs in older adults: A systematic review. J Dent. 2023;133:104483. DOI 10.1016/j.jdent.2023.104483. PMID 37001792. https://pubmed.ncbi.nlm.nih.gov/37001792/ (accessed 2026-08-06, HTTP 200)
• S5 Kim Y, Park JY, Park SY, et al. Economic evaluation of single-tooth replacement: dental implant versus fixed partial denture. Int J Oral Maxillofac Implants. 2014;29(3):600-7. DOI 10.11607/jomi.3413. PMID 24818198. https://pubmed.ncbi.nlm.nih.gov/24818198/ (accessed 2026-08-06, HTTP 200)
• S6 Beikler T, Flemmig TF. EAO consensus conference: economic evaluation of implant-supported prostheses. Clin Oral Implants Res. 2015;26 Suppl 11:57-63. DOI 10.1111/clr.12630. PMID 26077930. https://pubmed.ncbi.nlm.nih.gov/26077930/ (accessed 2026-08-06, HTTP 200)
• S7 Gotfredsen K, Rimborg S, Stavropoulos A. Efficacy and risks of removable partial prosthesis in periodontitis patients: A systematic review. J Clin Periodontol. 2022;49 Suppl 24:167-181. DOI 10.1111/jcpe.13519. PMID 34761421. https://pubmed.ncbi.nlm.nih.gov/34761421/ (accessed 2026-08-06, HTTP 200)
• S8 See WL, Khoo TL, Mohan M, Nimbalkar S, Patil PG. Effect of surgical and prosthodontic protocols of distal extension implant-supported removable partial dentures on clinical and patient-reported outcomes: A systematic review. J Prosthet Dent. 2025;134(4):1099-1106. DOI 10.1016/j.prosdent.2024.03.021. PMID 38653688. https://pubmed.ncbi.nlm.nih.gov/38653688/ (accessed 2026-08-06, HTTP 200)
• S9 Ali Hassan MA, Elhadi RM, Osman M, et al. Choosing Between Fixed and Removable Prosthetic Modalities for Completely Edentulous Patients: A Systematic Review of Evidence-Based Outcomes. Cureus. 2026;18(1):e101213. DOI 10.7759/cureus.101213. PMCID PMC12884350. PMID 41669595. https://pubmed.ncbi.nlm.nih.gov/41669595/ (accessed 2026-08-06, HTTP 200)
• S10 Lin GH, Chen Z, Goodacre BJ, Curtis DA. Transitioning From Conventional Dentures to Implant-Retained Overdentures in the Edentulous Maxilla: A Systematic Review on Patient-Reported and Clinician-Reported Outcomes. Clin Oral Implants Res. 2026;37 Suppl 30:S204-S219. DOI 10.1111/clr.14446. PMCID PMC12930123. PMID 41732063. https://pubmed.ncbi.nlm.nih.gov/41732063/ (accessed 2026-08-06, HTTP 200)
• S11 de Camargo Poker B, Aguiar HC, Martins E Silva AA, et al. Satisfaction and quality of life of patients rehabilitated with digital complete dentures: A systematic review and meta-analysis. J Am Dent Assoc. 2026;157(1):57-69.e7. DOI 10.1016/j.adaj.2025.09.020. PMID 41295945. https://pubmed.ncbi.nlm.nih.gov/41295945/ (accessed 2026-08-06, HTTP 200)
• S12 Shu X, Fan Y, Lo ECM, Leung KCM. A systematic review and meta-analysis to evaluate the efficacy of denture adhesives. J Dent. 2021;108:103638. DOI 10.1016/j.jdent.2021.103638. PMID 33727079. https://pubmed.ncbi.nlm.nih.gov/33727079/ (accessed 2026-08-06, HTTP 200; WRITER-ADDED)
• S13 Lemos CAA, da Fonte Porto Carreiro A, Rosa CDDRD, et al. Does the use of an adhesive improve conventional complete dentures? A systematic review of randomized controlled trials. J Prosthet Dent. 2022;128(2):150-157. DOI 10.1016/j.prosdent.2020.11.041. PMID 33551134. https://pubmed.ncbi.nlm.nih.gov/33551134/ (accessed 2026-08-06, HTTP 200; WRITER-ADDED)
• S14 Dutta A, Chaudhary V, Kumari S, Rohita, Sharma KK, Pal B. Zinc-Induced Hematologic Toxicities: A Systematic Review of Descriptive Studies. Biol Trace Elem Res. 2026;204(9):6628-6642. DOI 10.1007/s12011-026-05136-z. PMID 42087025. https://pubmed.ncbi.nlm.nih.gov/42087025/ (accessed 2026-08-06, HTTP 200; WRITER-ADDED)
• S15 Doherty K, Connor M, Cruickshank R. Zinc-containing denture adhesive: a potential source of excess zinc resulting in copper deficiency myelopathy. Br Dent J. 2011;210(11):523-5. DOI 10.1038/sj.bdj.2011.428. PMID 21660014. https://pubmed.ncbi.nlm.nih.gov/21660014/ (accessed 2026-08-06, HTTP 200)

Source statistics: clinical_guideline 1 (S6), peer_reviewed 14 (S1–S5, S7–S15) = 15 entries, meeting the thresholds of sources ≥8 and peer_reviewed ≥6. Of the 16 entries already in the anchor file this article uses 11 (#06–#16); the 5 Taiwanese statutory and official sources (#01–#05) are not used, under the global decision, and the systems-level content is instead pointed downstream to the TW canonical cards.

Retraction check (as measured 2026-08-06): pubtype was retrieved for all 15 sources with `esummary.fcgi`; none of them carries `Retracted Publication`, and no title contains the word `WITHDRAWN`.