An assessment of sensitivity to change of the Oral Health Impact Profile in a clinical trial

Patient-based assessment of oral health outcomes is of growing interest. Measurement of change following clinical intervention is a key property of a health status measure. To date, most of the research on oral health status measurement has focused on construct and discriminant validity of health status measures. OBJECTIVES: The objective of this study was to assess sensitivity to change of an oral-specific health status measure, the Oral Health Impact Profile (OHIP). METHODS: Study subjects were in three groups, namely, edentulous/edentate subjects who requested and received complete implant stabilised oral prostheses (IG, n=26), edentulous/edentate subjects who requested implants but received conventional dentures (CDG1, n=22), and edentulous subjects who had new conventional complete dentures (CDG2, n=35). Data were collected pre- and post-operatively using the OHIP and a validated denture satisfaction questionnaire. RESULTS: All subjects reported similar low levels of denture satisfaction pre-operatively. Denture problems had a more significant impact on oral health-related quality of life (OHRQL) for implant seekers (IG and CDG1 subjects) than subjects seeking conventional dentures (CDG2). Following treatment, significant improvement in satisfaction with oral prostheses and OHRQL was reported by IG and CDG2 subjects; the level of improvement was more moderate for CDG1 subjects. OHIP change scores were correlated with denture satisfaction change scores. CONCLUSIONS: It was concluded that sensitivity to change of the OHIP was good. This property was not improved by using statement weights.     

A longitudinal study of quality of life outcomes in older adults requesting implant prostheses and complete removable dentures

A longitudinal clinical trial involving 103 subjects was undertaken to assess the impact of oral implant therapy on the psychosocial well-being of subjects with complete denture wearing problems. There were four experimental groups: (1) an implant group, where subjects were edentulous/edentate in one jaw and requested and received implants to retain an oral prosthesis (IG); (2) subjects edentulous/edentate in one jaw requesting implants but who received conventional dentures (CDG1); (3) edentulous subjects requesting replacement of their dentures by conventional means (CDG2); (4) dentate subjects requiring routine treatment, who were included for comparison. Data were collected in each group pre- and post-treatment using validated oral specific [the Oral Health Impact Profile (OHIP)], and generic (the SF36) health status measures. Subjects in IG, CDG1 and CDG2 also completed a denture satisfaction scale. IG and CDG1 subjects reported that tooth loss and denture wearing problems had a much greater impact on their quality of life than subjects seeking conventional dentures. Dentate subjects had a much better oral health status compared with denture-wearing subjects. Following treatment, subjects who received implant-retained prostheses (IG) reported a significant improvement in satisfaction and health-related quality of life, as did subjects who requested and received conventional dentures (CDG2). Subjects who requested implants, but received conventional dentures (CDG1), reported little improvement in denture satisfaction and only modest improvement in their quality of life. None of the denture-wearing subjects reported health-related quality of life that was as good as that of dentate subjects. The findings have significant implications in the assessment of outcomes in future clinical trials.     

Food selection and perceptions of chewing ability following provision of implant and conventional prostheses in complete denture wearers

The loss of natural teeth compromises chewing efficiency, and edentulous patients often have a diet that is deficient in fibre and vitamins. Prostheses that are retained on implants offer the possibility of overcoming some of the limitations of conventional dentures in terms of chewing efficiency. The aim of this study was to test the hypothesis that improvement in satisfaction with oral prostheses would result in improved food selection in edentulous patients. This prospective study involved three groups, namely (i) subjects who requested and received implants to stabilise a complete fixed or removable prosthesis (IG, n = 26), (ii) edentulous subjects who requested implant prostheses, but received conventional dentures (CDG1, n = 22), and (iii) edentulous subjects who requested and received conventional dentures (CDG2, n = 35). Data were collected using validated questionnaires pre- and postoperatively. Prior to treatment, all subjects were asked whether they ate a variety of hard and soft foods, to indicate the degree of difficulty they experienced when chewing these foods, and to rate their satisfaction with various aspects of their maxillary and mandibular complete dentures. Following the completion of treatment, subjects completed the questionnaires again. Pre- and postoperative data were compared. Subjects who received implant prostheses reported significant improvement in chewing hard and soft foods. CDG2 subjects also reported improvement, but CDG1 subjects reported no change or even deterioration following treatment. Despite reported improvement in satisfaction with comfort and ability to chew food, 30-50% of IG and CDG2 subjects still avoided eating foods such as carrot and apple. This suggests that, in the absence of tailored dietary advice, apparently successful prosthetic rehabilitation does not necessarily result in a satisfactory diet.     

Implant retained or conventional dentures, which give more patients satisfaction?

DESIGN: This was a randomised controlled trial (RCT) set in a dental hospital. INTERVENTION: The implant group (IG) had two implants placed in the interforaminal region of the lower jaw followed (after healing) by a denture fixed to the implants by a ball attachment mechanism. In the conventional dentures group (CG), dentures were constructed using conventional replacement denture techniques. Patients in the IG had conventional upper dentures made in the same fashion. OUTCOME MEASURE: The performance of the dentures was evaluated using an oral health impact profile (OHIP) and a denture satisfaction scale before treatment and 3 months post-treatment. RESULTS: Analysis was conducted on an intention-to-treat basis. Substantial improvements in oral-health-related quality of life and denture satisfaction were reported by both groups. There were, however, no significant differences post-treatment between the groups. Patients randomised to the IG who declined implants had significantly lower pretreatment OHIP scores and there were significantly greater pre-/ post-treatment change-scores for individuals who had implants compared with the change-scores of people who declined. CONCLUSIONS: There were no significant post-treatment differences between the groups, but a treatment effect may be masked by the intention-to-treat analysis. The pre-/ post-treatment OHIP change-scores were significantly greater for people receiving implants than for those who refused.     

Comparing the efficacy of mandibular implant-retained overdentures and conventional dentures among middle-aged edentulous patients: satisfaction and functional assessment

PURPOSE: The aim of this randomized clinical trial was to compare the relative efficacy of mandibular overdentures retained by only two implants and a bar attachment with conventional dentures. MATERIALS AND METHODS: Edentulous adults, aged 35 to 65 years, were randomly assigned to two groups that received either a mandibular conventional denture (n = 48) or an overdenture supported by two endosseous implants with a connecting bar (n = 54). All subjects rated their general satisfaction and other features of their original dentures and their new prostheses (comfort, stability, ability to chew, speech, esthetics, and cleaning ability) on 100-mm visual analogue scales prior to treatment and 2 months postdelivery. Oral health-related quality of life was also evaluated pre- and posttreatment. RESULTS: Multiple regression analysis revealed that the mean general satisfaction was significantly higher in the overdenture group than in the conventional denture group (P = .0001). Age, gender, marital status, and income were not significantly associated with ratings of general satisfaction. Furthermore, the implant group gave significantly higher ratings on three additional measures of the prostheses (comfort, stability, and ease of chewing; P < .05). CONCLUSION: A mandibular two-implant overdenture opposed by a maxillary conventional denture is a more satisfactory treatment than conventional dentures for edentulous middle-aged adults.     

Patient satisfaction with mandibular implant overdentures and conventional dentures 6 months after delivery

PURPOSE: This study examined patient satisfaction with conventional complete dentures and mandibular implant overdentures opposing conventional maxillary dentures 6 months after delivery. MATERIALS AND METHODS: Sixty edentulous subjects (aged 65 to 75 years) were randomly assigned to either a mandibular conventional denture or an overdenture supported by two implants with ball-shaped retentive anchors. Patients rated their general satisfaction and other features of their prostheses, together with their ability to eat certain food items, on 100-mm visual analogue scales before assignment, and after 2 and 6 months. RESULTS: Both treatment groups reported greater satisfaction with their new prostheses at 6 months. General satisfaction ratings were higher in the implant group than in the conventional denture group by approximately 36% (mean difference 22.3 mm). The implant group also rated comfort (mean difference 22.4 mm), stability (mean difference 28.5 mm), and ability to chew (mean difference 17.3 mm) significantly higher. Significantly higher scores were also given by the implant group for their ability to chew certain hard foods. A trend for an increase in the differences between the groups, in favor of the implant group, was observed between the 2- and 6-month recalls, although the increase was only significant for ease of cleaning. The primary influence on general satisfaction 6 months after the delivery of the prostheses was the provision of the two-implant overdenture. CONCLUSION: Edentulous seniors who received mandibular implant overdentures opposing a conventional denture rated their general satisfaction approximately 36% higher than did a comparable group provided with new conventional dentures.     

Patient expectations of oral implant-retained prostheses in a UK dental hospital

STATEMENT OF PROBLEM: The loss of the natural dentition leads to severe functional impairment in many edentulous adults. A prosthesis retained and supported by osseointegrated dental implants may provide a satisfactory solution for people who have lost all their natural teeth. However, little information is available as to what patients requesting implants expect of implant-retained prostheses. AIM: The aim of this study was to assess the expectations of a group of edentulous patients requesting implant therapy. METHOD: The study included two groups: (1) a group of edentulous adults who requested implant therapy ('implant group'); and (2) an edentulous control group, of similar age and gender distribution as the implant group, receiving conventional complete dentures. Following a clinical and radiographic examination of the patients, data were collected using validated questionnaires. Both groups made a subjective assessment of current dentures. The implant group also completed a questionnaire which assessed expectations of implant-retained prostheses. RESULTS: Baseline satisfaction with current dentures was low in both groups, with the implant group being significantly less satisfied with comfort and stability of their mandibular dentures. Perceived ability of the implant group to chew hard foods was less than the control group. The implant group's expectations of an implant-retained prosthesis were significantly greater than for a conventional denture. CONCLUSION: Careful assessment of patient expectation of implant therapy is essential to determine appropriate treatment need, and to highlight unrealistic expectations.     

Oral health status and treatment satisfaction with mandibular implant overdentures and conventional dentures: a randomized clinical trial in a senior population

PURPOSE: The purpose of this study was to compare elderly patients' satisfaction and oral health-related quality of life with mandibular two-implant overdentures and conventional dentures. MATERIALS AND METHODS: Sixty edentulous subjects aged 65 to 75 years were randomly assigned to two groups treated with maxillary conventional dentures and either a mandibular conventional denture (n = 30) or an overdenture supported by two implants with ball retainers (n = 30). Subjects rated their general satisfaction, as well as other features of their dentures (comfort, stability, ability to chew, speech, esthetics, and cleaning ability), prior to treatment and 2 months postdelivery. Changes in ratings on the original Oral Health Impact Profile (OHIP) and its short form (OHIP-EDENT) were also used as indicators of oral health-related quality of life. RESULTS: The primary outcome of this study, ratings of general satisfaction 2 months postdelivery, was significantly better in the group treated with mandibular two-implant overdentures (P = .001). In addition, the implant group gave significantly higher ratings on comfort, stability, and ability to chew. Furthermore, using OHIP-EDENT, subjects who received mandibular two-implant overdentures had significantly fewer oral health-related quality of life problems than did the conventional group. CONCLUSION: These short-term results suggest that mandibular two-implant overdentures combined with maxillary conventional dentures provide better function and oral health-related quality of life than conventional dentures.     

A randomized-controlled trial of food choices made by edentulous adults

Aim: The aim of this study was to conduct a randomized‐controlled trial to compare food choices of edentulous adults provided with implant‐supported mandibular overdentures and conventional dentures. Methods: Edentulous patients were randomly allocated to an implant group (IG) or a denture group (DG). IG subjects (n=49) were provided with conventional maxillary dentures and implant‐retained mandibular overdentures. Subjects in this group refusing implants were retained using the ‘intention‐to‐treat principle’ and provided with conventional dentures. DG subjects (n=48) were provided with conventional dentures. Subjects indicated whether they consumed any of seven test foods and the level of chewing difficulty experienced. Data were collected pre‐treatment and 3 months post treatment. Results: IG subjects reported increased consumption of carrots, apples and nuts post‐treatment (P<0.05) and decreased post‐treatment difficulty in chewing apples and nuts. DG subjects reported decreased post‐treatment difficulty in chewing carrots, bacon and nuts (P<0.05). Between group differences for chewing difficulty were detected for nuts that DG subjects found easier to chew than IG subjects (P=0.002). Conclusion: Food selection and perceived chewing difficulty improved in both groups, with no significant differences between groups. Successful rehabilitation may not result in different food selection, which may require concurrent tailored dietary interventions, but may increase available food choices.     

A clinical trial of patient satisfaction and prosthodontic needs with ball and bar attachments for implant-retained complete overdentures: three-year results

STATEMENT OF PROBLEM: Few prospective trials of implant-retained mandibular dentures have evaluated the increase and duration of patient satisfaction, costs of denture maintenance in relation to different methods of attaching overdentures to implants, or the use of a reinforced framework. PURPOSE: This report evaluates subjects' satisfaction and prosthodontic maintenance during a 3-year randomized clinical trial of implant-retained mandibular complete dentures, whether reinforced or not with a cast framework, and attached by bar-clip or 2.25-mm ball-spring matrices to endosteal dental implants. MATERIALS AND METHODS: One hundred edentulous subjects, each having at least 1 year's experience with conventional complete dentures, were selected from respondents to a university dental clinic's request for volunteers. Candidates were examined to verify adequate mandibular bone and medical suitability for implants. Subjects then received 2 implants in the anterior mandible before being stratified by mandibular bone height and gender and assigned randomly to 1 of 4 treatment groups. Every subject received a new maxillary complete denture in addition to an implant-supported mandibular complete denture, with or without a reinforcing framework, connected to implants by either a bar-clip or a ball-spring patrix and matrix. The dentures were adjusted and repaired as needed. Subjects indicated on a visual analogue scale (VAS) satisfaction with conventional dentures prior to the study and then with new dentures at 1 month, 1 year, and 2 years. The results reported here are from the first 68 subjects observed for 3 years after receiving new dentures (19 subjects received new dentures less than 3 years before this analysis, and another 13 subjects were lost to follow-up). VAS scores are presented in simple tables and graphs, and results for different groups were compared using 2-sided nonparametric rank tests and repeated measures ANOVA. With respect to costs and maintenance, t tests were used to compare group means. Sample size and other design considerations used a .05 significance level. RESULTS: After receiving new dentures with mandibular implant supports, improved satisfaction "within subject" was prompt, durable, substantial, and statistically significant, regardless of the attachment mechanism, and with or without a reinforcing framework. In contrast, there were no notable satisfaction differences between the 2 attachment mechanisms, or with the presence or absence of a reinforcing framework, either at specific intervals after receiving the new dentures, or in repeated measures ANOVA. For both attachment groups, most denture adjustments occurred during the first year. This accounted for 81% of total adjustments during 3 years, when the 34 subjects in the ball-spring group and the 34 in the bar-clip group were combined. The mean numbers of adjustments per subject and associated clinical times did not differ significantly between the 2 groups. Conversely, denture repairs declined more slowly than adjustments. Almost all repairs (90%) occurred in the ball-spring group to correct problems with the attachments, 39% in the first year, and tapering off only slightly in the following 2 years. Over 3 years of follow-up, mean numbers of repairs per subject differed significantly between groups: 6.7 repairs per person in the ball-spring group, compared to 0.8 in the bar-clip group ( P<.001), and mean time per appointment was greater for repairs in the ball-spring group: 18.9 minutes compared to 16.9 ( P<.01). The cast framework had no influence on the satisfaction expressed or on adjustments and repairs. CONCLUSION: Subjects were very satisfied with the new dentures, although the ball-spring attachment tested in this trial required substantially more repairs.     

Patient satisfaction with mandibular implant overdentures and conventional dentures 6 months after delivery

Purpose

This study examined patient satisfaction with conventional complete dentures and mandibular implant overdentures opposing conventional maxillary dentures 6 months after delivery.

Materials and Methods

Sixty edentulous subjects (aged 65 to 75 years) were randomly assigned to either a mandibular conventional denture or an overdenture supported by two implants with ball-shaped retentive anchors. Patients rated their general satisfaction and other features of their prostheses, together with their ability to eat certain food items, on 100-mm visual analogue scales before assignment, and after 2 and 6 months.

Results

Both treatment groups reported greater satisfaction with their new prostheses at 6 months. General satisfaction ratings were higher in the implant group than in the conventional denture group by approximately 36% (mean difference 22.3 mm). The implant group also rated comfort (mean difference 22.4 mm), stability (mean difference 28.5 mm), and ability to chew (mean difference 17.3 mm) significantly higher. Significantly higher scores were also given by the implant group for their ability to chew certain hard foods. A trend for an increase in the differences between the groups, in favor of the implant group, was observed between the 2- and 6-month recalls, although the increase was only significant for ease of cleaning. The primary influence on general satisfaction 6 months after the delivery of the prostheses was the provision of the two-implant overdenture.

Conclusion

Edentulous seniors who received mandibular implant overdentures opposing a conventional denture rated their general satisfaction approximately 36% higher than did a comparable group provided with new conventional dentures.     

A randomised trial of a simplified method for complete denture fabrication: patient perception and quality

Complete denture fabrication involves a series of complex technical procedures. Nevertheless, simplified methods may be as effective as conventional ones albeit the lesser use of time and resources, without disadvantage for the patient. This study compared a simplified method for complete denture fabrication to a conventional protocol in terms of oral health‐related quality of life (OHRQoL), patient satisfaction and denture quality. Forty‐two edentulous patients requesting treatment with complete dentures were randomly allocated into two study groups. Group S received dentures fabricated by a simplified method and Group C received conventionally fabricated dentures. Before interventions and after three and 6 months following insertion, OHRQoL and patient satisfaction were analysed by specific instruments. A prosthodontist assessed denture quality 3 months after delivery. Groups presented no difference for OHRQoL, denture quality and general satisfaction. Differences regarding patient satisfaction with some aspects of the dentures were found after 3 months (S > C), but were insignificant at 6 months. It was concluded that the simplified method is able to produce dentures of a quality comparable to those produced by the conventional method, influencing OHRQoL and patient satisfaction similarly.     

Oral health-related quality of life in patients treated by implant-supported fixed dentures and removable partial dentures

Objectives: This study investigated the association between denture status [implant‐supported fixed dentures (IDs) and removable partial dentures (RPDs)] and oral health‐related quality of life (OHRQoL). Materials and methods: Consecutive patients with IDs and RPDs were recruited from the Prosthodontics Departments at Showa University and Tokyo Medical and Dental University. The Japanese version of the Oral Health Impact Profile (OHIP‐J‐49) was administered to each subject. For each OHIP‐J‐49 question, the subjects were asked to indicate the frequency with which they had experienced a dental problem during the last month. Responses were recorded on a 5 point Likert rating scale, with 0 being never and 4, very often. Summary scores were calculated and regression analyses conducted to investigate the association between denture status and OHIP‐J‐49 summary score. Results: In total 79 ID subjects (mean age±SD of 51.7±12.4 years, 44.3% men) and 109 RPD subjects (mean age of 66.5±8.6 years, 30% men) participated after giving informed consent. The regression analysis between the type of treatment and the OHIP‐J‐49 summary score revealed a significant association with a coefficient of 17.0 (Confidence interval, CI: 10.9–23.1). When age and duration of denture usage, which had significant associations with OHIP‐J‐49, were included in this model, the regression coefficient remained virtually unchanged at 17.4 (CI: 9.75–25.0), thus indicating little potential confounding by them. Conclusions: OHRQoL in patients with implant‐supported fixed dentures is generally less impaired than it is in those patients with RPDs. To cite this article :
Furuyama C, Takaba M, Inukai M, Mulligan R, Igarashi Y, Baba K. Oral health‐related quality of life in patients treated by implant‐supported fixed dentures and removable partial dentures.
Clin. Oral Impl. Res. 23 , 2012; 958–962
doi: 10.1111/j.1600‐0501.2011.02247.x     

Relationship between prosthodontic evaluation and patient ratings of mandibular conventional and implant prostheses

PURPOSE: The purpose of this study was to compare clinicians' ratings of the state of oral tissues and their satisfaction with treatment to edentulous patients' ratings of treatment success after provision of mandibular implant overdentures or conventional dentures. MATERIALS AND METHODS: Sixty subjects randomly received either mandibular overdentures retained by two implants (n = 30) or new conventional mandibular complete dentures (n = 30). All were given new conventional maxillary dentures. Baseline measures included clinical evaluation of the oral soft and hard tissues. Patients rated their general satisfaction before and after treatment, as well as their satisfaction with stability, speech, and esthetics on visual analogue scales. The treating prosthodontist rated the dentures for the same categories. Patient and clinician ratings were compared using correlations, t tests, and linear regression. RESULTS: None of the clinical variables were significantly correlated with patient satisfaction before or after treatment. The prosthodontist rated mandibular implant overdentures significantly better than conventional dentures regarding general satisfaction, stability, speech, and esthetics. Implant overdentures were also easier to fabricate (P < .0001). The prosthodontists' scores were not significantly correlated with patient scores for any question. CONCLUSION: Clinicians' assessments of the quality of denture-supporting tissues are poor predictors of patient satisfaction with mandibular implant or conventional prostheses. Prosthodontists and patients both rate mandibular implant overdentures as significantly superior to conventional dentures, but patients and clinicians do not usually agree when evaluating individual prostheses.     

Measuring the effect of intra-oral implant rehabilitation on health-related quality of life in a randomized controlled clinical trial

The importance of assessing the impact of treatments for chronic conditions on an individual's quality of life has been well-established. In this randomized clinical trial, oral-health-related quality of life, measured with the Oral Health Impact Profile (OHIP), was compared between two groups of edentulous patients. One group (n = 54) received mandibular implant-supported overdentures, and the other group (n = 48) received conventional dentures. Assessments were performed pre-treatment and two months after the prostheses were delivered. The multivariate model showed that implant treatment was significantly associated with lower post-treatment OHIP scores (p = 0.0002), indicating a better quality of life. In addition, pretreatment OHIP scores, treatment allocation, age, sex, and marital status explained 31% of the variation in post-treatment OHIP scores (F = 0.0001). These results suggest that implant treatment provides significant short-term improvement over conventional treatment in oral-health-related quality of life.     

A randomized controlled trial of implant-retained mandibular overdentures

Evidence from randomized clinical trials of implant-retained overdentures is very limited at the present time. The aim of this study was to compare implant-retained mandibular overdentures and conventional complete dentures in a randomized controlled trial (RCT). Our a priori hypothesis was that implant-retained mandibular overdentures would be significantly better than conventional complete dentures. Edentulous patients (n = 118) were randomly allocated to either an Implant Group (n = 62) or a Denture Group (n = 56). Patients completed the Oral Health Impact Profile (OHIP) and a denture satisfaction scale pre-treatment and three months post-treatment. Upon completion of treatment, both groups reported improvement (p < 0.001, Wilcoxon Ranks Sum test) in oral-health-related quality of life and denture satisfaction. There were no significant post-treatment differences between the groups, but a treatment effect may be masked by application of "intention to treat" analysis. The OHIP change scores were significantly greater for patients receiving implants than for those who refused them.     

Comparisons of chewing difficulty of consumed foods with mandibular conventional dentures and implant-supported overdentures in diabetic denture wearers

PURPOSE: This study compared the chewing difficulty of foods in diets of denture wearers with mandibular conventional and implant-supported overdentures. MATERIALS AND METHODS: One-week dietary logs were evaluated for 58 subjects with controlled diabetes at baseline with their original dentures and with new dentures 6 months after treatment completion. Subjects received new maxillary and mandibular complete dentures, 21 with mandibular conventional dentures and 37 with implant-supported overdentures. A 10-point chewing difficulty rating scale (10 for most difficult-to-chew foods) was used to rate food items in the dietary logs. RESULTS: ANOVA showed no differences between the chewing difficulty mean scores for all foods consumed either at baseline or posttreatment for the two groups. However, the mean scores for the combined consumption frequency of difficult-to-chew foods (6 to 10) showed a significant decrease following treatment with both types of dentures. This decline did not differ significantly between the denture types. With original dentures, more than 91% of subjects consumed foods with chewing difficulty scores of 6 to 10 at least seven times per week. With study dentures, only 21% maintained this level of consumption, with the frequency decreasing to four to six times per week in 24% and one to three times per week in 43% of subjects. The declines in consumption frequency of more difficult to chew foods with study dentures were in a higher percentage of subjects in the implant than in the conventional group. CONCLUSION: After 7 months of adaptation to new dentures, patients consumed fewer difficult-to-chew foods than with their original dentures. This decline was more frequent with mandibular implant-supported overdentures than with conventional dentures. Dietary counseling should be considered as part of implant and complete denture therapy.     

Comparing the efficacy of mandibular implant-retained overdentures and conventional dentures among middle-aged edentulous patients: Satisfaction and functional assessment : Manal A. Awad, James P. Lund, Eric Dufresne, Jocelyne S. Feine. Int J Prosthodont 2003;16:117-122

Purpose

The aim of this randomized clinical trial was to compare the relative efficacy of mandibular overdentures retained by only two implants and a bar attachment with conventional dentures.

Materials and methods

Edentulous adults, aged 35 to 65 years, were randomly assigned to two groups that received either a mandibular conventional denture (n = 48) or an overdenture supported by two endosseous implants with a connecting bar (n = 54). All subjects rated their general satisfaction and other features of their original dentures and their new prostheses (comfort, stability, ability to chew, speech, esthetics, and cleaning ability) on 100-mm visual analogue scales prior to treatment and 2 months postdelivery. Oral health-related quality of life was also evaluated pre- and posttreatment.

Results

Multiple regression analysis revealed that the mean general satisfaction was significantly higher in the overdenture group than in the conventional denture group (P=.0001). Age, gender, marital status, and income were not significantly associated with ratings of general satisfaction. Furthermore, the implant group gave significantly higher ratings on three additional measures of the prostheses (comfort, stability, and ease of chewing; P<.05).

Conclusion

A mandibular two-implant overdenture opposed by a maxillary conventional denture is a more satisfactory treatment than conventional dentures for edentulous middle-aged adults.     

Oral and general health-related quality of life with conventional and implant dentures

Implant overdentures and conventional prostheses have been compared in several trials using a variety of functional and oral health-related quality of life (OHQOL) outcomes. In this paper, we describe the impact of implant overdentures on general and OHQOL in seniors. OBJECTIVES: To compare the oral health-related and general quality of life of seniors (aged 65-75 years) who received either mandibular implant overdentures or conventional dentures. METHODS: Sixty edentulous patients were recruited. Thirty received mandibular overdentures retained by two implants (IOD) and a conventional maxillary denture, the other 30 subjects received new maxillary and mandibular conventional complete dentures (CD). All completed the 20-item version of the Oral Health Impact Profile (OHIP-20) before treatment, then at two and 6 months after delivery of the dentures. The SF-36 general health questionnaire was completed at baseline and 6 months only. RESULTS: Pretreatment and 6-month data from 55 subjects were analyzed. Those who received the IODs had significantly better OHIP-20 total scores at 6 months. Results for IOD subjects were also superior in the functional limitation, physical pain, physical disability and psychological disability subscales. While no significant between group difference was found on the SF-36 health survey, significant pre-post-treatment differences within the IOD group were detected for the role emotional, vitality and the social function scales. CONCLUSIONS: Mandibular overdentures retained by two implants provide elderly patients with better OHQOL. General health-related quality of life improved in the implant group.