Evaluation of masticatory performance and patient satisfaction for conventional and 3D-printed implant overdentures: a randomized crossover study.

BACKGROUND: This crossover clinical study aimed to evaluate and compare masticatory performance and patient satisfaction for patients rehabilitated with conventional heat-cured acrylic resin and 3D-printed mandibular implant overdentures retained with bar attachment. MATERIALS AND METHODS: Sixteen completely edentulous healthy participants received new conventional dentures. In the mandible, four interforaminal implants were inserted. Following the stage of osseointegration, the bar was constructed in a trapezoidal configuration. Each patient randomly received the following overdentures using a crossover design: (1) conventional heat-cured acrylic resin overdenture and (2) 3D-printed overdenture (developed by scanning of mandibular conventional overdenture). The masticatory performance was assessed by conducting a two-colour mixing ability test at 5, 10, 20, 30, and 50 masticatory cycles. Moreover, the McGill Denture Satisfaction Questionnaire (MDSQ) was employed to assess patient satisfaction. Evaluation was performed after 3 months of using each overdenture. Paired sample t tests were used to compare the masticatory performance and MDSQ scores of patients for both prostheses. RESULTS: No significant difference in masticatory performance was reported between the two types of overdentures. Regarding patient satisfaction, only the esthetic aspect was significantly better for conventionally processed overdentures than for printed overdentures. Insignificant differences were observed regarding other MDSQ items between the two overdentures. CONCLUSION: Within this clinical study, 3D-printed implant overdentures showed promising results in terms of chewing efficiency and patient satisfaction compared to conventionally fabricated implant overdentures. TRIAL REGISTRATION: Retrospectively registered at www. CLINICALTRIALS: gov : NCT06148727.(28/11/2023).

Satisfaction and Oral Health-Related Quality of Life of Different Attachments Used for Implant-Retained Overdentures in Subjects with Resorbed Mandibles: A Crossover Trial.

PURPOSE: The aim of this crossover study was to evaluate patient satisfaction and oral health related-quality of life (OHRQoL) with different connectors used for implant-retained overdentures in subjects with resorbed mandibles. MATERIALS AND METHODS: Eighteen edentulous patients with atrophied mandibular bone received traditional maxillary and mandibular dentures (control). After 3 months, two implants were inserted in the canine regions. Three months later, each patient received the following overdentures using a crossover design: (1) bar overdentures, (2) telescopic overdentures, and (3) stud overdentures. Patient satisfaction (primary outcome) was measured by visual analog scale (VAS). OHRQoL (secondary outcome) was measured by oral health impact profile (OHIP-14). Questions of VAS and OHIP-14 were evaluated after 3 months of using conventional dentures, bar overdentures, telescopic overdentures, and stud overdentures. RESULTS: For all questionnaires, conventional dentures recorded significantly lower satisfaction than implant overdentures. Stud overdentures showed significantly higher satisfaction with maxillary denture comfort, self-consciousness, and feeling that the prosthesis is a part of the patient compared with other attachments. Bar and telescopic overdentures showed higher satisfaction during biting of hard and soft foods, while telescopic and stud overdentures showed higher satisfaction with oral hygiene. No significant differences between attachments regarding other VAS and OHIP-14 questions were noted. CONCLUSION: Implant overdentures for subjects with mandibular bone resorption improved patient satisfaction and OHRQoL compared with traditional dentures regardless of the form of attachments. However, studs are more advantageous in terms of comfort with maxillary overdentures, self-consciousness, and feeling that the prosthesis is a part of the patient. Bar and telescopic attachments had more satisfaction during biting of soft and hard foods, while telescopic and stud attachments had more satisfaction with oral hygiene.

Clinical denture base deformation with different attachments used to stabilize implant overdentures: A crossover study.

OBJECTIVES: The aim of this crossover study was to compare clinical denture base deformation with different attachments used for mandibular implant overdentures. MATERIALS AND METHODS: Twenty-four patients with edentulous mandibular ridges received two implants in the former canine regions. Three months thereafter, each patient was randomly given the following implant overdentures in a crossover design: (a) bar implant overdentures (BOD), (b) resilient telescopic implant overdentures (TOD), and (c) stud implant overdentures (SOD). Six linear strain gauges were attached to the lingual surface of the implant overdentures opposite to the abutments (Ch1and Ch2 at clenching [left] side and Ch5and Ch6 at non-clenching [right] side) and at midline (Ch3 and Ch4). Three months after wearing each implant overdenture, strain registrations were performed during clenching without food and during clenching on soft (cake) and hard (carrot) foods. Kruskal-Wallis test was used to compare denture strains between group, channels, and clenching conditions. RESULTS: Bar implant overdentures showed significantly higher (p < .001) total microstrains (403.7 ± 306.8 µÉ›) than TOD (146.9 ± 131.8 µÉ›) and SOD (99.8 ± 75.6 µÉ›). No difference in microstrain was noted between TOD and SOD (p = .06, n.s.). Channels opposite to the abutments at clenching side (ch2) recorded the highest total strain during clenching hard (390.4 ± 381.6 µÉ›) and soft (223.5 ± 220.2 µÉ›) foods. Clenching hard food was associated with significant higher total microstrain than clenching soft food (p = .002). CONCLUSION: Telescopic and stud attachments are recommended to be used for two-implant mandibular over dentures as they were associated with reduced denture base deformation compared with bar attachments.

Biomechanical aspects of reinforced implant overdentures: A systematic review.

PURPOSE: The purpose of this systematic review was to investigate the effect of reinforcement on the mechanical behaviour of implant overdenture (IOD) bases and its cumulative biological effect on the underlying supporting structures (implants and the residual ridge). MATERIAL AND METHODS: The required documents were collected electronically from PubMed and Web of Science databases targeting papers published in English that focused on denture base reinforcement for IOD prostheses in order to recognize the principal outcomes of reinforcement on the mechanical and biological properties of overdentures. Such biological outcomes as: strains on implants, peri-implant bone loss, residual ridge resorption, and strain on the residual alveolar ridge. RESULTS: A total of 269 citations were identified. After excluding any repeated articles between databases and the application of exclusion and inclusion criteria, only 13 publications fulfilled the inclusion criteria. Three publications investigated the mechanical properties of fibre and/or metal-reinforced implant overdentures while another 3 articles investigated the effect of metal reinforcement on stress distribution and strains transmitted to the underlying implants. In addition, 3 in vitro studies investigated the effect of metal reinforcement on overdenture base strain and stresses. Stress distribution to the residual ridge and strain characteristics of the underlying tissues were investigated by 2 in vitro studies. Five clinical studies performed to assist the clinical and prosthetic maintenance of metal-reinforced IOD were included. Data concerning denture base fracture, relining, peri-implant bone loss, probing depth, and implant survival rates during the functional period were extracted and considered in order to evaluate the mechanical properties of the denture base, residual ridge resorption and implant preservation rates, respectively. CONCLUSION: The use of a denture base reinforcement can reduce the fracture incidence in IOD bases by enhancing their flexural properties and reducing the overdenture base deformation. Strains on the underlying supporting structures of overdenture prostheses including dental implants and the residual ridge can be decreased and evenly distributed using a metal reinforcement.