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.     

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.     

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.     

The impact of conventional and implant supported prostheses on social and sexual activities in edentulous adults Results from a randomized trial 2 months after treatment

OBJECTIVES: To determine the impact of mandibular two-implant overdentures or conventional complete dentures on leisure and sexual activities. METHODS: One hundred and two subjects, aged 35-65 years, received either mandibular overdentures retained by two implants (IOD; n=54) or new mandibular conventional complete dentures (CD; n=48) in a randomized controlled clinical trial. A Social Impact Questionnaire was used to assess the impact on social and sexual activity including avoiding conversation, refusing invitations, avoiding sport and feeling uneasy when kissing and in sexual relationships, and the looseness of the prostheses during such activities. Ratings were recorded on categorical scales at baseline and 2 months after treatment. Oral health related quality of life was measured with the Oral Health Impact Profile (OHIP). Between and within group comparisons were carried out using regression models. The correlation between post-treatment OHIP scores and the leisure and sexual impact items was assessed. RESULTS: Two months after delivery of the prosthesis there was significant improvements in the IOD group for looseness when eating, speaking, kissing and yawning. The IOD group reported significantly less post treatment looseness than the CD group for all parameters investigated (p<0.0001). IOD subjects felt less uneasy kissing and less uneasy during sexual activity than CD subjects. Correlations between the two sexual activity items (uneasiness when kissing and during sexual relations) and the OHIP scales were weak. CONCLUSIONS: Edentulism has a negative impact on social and sexual life. Mandibular overdentures provide greater improvement in of unease in intimate activities than new conventional mandibular dentures.     

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.     

The effects of mandibular two-implant overdentures on nutrition in elderly edentulous individuals

It is unclear whether mandibular implant overdentures improve the nutritional state of edentulous patients better than conventional dentures. In a randomized clinical trial, we tested for post-treatment differences in nutritional status between patients with mandibular two-implant retained overdentures and those with conventional complete dentures. Edentulous subjects (ages 65-75 yrs) received two-implant mandibular overdentures (IOD, n = 30) or conventional dentures (CD, n = 30). Measures of nutritional state were gathered before and 6 mos after treatment. Significant improvements in anthropometric parameters were detected in the IOD but not in the CD group, for percent body fat (p = 0.011) and skin-fold thickness at the biceps, subscapularis, and abdomen (p < 0.05), with significant decreases in waist circumference (p < 0.0001) and waist-hip ratio (p = 0.001). Significant increases were seen in concentrations of serum albumin (p = 0.015), hemoglobin (p = 0.01), and B12 (p = 0.01). No significant between-group differences were found. These results suggest that low-cost IOD treatment may improve the nutritional state of edentulous people.     

Sex differences in denture satisfaction

OBJECTIVES: Males and females differ in their responses to many health conditions and treatments. The aim of this randomized clinical trial was to determine whether there are differences in the way that male and female edentulous elders rate their satisfaction with new mandibular implant overdentures (IODs) and conventional dentures (CDs), at 6 and 12 months following delivery. METHODS: Edentulous elders (n=256) were randomly assigned to receive maxillary conventional dentures and either mandibular overdentures supported by two implants with ball attachments or conventional dentures. Participants rated their general satisfaction, as well as other features of their dentures (comfort, stability, ability to chew, aesthetics, etc.) prior to treatment and 6 and 12 months after delivery. RESULTS: Ratings of satisfaction with IODs were significantly higher than with CDs. Six months after delivery, females in the CD group rated their general satisfaction and satisfaction with ability to chew and aesthetics significantly lower than did the males. The sex differences in the CD group remained at 12 months after delivery. However, males and females in the IOD group rated their general satisfaction and all six subcategories equally. CONCLUSIONS: Elderly females are less satisfied with conventional dentures than elderly males with regards to aesthetics and ability to chew, but equally satisfied with implant overdentures. At 6 and 12 months after delivery, elderly edentulous males and females wearing mandibular implant overdentures were significantly more satisfied than those wearing conventional dentures.     

Within-subject comparison of maxillary long-bar implant-retained prostheses with and without palatal coverage: patient-based outcomes

Although maxillary implant overdentures are used in oral rehabilitation, different designs have not been compared previously in clinical trials. This crossover trial was designed to measure differences in patient satisfaction with maxillary long-bar implant overdentures with and without palatal coverage opposed by a fixed mandibular implant-supported prosthesis. Data were also gathered on new conventional dentures and on maxillary conventional dentures opposed by mandibular fixed prostheses. Sixteen participants were selected from a population wearing conventional dentures. Fifteen received new upper and lower dentures (1 drop-out). Four implants were placed in the maxilla and mandible (2 drop-outs). A mandibular fixed prosthesis was inserted in 13 participants, who were then divided into 2 groups. One group (n = 7) received long-bar overdentures with palate, then long-bar overdentures without palate. The other group (n = 6) received the same treatments in the reverse order. Mastication tests and psychometric evaluations using Visual Analog Scales and Categorical Scales were performed throughout the study. General satisfaction was very high with both maxillary implant-supported prostheses, as were ratings of almost all psychosocial and functional variables. There were no significant differences between treatments, suggesting that patients are equally satisfied with long-bar overdentures with and without palate when these are opposed by mandibular fixed prostheses. However, the ratings given to the maxillary implant prostheses were not significantly higher than for new conventional maxillary prostheses. This suggests that maxillary implant prostheses should not be considered as a general treatment of choice in patients with good bony support for maxillary conventional prostheses.     

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.     

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.     

Randomized clinical trial comparing the efficacy of mandibular implant-supported overdentures and conventional dentures in diabetic patients. Part III: comparisons of patient satisfaction.

STATEMENT OF PROBLEM: There is insufficient evidence to indicate the functional superiority of mandibular implant-supported overdentures to justify their use in edentulous patients. PURPOSE: This study compared the benefits perceived by patients who received a new maxillary denture and a mandibular conventional denture (CD) and an implant-supported overdenture (IOD). METHOD: New maxillary and mandibular dentures were delivered to 89 diabetic denture wearers with clinically acceptable metabolic control who treated their diabetes either with insulin (IT) or without insulin (NIT). Of the 89 patients, 37 received maxillary and mandibular CDs and 52 received a maxillary CD and an IOD. Two questionnaires with categorical responses were used; the first contained 13 questions to ascertain a patient's absolute assessments of original dentures at entry and study dentures at 6- and 24-months after treatment completion; the second questionnaire had 11 questions that assessed the relative change perceived by patients with study dentures. Of the 78 patients who completed the posttreatment (PT) assessments at 6 months, 68 patients provided longitudinal data for questionnaire I and cross-sectional data for questionnaire II. In addition, 46 patients (18 CD and 28 IOD) also provided PT assessments at 24 months. RESULTS: Both mean scores and percentage distributions of longitudinal data for questionnaire I showed perceptual improvements with both types of study dentures. Improvements were higher in the IOD than in the CD group. Mean scores failed to show any significant differences between the 2 treatment groups. The only significant difference was found in the change in percentage distributions for perceptual chewing ability in favor of the IOD group. Even this advantage was lost at 24 months. With the comparative questionnaire, a higher percentage of patients in the IOD group than in the CD group perceived improvements with study dentures from their original dentures in chewing ability, chewing comfort, and denture security. However, mean differences were statistically significant in favor of the IOD group only for chewing ability and less difficulty to chew hard foods. CONCLUSION: The mandibular implant-supported overdenture offers same advantage in terms of perceived chewing function over the conventional denture.     

Cost-effectiveness of mandibular two-implant overdentures and conventional dentures in the edentulous elderly

Implementation of new therapies is usually governed by financial considerations, so efficacy studies should also include cost comparisons. The cost and effectiveness of mandibular conventional dentures (CD, n = 30) and two-implant overdentures (IOD, n = 30) were compared in elderly subjects. Effectiveness (Oral Health Impact Profile, OHIP-20) and cost were measured up to one year post-treatment. Data for subsequent years were estimated by the Delphi method. Using an average life expectancy of 17.9 years, the equalized annual costs (in Canadian dollars) were dollar 399 for CD and dollar 625 for IOD (p < 0.001), and the equalized annual values for the outcome (OHIP-20) were 47.0 for CD and 31.3 for IOD treatment (p < 0.05). These values translate into a yearly additional cost for IOD treatment of dollar 14.41 per OHIP-20 point. These results are key to the implementation of programs to provide this form of therapy for edentulous adults.     

Association between personality traits and quality of life in patients treated with conventional mandibular dentures or implant-supported overdentures

Studies investigating the relationship between personality traits and quality of life related to the types of dental prostheses are scarce. The aim of the present study was to assess personality traits and their impact on quality of life for individuals treated with either conventional mandibular dentures (CMD) or implant-supported overdentures. Fifty patients with CMD and 50 patients with implant-supported mandibular overdentures (IMOD) were recruited. Individuals were examined; clinical and demographic data of interest were collected. All participants agreed to answer two questionnaires: the Oral Health Impact Profile (OHIP-14), which assessed quality of life related to oral health, and the Neuroticism Extraversion Openness Five-Factors Inventory (NEO FFI-R), which evaluated five personality domains. The influence of variables of interest on oral health-related quality of life was tested by univariate analysis and multiple linear regression. Patients with CMD reported higher levels of impact on quality of life (OHIP-14=10·30 ± 5·88) when compared to patients with IMOD (OHIP-14=6·52 ± 5·91; P=0·002). Multivariate predictive regression model for quality of life included neuroticism, conscientiousness and gender for the conventional mandibular denture group (P<0·05; R(2)=36·59%), whereas neuroticism, openness and schooling (P<0·05; R(2)=21·09%) were included in the implant-supported mandibular denture group model. Patients with IMOD had less impact on quality of life than patients with CMD. Personality traits, mainly neuroticism, had a significant influence on oral health-related quality of life linked to a chosen modality of prosthetic therapy.     

Does a prosthodontist spend more time providing mandibular two-implant overdentures than conventional dentures?

PURPOSE: In this article, the time taken by a prosthodontist to fabricate and maintain mandibular overdentures retained by two implants and conventional dentures is compared. MATERIALS AND METHODS: Sixty edentulous patients between the ages of 65 and 75 completed a randomized clinical trial. All received new maxillary conventional dentures and either a mandibular conventional denture (n = 30) or a two-implant overdenture on ball attachments (n = 30). The time spent by the prosthodontist and the number of visits required for treatment, including both scheduled and unscheduled visits, were recorded for each patient from preliminary impressions to 6 months following delivery. Data from the two groups were compared using Mann-Whitney U tests. RESULTS: The prosthodontist spent a mean total time of 296 minutes in treating an implant overdenture patient and 282 minutes on a conventional denture patient during the period from preliminary impressions to the 6-month follow-up. The mean numbers of appointments were 10.1 (implant group) and 10.8 (conventional group). These differences were not significant. CONCLUSION: Although additional knowledge is required to treat patients with implant prostheses, the time required by the prosthodontist to provide two-implant mandibular overdentures with ball attachments was not significantly different than the time needed for conventional denture treatment.     

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.     

Impact of implant support for mandibular dentures on satisfaction, oral and general health-related quality of life: a meta-analysis of randomized-controlled trials

Objectives: The aim of this study was to examine systematically the data published on the efficacy of mandibular implant-retained overdentures from the patient's perspective.
Material and methods: Medline, Embase, The Cochrane Central Register of Controlled Trials and The Cochrane Systematic Reviews Database were searched and complemented by hand searching. All randomized-controlled trials published in English or French up to April 2007 were included, in which conventional dentures and mandibular implant overdentures in adult edentulous individuals were compared. The outcomes of interest were patient satisfaction, oral and general health-related quality of life. Random effects models were used to pool the effect sizes (ES) of all included studies.
Results: Ten publications of seven randomized-controlled trials were identified and eight were included in the meta-analysis. When compared with mandibular conventional dentures, implant overdentures were rated to be more satisfactory at a clinically relevant level [pooled ES 0.80, z =3.56, 95% confidence intervals (CI) 0.36–1.24, P =0.0004], but a statistical heterogeneity was found (χ²=31.63, df=5, P <0.00001, I ²=84%). The pooled ES for oral health quality of life was −0.41 ( z =1.31, 95% CI, −1.02 to 0.20; P =0.19, χ²=11.53, df=2, P <0.003, I ²=83%). There was a lack of evidence to show the impact of mandibular implant overdenture on perceived general health.
Conclusions: Our findings suggest that, although mandibular implant-retained overdentures may be more satisfying for edentulous patients than new conventional dentures, the magnitude of the effect is still uncertain. There is a need for additional evidence including cost-effectiveness analyses on the impact of mandibular implant overdentures and conventional dentures.     

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.     

种植覆盖义齿修复牙列缺失的生活质量研究

目的研究下颌牙列缺失患者采用全口义齿（CD）和种植覆盖义齿（IOD）修复后的患者满意度以及口腔健康相关生活质量（OHRQoL）,探讨种植覆盖全口义齿修复对老年下颌牙缺失患者的心理及社会行为是否存在积极的影响。 方法收集2016至2018年在中山大学附属口腔医院门诊就诊,50 ~ 80岁下颌牙列缺失,曾采用传统全口义齿修复且因义齿稳定性差而自愿行种植覆盖全口义齿修复的受试者19例,其中男8例,平均69.25岁;女11例,平均72.45岁。通过自身对照研究,每位受试者均先后佩戴在相同标准下制作的新传统全口义齿（CD）以及种植覆盖义齿（IOD）,并于戴用义齿3个月后完成口腔健康影响程度量表（OHIP-20）、老年口腔健康评价指数量表（GOHAI）和日常生活牙科影响量表（DIDL）调查,分析传统全口义齿和种植覆盖全口义齿修复对患者心理状态和生活质量的影响。数据采用Wilcoxon符号秩检验进行统计分析,P<0.05为差异有统计学意义,并计算CD组和IOD组OHRQoL得分的效应量（ES值）以评价其影响程度。 结果OHIP-20、GOHAI、DIDL量表均显示,IOD组在量表的功能限制、疼痛、心理不适、生理能力受限、心理能力受限、社交能力丧失、身心缺陷、美观、口腔舒适的各领域得分及总体得分上均明显优于CD组,差异具有统计学意义（P<0.05）。此外,根据DIDL量表评价标准得知,IOD修复可有效提提升患者满意度,并减少不满意人数的比例。3个量表在各领域及总得分的ES值均大于0.8,代表每个领域均受到高度影响,并以咀嚼能力（ES = 3.74）、生理能力受限（ES = 3.12）和功能限制（ES = 2.94）等生理功能改善最为显著。说明,IOD组比CD组对患者的生活质量改善较好,且对各方面的改善程度较高。 结论OHIP-20、GOHAI、DIDL量表调查结果反映种植覆盖全口义齿修复对老年下颌牙缺失患者的心理及社会行为有积极的影响。     

Masticatory performance with mandibular implant-retained overdentures

It was investigated in a clinical trial whether the masticatory performance of complete-denture wearers depended on the support for their mandibular dentures by implants or mucosa. The trial involved the provision of a new maxillary denture and either a new conventional mandibular denture (mucosa-borne), a mandibular overdenture retained by two IMZ-implants (implant-mucosa-borne), or a mandibular overdenture on a transmandibular implant (TMI; mainly implant-borne). In comparison with mandibular implant-retained overdentures, subjects with conventional dentures needed 1.5 to 3.6 times more chewing strokes for an equivalent reduction in particle size. No differences in masticatory performance were found between subjects with IMZ-implants and those with TMI. This suggests that the increased stability of the mandibular denture with implants determines the wearer's masticatory performance, rather than the support by implants.