Within-subject comparisons of maxillary fixed and removable implant prostheses: Patient satisfaction and choice of prosthesis

Dental implants provide patients with restorative options for the edentulous maxilla. Both fixed and removable prostheses can be attached to the edentulous maxilla, but the efficacy of different designs has not been determined. In this two-session within-subject crossover trial we compared maxillary implant retained fixed prostheses with removable implant overdentures opposed by mandibular implant-supported overdentures. Sixteen patients, who had previously received mandibular implants, entered the study and received four to six maxillary implants. After dropouts as a consequence of a lack of osseointegration and general health problems, 13 remained. Of these, five received the removable prosthesis first and eight the fixed prosthesis. After 2 months, the prostheses were exchanged and the second was also worn for 2 months. Psychometric measurements of general satisfaction with the prostheses as well as comfort, ability to speak, stability, esthetics, ease of cleaning and occlusion were obtained once each prosthesis had been worn for 2 months. Chewing ability was assessed for seven types of food. Removable long-bar overdentures received significantly higher ratings of general satisfaction than fixed prostheses (P = 0.003). Patients also rated their ability to speak and ease of cleaning significantly better with the removable overdentures. Nine patients chose to keep the removable prosthesis and four preferred to keep the fixed prosthesis. The results suggest that maxillary removable overdentures on multiple implants may provide patients with better function than fixed prostheses.     

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.     

Neuromuscular coordination of masticatory muscles in subjects with two types of implant-supported prostheses

OBJECTIVES: To compare the electromyographic (EMG) characteristics of masticatory muscles in patients with fixed implant-supported prostheses and implant overdentures. MATERIAL AND METHODS: Nineteen subjects aged 45-79 years were examined. Fourteen were edentulous and had been successfully rehabilitated with (a) maxillary and mandibular implant-supported fixed prostheses (seven patients); (b) mandibular implant overdentures and maxillary complete dentures (seven patients). Five control subjects had natural dentition or single/partial (no more than two teeth) tooth or implant fixed dentures. Surface EMG of the masseter and temporal muscles was performed during unilateral gum chewing and during maximum teeth clenching. To reduce biological and instrumental noise, all values were standardized as percentage of a maximum clenching on cotton rolls. RESULTS: During clenching, temporal muscle symmetry was larger in control subjects and fixed implant-supported prosthesis patients than in overdenture patients (analysis of variance, P=0.005). No differences were found in masseter muscle symmetry or in muscular torque. Muscle activities (integrated areas of the EMG potentials over time) were significantly larger in control subjects than in implant-supported prosthesis patients (P=0.014). In both patient groups, a poor neuromuscular coordination during chewing, with altered muscular patterns, and a smaller left-right symmetry than in control subjects were found (P=0.05). No differences in masticatory frequency were found. CONCLUSION: Surface EMG analysis of clenching and chewing showed that fixed implant-supported prostheses and implant overdentures were functionally equivalent. Neuromuscular coordination during chewing was inferior to that found in subjects with natural dentition.     

Speech with maxillary implant prostheses: ratings of articulation

Speech is often perturbed after placement of maxillary implant-retained prostheses. We tested the hypothesis that the rate of speech errors varies with prosthetic design. Thirty edentulous subjects with mandibular implant prostheses entered two within-subject crossover trials. Subjects wore maxillary fixed prostheses and removable long-bar overdentures (Trial 1), or overdentures with and without palates (Trial 2). Test words from a French language speech battery were recorded after each prosthesis had been worn for two months. The percentages of stops, fricatives, and vowels correctly perceived by lay judges were calculated. Subjects produced a significantly higher percentage of sounds correctly with overdentures than with fixed prostheses. Between-treatment differences were significant for stops and fricatives (p < 0.01), but not for vowels. There were no significant differences in error rates between the two overdentures. In conclusion, maxillary implant overdentures with and without palates enable patients to produce more intelligible speech than fixed prostheses.     

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.     

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.     

The effectiveness of 2‐implant overdentures – a pragmatic international multicentre study

Summary The purpose of this multicentre observational study was to determine patient satisfaction with either conventional dentures or mandibular 2‐implant overdentures in a ‘real world’ setting. Two hundred and three edentulous patients (mean age 68·8 ± 10·4 years) were recruited at eight centres located in North America, South America and Europe. The patients were provided with new mandibular conventional dentures or implant overdentures supported by two implants and ball attachments. At baseline and at 6 months post‐treatment, they rated their satisfaction with their mandibular prostheses on 100‐mm visual analogue scale questionnaires. One hundred and two (50·2%) participants had valid baseline and 6‐month satisfaction data. Although both groups reported improvements, the implant overdenture group reported significantly higher ratings of overall satisfaction, comfort, stability, ability to speak and ability to chew. These results suggest that edentulous patients who choose mandibular implant overdentures have significantly greater improvements in satisfaction, despite their relatively higher cost, than those who choose new conventional dentures.     

A within-subject comparison of mandibular long-bar and hybrid implant-supported prostheses: evaluation of masticatory function.

Sixteen edentulous subjects participated in a within-subject crossover clinical trial to test the hypotheses that a long-bar overdenture attached to 4 implants gives greater patient satisfaction and masticatory efficiency than a two-implant hybrid overdenture. All subjects were given a new maxillary conventional denture. Ten received mandibular long-bar overdentures first and six the hybrid overdentures. Two months later, psychometric assessments and functional tests were repeated 3 times at one-week intervals. The mandibular prosthesis was then changed, and recordings were repeated after another 2 months. Mandibular movements and electromyographic activity of jaw muscles were recorded while subjects chewed standard-sized pieces of 5 foods: bread, cheese, apple, sausage, and carrot. Measurements included masticatory time, cleaning time (the time between the end of mastication and the last swallow), and duration and amplitude of masticatory cycles and phases. Multilevel analyses were performed. No significant differences in masticatory time were found between prostheses for any test food. However, cleaning time for carrot [estimated mean of difference (delta) +/- SE: 1.6 sec +/- 0.7] and bread (delta = 1.0 sec +/- 0.4) was slightly but significantly longer for subjects wearing long-bar overdentures. Cycle duration was longer with the long-bar overdenture only for subjects chewing carrot. The opening phase was shorter and the closing phase longer with the long-bar overdenture for almost all test foods. Vertical amplitude was significantly less with the long-bar overdenture for cheese (delta = -2.6 mm +/- 1.1), apple (delta = -2.6 mm +/- 1.0), and sausage (delta = -2.9 mm +/- 1.3). These results suggest that mastication with the 2 prostheses is equally efficient, although clearance of some foods from the mouth is longer with the long-bar overdentures. They also indicate that patients adapt their masticatory movements to the characteristics of different prostheses.     

Level of satisfaction in patients with maxillary full-arch fixed prostheses: zygomatic versus conventional implants

PURPOSE: To evaluate the satisfaction of patients with maxillary fixed prostheses supported by conventional and/or zygomatic implants. MATERIALS AND METHODS: Patients restored with complete maxillary implant-supported fixed prostheses were included in the study. They were divided into 2 groups: those with at least 1 zygomatic implant (the zygomatic group) and those with no zygomatic implants (the nonzygomatic group). Twelve months after prosthesis delivery, subjects indicated their satisfaction with the new prosthesis on a visual analog scale. Prostheses were rated in terms of general satisfaction, comfort and stability, ability to speak, easy of cleaning, esthetics, self-esteem, and functionality. RESULTS: Forty-six patients participated in the study (23 in each group). The mean level of satisfaction was high; the groups differed significantly only in satisfaction with esthetics. Patients in the zygomatic group had a higher average score for esthetics than those in the nonzygomatic group. Those who had previously worn conventional removable prostheses gave a higher score for functionality to the implant-supported fixed prosthesis compared to the removable prosthesis. CONCLUSION: Patient satisfaction with zygomatic implant-supported fixed prostheses was similar to that for fixed prostheses supported by conventional implants.     

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 1- to 12-year clinical evaluation of 106 endosseous implants supporting fixed and removable prostheses

The purpose of this article is to report on the long-term clinical evaluation of patients treated with dental implants. A total of 106 implants were placed in 34 patients and restored with fixed partial dentures and overdentures. The 12-year cumulative implant survival and success rates were 95.2% and 90.2%, respectively. Probing depths around mandibular implants were significantly lower than those around maxillary implants (P < .05). The cumulative implant success rate in nonsmokers was 97.7%, but this dropped to 75.81% in smokers. Also, patients rehabilitated with implant-supported overdentures had more peri-implant tissue inflammation than patients with fixed prostheses.     

Replacement of a mandibular implant-fixed prosthesis with an implant-supported overdenture to improve maintenance and care

PatientsA 69-year-old woman presented to the Osaka University Dental Hospital. She had two chief complaints, (a) food accumulation under the lower teeth and (b) poor maxillary denture retention while eating. On clinical examination the patient presented with a maxillary complete denture and fixed mandibular implant prosthesis. For preventing food accumulation under the fixed implant prosthesis and to keep the maxillary denture stable by providing posterior occlusal contact for bilaterally balanced occlusion, the use of a mandibular implant-supported overdenture with self-adjusting magnetic attachments provided a prosthetic solution for this patient. After provided the new dentures, the patient was pleased and was comfortable with the aesthetic, stability and retention of the dentures. There were no discernable clinical or radiographic changes after 1 year of use.DiscussionTo prevent food accumulation beneath the fixed implant prosthesis and maintain the stability of the maxillary denture by providing posterior occlusal contact for bilaterally balanced occlusion, a mandibular implant-retained overdenture with magnetic attachments was used to provide a prosthetic solution for this patient.ConclusionIn this clinical case, an implant-fixed prosthesis in the edentulous mandibular region was replaced into an implant-supported overdenture with considerations for (a) preventing the food accumulation beneath the lower prosthesis, (b) achieving the proper occlusion in the posterior part for maxillary denture stability and (c) ease of maintenance and care for the prostheses.     

Use of mandibular implant overdentures: treatment policy in prosthodontic specialist clinics in Sweden

The aim was to examine the use of mandibular implant overdentures in Swedish prosthodontic specialist clinics. Questionnaires related to treatment with mandibular implant overdentures during 2001 were sent to the heads of the 30 prosthodontic specialist clinics of the Public Dental Health Service in Sweden. Completed questionnaires were received from 28 (93%). The number of treatments with mandibular implant overdentures varied much among the clinics (0 to 22). Seven clinics had not performed any such treatment, and the median number was 2. The number of fixed implant-supported prostheses was much higher (median value 17, range 4 to 100). The correlation between the number of implant overdentures and fixed implant-supported prostheses in edentulous mandibles was weak (r = 0.33; P = 0.10). The most common anchorage system was ball attachments on two unsplinted implants. The most common reason for the choice of the overdenture treatment was the reduced cost, whereas the patient's main wish to improve denture retention came next. The question whether the demand for implant overdentures had increased during the last few years, was answered with "no" by 19, with "yes" by 5 and with "don't know" by 4 clinics. All but one responded that their attitude to implant overdentures had not changed after the introduction of free pricing in Swedish dentistry. It can be concluded that compared to the rapidly increasing international use of mandibular implant overdentures, this treatment of edentulous patients is rare in Sweden, where fixed implant-supported prostheses still are predominant.     

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.     

The effect of different mandibular dentures on antagonistic maxillary ridge

PURPOSE: Is to evaluate the antagonistic, maxillary ridge resorption for different prosthetic modalities mainly mucosa-supported mandibular complete overdentures, combined mucosa implant-supported mandibular complete overdenture, and lower conventional complete dentures. MATERIALS AND METHODS: Fifteen completely edentulous patients were divided into 3 groups; 5 patients each. Group I patients received maxillary conventional denture and mandibular overdentures retained by magnet attachment on 2 implants (mainly mucosa-supported overdenture). Group II patients received maxillary conventional denture and mandibular overdentures retained by bar attachment on 2 implants (combined mucosa implant-supported overdenture). Group III patients received upper and lower conventional complete denture. All patients were evaluated clinically and radiographically immediately after insertion and after 1 and 2 years. Panoramic radiographic film was used to evaluate the antagonistic maxillary ridge resorption. RESULTS: Indicated a more pronounced annual bone resorption of the antagonistic maxillary ridge after 2 years in patients with conventional complete denture wearers when compared with patients with combined mucosa implant-supported mandibular complete overdenture and mainly mucosa-supported mandibular complete overdenture groups. CONCLUSION: Using a combined mucosa implant-supported mandibular complete overdenture the amount of antagonistic maxillary alveolar bone resorption increases when compared with the mainly mucosa-supported complete overdenture.     

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.     

Restoration with implants in patients with recessive dystrophic epidermolysis bullosa and patient satisfaction with the implant-supported superstructure

PURPOSE: The use of endosseous implants in the prosthetic restoration of edentulous patients with recessive dystrophic epidermolysis bullosa (RDEB) may provide improved outcomes when compared with traditional prosthetic methods. The aim of this study was to evaluate the feasibility of placing endosseous implants in patients with RDEB and to compare the treatment outcomes of fixed and removable implant-supported restorations in the edentulous maxilla or mandible with the main emphasis on patient response. MATERIALS AND METHODS: Six patients with RDEB were treated with implants. All patients were completely edentulous in either the maxilla or mandible and had marked oral involvement, with alterations in the soft and hard tissues in all cases. Three patients were treated with fixed, screw-retained implant-supported prostheses, and 3 were treated with removable implant-supported prostheses. Six months after prosthetic restoration, patients were given a questionnaire to assess their psychologic well-being and satisfaction with the implant-supported restoration marked on a visual analog scale. RESULTS: A total of 38 dental implants (21 maxillary, 17 mandibular) were placed in 6 patients. The implant success rate was 97.9%. The average follow-up from implant placement was 5.5 years (range, 1 to 9). The fixed and removable implant-supported prostheses were associated with improvements in comfort and retention, function, esthetics and appearance, taste, speech, and self-esteem. The level of satisfaction was slightly higher in patients with a fixed prosthesis. CONCLUSION: These findings suggest that endosseous implants can be successfully placed and provide support for prostheses in patients with RDEB. Patients with fixed prostheses and overdentures were satisfied with their implant-supported prostheses in the edentulous maxilla and mandible.     

A survey of implant-retained superstructure types in the edentulous mandible in The Netherlands

Treatment of mandibular edentulousness with endosseous permucosal implants has evolved to a common treatment option during the last decades. In The Netherlands, the relative cheap prosthetic treatment of implant-supported overdentures is considered a qualitatively adequate treatment. The aim of the study described in this article was to survey the treatment of edentulous mandibles by fixed implant-supported prostheses and implant-supported overdentures, and to register the different mesostructures used. All clinics of special dental care and all larger clinics for implant dentistry in The Netherlands received a questionnaire. The data provided showed that more than 90% of patients treated with implants because of mandibular edentulousness, were provided with an overdenture. In 85% of cases a bar-clip mesostructure was used. Cost control was the most important reason to choose an overdenture above a fixed implant-supported prosthesis.     

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.