ABSTRACT
BACKGROUND: Patient-based outcomes with maxillary overdentures on a minimum number of implants, opposing mandibular 2-implant overdentures are not evident in the literature. PURPOSE: To evaluate patient's satisfaction with maxillary 3-implant overdentures, opposing mandibular 2-implant overdentures, using two different attachment systems over the first 2 years of service. MATERIALS AND METHODS: Forty participants wearing mandibular 2-implant overdentures for 3 years were randomly allocated to one of two similar implant system groups to receive maxillary 3-implant overdentures. Twenty participants were allocated to splinted and unsplinted attachment system treatment groups for each system. Patient satisfaction with pre-treatment complete maxillary dentures, with maxillary 3-implant overdentures at baseline and annually for 2 years, was measured using visual analogue scale questionnaires and the oral health impact profiles. Palatal coverage of the maxillary overdentures was reduced at the first annual recall. RESULTS: Data showed significant improvement in pain reduction, comfort, stability, and function variables of the visual analogue scale after treatment. Analysis by prosthodontic design using visual analogue scale showed no significant difference. The total oral health impact profile-14 scores after treatment for all participants, regardless of prosthodontic design, were significantly lower (more satisfied). The overall oral health impact profile-20E score at baseline was significantly higher (more satisfied) compared with pre-treatment conventional maxillary dentures. No significant changes were observed in the first or second years compared with baseline results. Twenty-two participants (84.6%) preferred reduced palatal coverage, regardless of prosthodontic design, after 1 year. Twenty participants (76.9%) still preferred reduced palatal coverage at the end of the second year. CONCLUSIONS: The provision of maxillary 3-implant overdentures to oppose mandibular 2-implant overdentures significantly improve levels of patient satisfaction compared with conventional maxillary dentures.
Subject(s)
Dental Implants/psychology , Dental Prosthesis, Implant-Supported/psychology , Denture, Complete, Lower/psychology , Denture, Complete, Upper/psychology , Denture, Overlay/psychology , Patient Satisfaction , Attitude to Health , Denture Bases , Denture Design/psychology , Denture Retention/instrumentation , Eating/physiology , Esthetics, Dental , Follow-Up Studies , Gold Alloys/chemistry , Humans , Middle Aged , Pain/psychology , Patient Preference , Speech/physiology , Treatment OutcomeABSTRACT
BACKGROUND: Different attachment systems for mandibular two-implant overdentures could influence levels of patient satisfaction. Positive consensus of the majority of patients being satisfied does not preclude the possibility of dissatisfaction for some. PURPOSE: To evaluate patient satisfaction and dissatisfaction before and after 5 years of wearing mandibular two implant overdentures using different attachment systems ; to determine the prognostic relevance of pretreatment complete denture complaints to treatment outcomes. MATERIALS AND METHODS: A total of 106 edentulous participants enrolled in a clinical trial completed a preliminary self-report inventory of their original complete denture complaints.New complete maxillary dentures and mandibular two-implant overdentures were provided to each participant using one of six different attachment systems. Patient satisfaction was determined at pretreatment; at baseline with mandibular two-implant overdenture insertion; and then annually for 5 years, using visual analogue and Likert-type scales. RESULTS: Patient satisfaction with mandibular two-implant overdentures showed significant changes pre- to posttreatment(baseline) in all domains, but these were significant immediately and maintained without further significance for 5 years, other than pain with the overdenture. After 5 years, no significant differences were observed with all the attachment systems. Highly significant differences were found with some social and psychological aspects by the fifth year compared to baseline. Diagnostic and prognostic indicators from a pretreatment inventory identified 12 participants (13.5%) who were dissatisfied. These indicators revealed a maladaptive predisposition to mandibular two-implant overdentures. CONCLUSIONS: The provision of mandibular two-implant overdentures will, in the majority of patients, significantly enhance levels of patient satisfaction for 5 years, as compared to complete mandibular dentures, regardless of the attachment system. Careful evaluation of pretreatment complaints with conventional dentures can possibly identify patient dissatisfaction with mandibular two-implant overdentures [corrected].
Subject(s)
Dental Prosthesis Retention/instrumentation , Dental Prosthesis Retention/psychology , Dental Prosthesis, Implant-Supported/psychology , Denture, Overlay/psychology , Patient Satisfaction , Adaptation, Psychological , Aged , Analysis of Variance , Humans , Mandible , Pain Measurement , Self ReportABSTRACT
Root overdentures and implant overdentures are two similar treatment options for the nearly-edentulous or edentulous mandible. The purpose of this literature review was to specifically compare their prosthodontic treatment philosophies and follow-up maintenance requirements. Critical comparison of these two prosthodontic treatment philosophies revealed that the foundation for overdentures which is provided by oral implants is more predictable than that provided by the roots of natural teeth. The two treatment modalities have both similarities and differences in their associated prosthodontic maintenance. The findings of this literature review suggest the future possibility that mandibular root overdentures may become obsolete as a treatment approach.
