The number of implants required to support a maxillary overdenture: a systematic review and meta-analysis.

PURPOSE: The number of implants needed to support a maxillary overdenture is still a controversial issue. The aim of this systematic review was to investigate the number of implants required to support a maxillary overdenture in order to obtain optimal treatment outcomes in terms of implant survival, overdenture longevity and patient satisfaction. STUDY SELECTION: Pubmed and EMBASE databes were systematically searched and complemented by hand searching from 2000 to 2017. The Prisma statement and a PICOS approach were adopted. All selected articles provided at least two-year follow-up and 10 totally edentulous patients. Survival rate of implants and overdentures were statistically analyzed according to number of implants and according to splitting technique, employing non-parametric Fisher Test for unpaired data. For the pooled analysis of implant failures, the odds ratio between group of 4 splinted implants and group of more than 4 splinted was calculated. RESULTS: A total of 28 articles were included. Data analysis of the included studies showed that the survival rate of implants appeared higher in ≥ 4 implants group, whereas the high survival rate of overdentures and patient satisfaction were not significantly influenced by the number of implants. CONCLUSIONS: The findings of our analysis indicate that overall the most frequent tendency is to place at least four implants, splinted or unsplinted, in order to ensure a higher survival rate of implants. However, the relationship between overdenture survival, the patient's quality of life, and the number of implants required to support a maxillary overdenture has yet to be clarified.

Perceptions and experiences of patients following treatment with single-implant mandibular overdentures: A qualitative study.

OBJECTIVE: This study aimed to explore the perceptions and long-term experiences of edentulous patients rehabilitated with single-implant mandibular overdentures (SIMO). METHODS: Thirteen participants, mean age 65.7 years, 69.2% women, who had had their treatment completed for at least 1 year, were invited and included in the study. Focus groups including four to five participants each were conducted, audio and video recorded and transcribed verbatim. Subsequently, the transcripts were analysed according to the principles of thematic analysis. RESULTS: Four major themes emerged as follows: before decision to undergo treatment with SIMO, implant surgery experience, perception of treatment outcomes and impressions about the care received. Lack of information, cost, comorbidities, older age and fear were initial barriers to the decision for treatment. Dissatisfaction with previous treatment and a sense of opportunity motivated the decision. There were ambivalent reports of absence of pain during surgery and discomfort during anaesthesia. Post-surgical recovery exceeded the pre-surgical negative expectations in most cases. There was a tendency for a positive impact of SIMO on the patients' quality of life, comprising improved ability to chew and communicate, dietary diversification, greater comfort and safety, increased self-confidence and social interaction. Few minor inconveniences were reported such as the feeling of insecurity after an episode of denture fracture and the need to use adhesive paste. Satisfaction with the care received and the trust in the dentist and dental team were evident. CONCLUSION: In general, participants presented positive perceptions and rewarding experiences after rehabilitation with SIMO.

Oral health-related quality of life and clinical outcomes of immediately or delayed loaded implants in the rehabilitation of edentulous jaws: a retrospective comparative study.

BACKGROUND: Patient-centered outcomes are being given great attention by the dental scientific community. The Oral Health Impact Profile -14 questionnaire (OHIP-14) has been introduced to address patients' success criteria when describing the impact of oral rehabilitations on quality of life (OHrQoL). METHODS: Thirty-five patients wearing a full-arch implant-prosthesis being in place between 4 and 6 years before this analysis were considered eligible and then enrolled in the present retrospective study. According to their prosthetic anamnesis, two groups were defined: delayed loading group (IL-group) and immediate loading group (IL-group). At the moment of analysis, clinical and radiographic parameters were collected, and patients were asked to complete the Oral Health Impact Profile -14 questionnaire (OHIP-14) in order to measure their OHrQoL. RESULTS: Independent t-test showed total OHIP-14 scores to be not significantly different between groups; however, the domains "functional limitation" and "physical disability" resulted significantly higher in patients within the DL-group. On the contrary, social disability was higher in the IL-group. When the comparison was performed taking sex into account, no significant differences between groups were highlighted. Instead, the stratification for years of follow-up led to significant evidences. When the follow-up was shorter (less-than-5 years), the functional limitation reported scores were higher. CONCLUSIONS: Within the limitations of this study, the analysis supports the absence of significant differences between immediate loading and delayed loading full-arch protocol in term of clinical, radiological parameters and OHrQoL.

Clinical Performance of Implant Overdenture Versus Fixed Detachable Prosthesis.

AIM: To evaluate the satisfaction of completely edentulous patients with a different number of implants to retain removable and support the fixed prosthesis. MATERIALS AND METHODS: Fifty patients with the single edentulous ridge (maxilla or mandible) were selected for this study and divided equally into five groups. Each group contained 10 patients. Group 1: conventional complete denture (negative control group), group 2: two implants retained overdenture, group 3: three implants retained overdenture, group 4: four implants retained overdenture, group 5: fixed detachable prosthesis with five implants placed between the mental foramen. After one year from completing the treatment, the patients were requested to fill a specially designed questionnaire to assess their overall quality of life and level of satisfaction, both estheti-cally and functionally. Comparison of data between groups was performed using the Chi-square tests. The level of statistical significance was considered at p < 0.05. RESULTS: Patients treated with conventional complete denture were all unsatisfied in their masticatory function, and 80% were also unsatisfied in phonetics, while only 50% of patients were satisfied aesthetically and mentally and 70% were satisfied in social life. The addition of two or more dental implants resulted in 100% satisfaction in the variables tested. There was no statistical difference between the number of implants and supra-structure design regarding patients' satisfaction. Furthermore, implants retained overdenture and fixed detachable prosthesis design scored the same satisfactory level. CONCLUSION: The satisfaction level of the conventional complete denture in the treatment of an edentulous arch can be dramatically improved by adding dental implants and changing the design to an overdenture. Two implants with an overdenture design is a valid treatment option for the edentulous arch as well as three and four implants. Fixed detachable prosthesis did not add any further patient satisfaction when compared to implant retained overdenture. CLINICAL SIGNIFICANCE: Two implants with overdenture to treat edentulous jaw is effective as five implant fixed prosthesis.

Patient-centered and clinical outcomes of mandibular overdentures retained with the locator system: A prospective observational study.

STATEMENT OF PROBLEM: Whether clinical or demographic variables affect the perception of treatment in terms of quality of life and satisfaction is unknown. PURPOSE: The purpose of this prospective study was to make an evidence-based assessment of the treatment outcomes (patient- and clinically based) of locator-retained mandibular overdentures. MATERIAL AND METHODS: This prospective observational study assessed patients with edentulism who had worn mandibular overdentures supported by 2 implants and retained by the locator system for at least 1 year of functional life (N=80). Medical histories were reviewed, and patients underwent oral examinations. Prosthetic clinical outcomes and patient well-being were registered using the Oral Health Impact Profile 20 (OHIP-20) and Oral Satisfaction Scale (OSS). RESULTS: Patient well-being scored an overall OHIP-20 score of 19.0 ±14.0 of 80 (the higher the score, the greater the impact and the worse the oral health-related quality of life); overall oral satisfaction was 8.3 ±1.7 of 10. Women suffered greater social impact (0.8 ±1.0) and disability (0.4 ±0.8) than men (0.4 ±0.7 versus 0.2 ±0.4, respectively). Impact on well-being was inversely proportional to both patient age and the age of the prosthesis (r=-0.25; P<.01). Implants had been placed on average 73.6 ±39.2 months previously, showing a survival rate of 82.5%. Most of the overdentures had been functioning for over 60 months. Relining (46.3%), readjustments (82.5%), and changes of nylon retention (1.5 ±1.8 per patient over 60 months of use) devices negatively influenced well-being. CONCLUSIONS: Mandibular overdentures produced good results with regard to quality of life and oral satisfaction, but attention should be paid to factors affecting clinical outcomes and patient well-being.

Masticatory function parameters in patients with varying degree of mandibular bone resorption.

PURPOSE: This cross-sectional study analyzes how bone resorption affects the masticatory function and investigates the relation between perceived and measured masticatory function. METHODS: Thirty complete dentures wearers were divided in two groups according to mandible bone atrophy based on the classification criteria from Cawood & Howell. Retention and stability of the mandibular complete denture, masticatory performance (MP) indexes (X_50 and B) and masticatory efficiency (ME, sieves 4 and 2.8) were evaluated. Geriatric Oral Health Assessment Index (GOHAI) and Dental Impact on Daily Living (DIDL) questionnaires were completed by the patients. RESULTS: A strong correlation between bone atrophy and poor retention was found (P=0.0132). Neither masticatory performance indexes nor GOHAI and DIDL domains showed statistical differences (P>0.05) when patients were compared according to the atrophy criteria. Mandibular length showed a negative correlation with ME4, showing a positive association (R2=0.17, ß=-0.67, P=0.029). Mandibular denture retention was significantly correlated with MPB (P=0.01) and ME2.8 (P=0.01). GOHAI showed a positive association between the physical and the functional domains and ME2.8 (R2=0.17; ß=1.22; P=0.02). DIDL showed a negative association between ME4 and oral comfort domain (R2=0.16; ß=-2.94; P=0.02). CONCLUSION: Mandibular bone height does not directly affect the masticatory function and is inversely correlated with the self-perceived masticatory ability.

Oral health and quality of life in the municipal senior citizen social clubs for people over 65 of Valencia, Spain

BACKGROUND: The world population is aging considerably. The state of elderly's dentition is poor. Many authors agree that the oral health status influence the elderly's quality of life. The objective of our study was to analyze the relation between the oral health status and the general health status through the quality of life of elderly people aged 65 years or more in Valencia, Spain. MATERIAL AND METHODS: A cross-sectional oral health survey and an oral examination have been designed to study an elderly population. There were 202 adults (103 men and 99 women). Age: 65 years of age and over. Randomly selected senior citizen's social clubs. The Oral Health Impact Profile (OHIP-14) has been used to obtain the health survey. Moreover, the EuroQol-5d and a Visual Analogue Scale (VAS) have been the tools to obtain the general health status. Finally, sociodemographic and oral health questions have been needed. RESULTS: Descriptive and inferential results have been done and the main results are the following, the mean additive score of the OHIP-14 was 8.88, the mean value of the EuroQol-5d was 0.58 and of the VAS, 72.90. The OHIP-14 was consistently and significantly correlated with the index EuroQol-5d and with variables such as number of teeth, missing teeth, DMFT, dental status (being or not edentulous) and occupation. The EuroQol-5d was related to dental habits, sex, income, systemic pathologies and filled teeth. CONCLUSIONS: The oral health has a high impact on quality of life. The oral health and the general health are closely related. The oral hygiene and getting toothless influence negatively on the quality of life of elderly people

The effect of denture installation at mandibular rest position on unsteady motion of the centre of pressure in postural sway.

Wearing dentures has been believed to decrease the instability of the postural sway using the total length of centre of pressure (CoP) trajectory or the magnitude of its variability. However, the physical aspects of the postural sway have not been taken into account while evaluating the CoP in patients who wear dentures. The CoP fluctuations are found to show a random walk process. Therefore, changes in the random movement of CoP caused by wearing dentures should be examined by nonlinear dynamics that enables analysis of the characteristics found in the random movement. We evaluated the effect of complete denture installation on CoP sway for twenty-six edentulous patients by performing the following steps. First, we excluded subjects who did not show crossover in spectral analyses. Then, we evaluated the spectral characteristics and phase shifts of the velocities of CoP sway for the subjects who showed crossover. We found that wearing complete dentures decreased the fluctuations in the high-frequency part of the power spectral density (PSD) and the phase shift in the mediolateral direction. On the other hand, we also found that the use of complete dentures decreased the fluctuations of PSD amplitude in the anteroposterior direction. From the point of view of the kinetic energy of the musculoskeletal system, we suggested that the use of complete dentures could reduce the energy consumption for the standing posture.

Changes in oral health-related quality of life during implant treatment in partially edentulous patients: A prospective study.

PURPOSE: The aim of this prospective study was to evaluate the changes in oral health-related quality of life (OHRQoL) during implant treatment for partially edentulous patients, and to evaluate the influence of the type of partially edentulous arch. METHODS: Twenty patients with a small number of lost teeth (fewer than 4 teeth) who underwent implant treatment were selected. Chronological QOL change during implant treatment was measured. The subjects completed the shortened Japanese version of the Oral Health Impact Profile (OHIP-J14) before the surgery (T0), 1 week after the surgery (T1), 1 week after interim prosthesis placement (T2), and 1 week after definitive prosthesis placement (T3). Complete data of the twenty subjects were analyzed with the Wilcoxon signed-rank test. RESULTS: The total OHIP-J14 score was significantly reduced only at T3 (P<0.05). "Physical pain" and "Physical disability" scores significantly decreased at T3, and "Psychological discomfort" scores also significantly dropped at T2. However, "Functional limitation" scores significantly increased at T1. "Psychological disability", "Social disability", and "Handicap" scores remained the same. On the other hand, in the comparison depending on the type of partially edentulous arch, the total OHIP-J14 score significantly decreased at T3 in the unilateral free-end edentulous space, whereas no significant difference was observed in the bounded edentulous space. CONCLUSION: Although there is a temporary functional limitation after implant placement in overall OHRQoL improvement was observed after the definitive prosthesis placement. Moreover, implant treatment was more effective in the unilateral free-end edentulous space.

Application of Ce-TZP/Al2O3 nanocomposite to the framework of an implant-fixed complete dental prosthesis and a complete denture.

PATIENT: A 69-year-old Japanese male visited Nihon University Dental Hospital for refabrication of his mandibular implant-supported complete fixed prosthesis (ISCFPD) and maxillary complete denture, which had been fabricated 15 years previously. In this case, Ce-TZP/Al2O3 nanocomposite (Ce-TZP/A) was applied to the framework of the mandibular ISCFPD and maxillary complete denture. Three years after deliver of the framework, no particularly notable biological or prosthetic complications were observed, and a high level of patient satisfaction had been achieved. DISCUSSION: Conventional ISCFPD frameworks were fabricated by casting gold alloys; however, with the recent advancement of CAD/CAM technology, titanium (Ti) or yttria tetragonal zirconia polycrystal (Y-TZP) frameworks have become more common. In contrast, the main fabrication method for Ti or Co-Cr frameworks of removable dental prostheses has shifted from the conventional casting method to CAD/CAM fabrication. Ce-TZP/A, which was chosen as the framework material this time, shows higher strength and greater toughness than Y-TZP. However, since it has a low light-transmitting property and exhibits an opaque white color, the range of its application in fixed prostheses, particularly in the esthetic area, is limited. CONCLUSION: We described a case in which Ce-TZP/A was applied to the frameworks of a mandibular ISCFPD and a maxillary complete denture. No particularly notable biological or prosthetic complications were observed in the mandibular ISCFPD or the maxillary complete denture, and a high level of patient satisfaction was achieved. Medium- and long-term observations with a greater number of cases are essential to obtain information concerning various phenomena related to this procedure.

Comparison of implant supported mandibular overdentures and conventional dentures on quality of life: a systematic review and meta-analysis of randomized controlled studies.

BACKGROUND: Conventional complete dentures and implant supported overdentures are commonly used by dentists to treat completely edentulous mandibular arches. There have been problems associated with retention and stability while treating completely edentulous mandibular arches compared to maxillary arches. Many factors have been attributed to this, primarily focusing on the decreased area available for support and increased resorption. Implant supported overdentures have increased the treatment options for resorbed ridges, especially the mandible. However, no reports have proved the superiority of one treatment option over the other, especially in terms of patient-centric outcome measures such as the Oral Health Impact Profile (OHIP). Hence, this meta-analysis was conducted. METHODS: A literature search of Medline (via PubMed), the Cochrane Central Register of Clinical Trials (CENTRAL) and the Database of Abstracts of Reviews of Effects (DARE) was performed. The reviewers screened titles, abstracts and performed full-text screening of eligible studies. The references from these studies were further screened for additional relevant studies. A random effects model was applied to measure the significance of the per cent mean difference in OHIP scale improvement between implant and conventional dentures. The Cochrane Risk of Bias Tool was applied to assess the selection, ascertainment and selective reporting biases. RESULTS: Five studies were reviewed and identified. Results of 441 patients (228 implant and 213 conventional) were pooled for analysis of primary outcome and other secondary outcomes. A forest plot of total OHIP scores and for secondary outcomes were obtained between the interventions. Results of 441 patients (228 implant and 213 conventional) were pooled for analysis of primary outcome with a mean difference [95% confidence interval] in the score of -30.72[-48.39, -13.05]; mean difference [95% confidence interval] in the score of -26.45[-43.56, -9.35] for functional limitation; -29.16[-60.89, 2.56] for physical pain; -77.61[-154.63, -0.60] for psychological discomfort; -33.70[-47.96, -19.44] for physical disability; -41.17[-55.93, -26.40] for psychological disability; -17.27[-29.44, 5.10] for social disability; and -28.45[-33.97, -22.92] for handicap. A statistically significant difference favouring the implant group was obtained except for physical pain. CONCLUSIONS: The implant overdenture group performed better in regard to patient satisfaction as measured using the OHIP questionnaire. Further studies are required to identify superiority between the two treatment options.

Oral Health-Related Quality of Life in Edentulous Patients with Two- vs Four-Locator-Retained Mandibular Overdentures: A Prospective, Randomized, Crossover Study.

PURPOSE: To compare the oral health-related quality of life (OHRQoL) in a prospective, randomized crossover trial in patients with mandibular overdentures retained with two or four locators. MATERIALS AND METHODS: In 30 patients with edentulous mandibles, four implants (ICX-plus implants [Medentis Medical]) were placed in the intraforaminal area. Eight weeks after transgingival healing, patients were randomly assigned to have two or four implants incorporated in the prosthesis. After 3 months, the retention concepts were switched. The patients with a two-implant-supported overdenture had four implants incorporated, whereas patients with a four-implant-supported overdenture had two retention locators taken out. After 3 more months, all four implants were retained in the implant-supported overdenture in every patient. To measure OHRQoL of the patients, the Oral Health Impact Profile 14, German version (OHIP-14 G), was used. RESULTS: A considerable increase in OHRQoL could be seen in all patients after the prosthesis was placed on the implants. Also, a statistically significant difference of OHRQoL could be seen in the OHIP-14 G scores between two-implant and four-implant overdentures. Patients had a higher OHRQoL after incorporation of four implants in the overdenture compared with only two implants. CONCLUSION: Patients with implant-retained overdentures had better OHRQoL compared with those with conventional dentures. The number of incorporated implants in the locator-retained overdenture also influenced the increase in OHRQoL, with four implants having a statistically significant advantage over two implants.

The effect of nocturnal wear of complete dentures on sleep and oral health related quality of life: study protocol for a randomized controlled trial.

BACKGROUND: Edentulism and sleep disturbance are chronic conditions that are common in older people and have serious adverse consequences for their functioning and quality of life. Edentulism can disturb sleep through the alteration of the craniofacial structure and surrounding soft tissue. However, the effect of prosthetic rehabilitation of edentulism on sleep quality is still not well understood. The objectives of this study are to test whether nocturnal denture wear affects sleep quality, daytime sleepiness, and the oral health related quality of life of edentate older people with moderate to severe sleep apnea, and to identify modifiers of effect of nocturnal denture wear. METHODS/DESIGN: We will carry out a single-blind randomized cross-over trial. Seventy edentate older people with moderate to severe obstructive sleep apnea will be enrolled. The study participants will be assigned to wear and not wear their dentures on alternate periods of 30 days. The outcome measures will be sleep quality (assessed by portable polysomnography), daytime sleepiness (assessed by the Epworth Sleepiness Scale), and oral health related quality of life (assessed by validated questionnaire). A number of characteristics (sociodemographic, oropharyngeal morphology, oral and prosthesis characteristics, and perceived general health quality of life) will be assessed by means of clinical examination, 3D imaging of the craniofacial structure, and validated questionnaires at baseline. Linear mixed effects regression models for repeated measures will be fitted to test the study hypotheses. The main analyses will be based on the intention-to-treat principle. To assess the robustness of the findings to potential incomplete adherence, sensitivity analyses will be conducted while applying the per-protocol principle. DISCUSSION: This practice-relevant evidence could represent a preventive approach to improve sleep characteristics of the older population and improve their well-being and quality of life. TRIAL REGISTRATION: ClinicalTrials.gov NCT01868295.

Evaluation of the efficacy of mandibular conventional and implant prostheses in a group of Turkish patients: a quality of life study.

PURPOSE: The aim of this study was to compare the satisfaction and quality of life (QoL) in a group of patients using mandibular complete dentures, implant-retained overdentures, removable partial dentures (RPDs), or implant-supported fixed partial dentures (FPDs). MATERIALS AND METHODS: A total of 116 patients (aged 36 to 81, mean age 58 ± 10.03 years) were assigned to four groups (n = 29) and treated with mandibular implant-retained overdentures, implant-supported FPDs (two implants/three unit FPDs), conventional complete dentures, or RPDs. The groups were well matched in terms of gender, age, and the edentulous period. All patients had edentulous maxillary arches and completely or partially edentulous mandibles. All prostheses were mandibular prostheses. The OHIP-14, OHQoL-UK, and SF-36 surveys were used to determine QoL before implant surgery and 1 year after prosthetic treatment. RESULTS: The baseline and 1-year data from 116 patients were analyzed. A significant improvement was found among the QoL scales for all groups (p < 0.05). The most significant improvement was found in the implant-retained overdenture group (15.67 ± 2.47), while the least improvement was found among the implant-supported FPD group (5.14 ± 2.08). The SF-36 test revealed no differences between the before and after treatment scores for general health, pain, vitality, social function, and physical function difficulties (p > 0.05). The only significant difference was found for mental health (p = 0.011). CONCLUSION: A positive influence on oral health-related QoL was observed in all groups. The QoL values were the most improved in the implant-retained overdenture group.

Oral health-related quality of life and periodontal and dental health status in Iranian hemodialysis patients.

AIM: The aim of this study was to evaluate oral health status and oral health related quality of life (OHRQoL) in Iranian patients undergoing hemodialysis. MATERIALS AND METHODS: In this cross-sectional study 145 (95 dentate and 50 edentulous) patients undergoing hemodialysis participated. Demographic information, laboratory findings and dental health status was recorded by a standard form. Oral hygiene status was obtained by simplifed oral hygiene index (OHI-S) and oral health was evaluated by decay missing flling teeth (DMFT) index, plaque index (PLI) and periodontal disease index. Oral health related quality of life was determined by means of short form oral health impact profle (OHIP-14) and general oral health assessment index (GOHAI). RESULTS: The mean (± SD) DMFT, PLI and PDI were 15.47 ± 7.85, 2.03 ± 0.95, 4.09 ± 1.31 respectively. OHI-S was good in 7 (7.4%), fair 25 (26.6%) and poor in 38 (26.6%) of patients. The mean OHIP-14 and GOHAI scores were 31.32 ± 12.53 and 29.07 ± 8.5 respectively. The self-perceived oral health of 58 (40%) was good, 49(33.8%) was fair and 38 (26.2%) was poor. Patients with higher scores for the questionnaires had significantly worst self-rated oral health. Besides, there was a significant positive correlation between dental and periodontal variables with OHIP-14 and GOHAI scores. CONCLUSION: Hemodialysis patients had a poor oral hygiene and periodontal status, weak attitudes and negligence toward oral health but they were satisfed of their oral health condition and their OHRQoL was approximately good. Therefor it should be communications between nephrologists and oral health care professionals for promoting the oral health status of the patients. CLINICAL SIGNIFICANCE: The findings high light the need of comprehensive oral examinations including periodontal therapy, restorative treatment, preventive dental treatment and follow-up care in the hemodialysis patients.

The influence of relining or implant retaining existing mandibular dentures on health-related quality of life: a 2-year randomized study of dissatisfied edentulous patients.

PURPOSE: The purpose was to assess and compare self-reported oral health and oral and general health related quality of life (OHRQoL and HRQoL) in two groups of edentulous adults who reported dissatisfaction with their mandibular dentures, and who were treated with a conventional relining of this denture or by having it converted into an implant-retained one. MATERIALS AND METHODS: Sixty subjects were randomly allocated into two equal groups, a relined conventional denture (RCD) group and an implant-retained overdenture (IOD) group. Data on demographics, oral health, OHRQoL, and HRQoL were recorded by means of a self-administered questionnaire at baseline, 3 months, and 2 years. RESULTS: Fifty-four subjects completed the protocol, 28 in the IOD-group and 26 in the RCD-group. The IOD group reported significant improvement in oral health and Oral Health Impact Profile (OHIP-20) sum score and all its domains after 3 months. The improvements remained stable at the 2-year control. The RCD group reported almost no significant improvements. Neither group reported improved HRQoL. CONCLUSION: The results of this study support the findings from other RCT studies that to implant-retain the mandibular denture significantly improves self-reported oral health and OHRQoL. This treatment modality should be a minimum standard of care in complete denture wearers dissatisfied with their mandibular denture.

Denture wearer's perception of ambient care. Part 2. Analyses of data.

OBJECTIVE: The aim was to investigate to what extent denture wearers were satisfied with the ambient care (care) received. MATERIALS AND METHODS: A study sample of 117 completely edentulous and 56 partially edentulous patients, who had received their dentures in the period 1997-2005 at Bergen School of Dentistry, completed a questionnaire containing eight specific items regarding different aspects of care, each with two positive (a and b) and two negative (c and d) categories, and four global items. The care items, including confidence in the dental team, information, waiting time and cost, constitute the Ambient Care Scale; the global items were concerned with overall care, satisfaction with dentures, self-reported oral and general health. RESULTS: Between 91-100% of Ambient Care Scale responses were in the two positive categories. The completely edentulous group was significantly more satisfied than the partially edentulous group regarding several Ambient Care Scale items and oral health. Also, ratios between categories b and a showed systematic higher degrees of satisfaction for the completely edentulous group than the partially edentulous group. Fifty-six per cent in the completely edentulous group and 36% in the partially edentulous group were very satisfied, i.e. with ≥ 6 of 8 possible responses in category a. Analysis of the very satisfied showed that the highest degrees of satisfaction for both groups were found regarding students and staff, the lowest regarding cost and waiting times. CONCLUSIONS: Patient satisfaction with care was very high. Completely edentulous patients were systematically more satisfied than partially edentulous ones.

Patient preference and satisfaction with implant-supported mandibular overdentures retained with ball or locator attachments: a crossover clinical trial.

PURPOSE: To determine patient satisfaction and preference for implant-supported mandibular overdentures (IOD) retained with ball or Locator attachments. In addition, peri-implant conditions and prosthodontic maintenance efforts for the final attachments were evaluated after 1 year of function. MATERIAL AND METHODS: In this crossover clinical trial, 20 edentulous patients were recruited to receive two mandibular implants in the canine region and were provided with implant-retained mandibular overdentures and new complete maxillary dentures. Implant-retained mandibular overdentures were stabilized with either ball attachments or Locator attachments, in random order. After 3 months of function, the attachments in the existing denture were changed. Questionnaires on satisfaction/complaints with the prostheses were administered at baseline (with the old dentures) and after 3 months of function with each attachment, thus providing for an intraindividual comparison. The decision for the final attachment chosen was based on the patient's preference. For the definitive attachment, peri-implant conditions (peri-implant marginal bone resorption, pocket depth, and Plaque Index, Gingival Index, and Bleeding Index) as well as prosthodontic maintenance efforts and satisfaction score were evaluated after an insertion period of 1 year. RESULTS: Nineteen (95%) patients completed the study (1 dropout). Patient satisfaction improved significantly (P<.05) from baseline (old dentures) to the new prostheses retained with each of the two attachment types for all domains of satisfaction. However, there were no differences between ball or Locator attachment for any items of satisfaction evaluated and neither attachment had a significant patient preference. No differences for peri-implant parameters or for patient satisfaction were noted between the definitive attachments (ball, n=10; Locator, n=9) after 1 year. Although the overall incidence rate of prosthodontic maintenance did not significantly differ between both retention modalities, the Locator attachment required more postinsertion aftercare (activation of retention) than the ball anchors.

Quantity and quality analysis of dental prosthodontics among retirement age residents from nursing homes in different regions of Latvia and retirement age patients from dental clinic in Riga.

INTRODUCTION: The quality of life is closely related with condition of oral health, influence of subjective factors on the whole human body and patients perception of their oral health. In spite of the fact that the most part of Latvian retirement age residents use low-quality dentures and assess them satisfactory, these patients often have problems associated with quality of dentures. The aim of the present study was to evaluate oral health status, prosthodontics indicators and patients satisfaction with oral health among Latvian retirement age residents. PATIENTS AND METHODS: There were examined 465 retirement age volunteers (170 men and 295 women), 116 of them in dental clinic Sandent (Riga, 24.9% - control group), 137 (29.5%) in nursing homes in Zemgale and 212 (45.6%) in nursing homes in Kurzeme (Zemgale and Kurzeme are districts of Latvia). There were assessed quantity of prosthodontics among patients with partial defects of dental arches, there were estimated quality of dentures and patients satisfaction with existing prosthodontics. RESULTS: Oral health indicators among Latvian retirement age population are better than the same indicators among elderly residents of nursing homes. Among nursing homes residents with partial edentulousness in most of cases in oral cavities remained only few residual teeth which needed treatment. Removable and fixed dental prostheses used by nursing homes residents do not meet denture's quality criteria. Self-evaluation of dentures quality among retirement age residents of nursing homes is better and not correspond with existing dentures quality. CONCLUSIONS: In Latvia the quantity of prosthodontics in respect of partial removable dentures among the retired who regularly visit a dentist does not significantly differ from European retirement age population's dental prosthodontics quantity. Dental prosthodontics indicators of residents of nursing homes in Latvia are unsatisfactory (p<0.001). In retirement age population self-evaluation with quality of dentures is higher than actually existing.

Changes in mental health and quality of life with dental implants as evaluated by General Health Questionnaire (GHQ) and Health Utilities Index (HUI).

OBJECTIVES: The purpose of this study was to assess and compare the improvement in oral and systemic conditions and health-related quality of life in patients with missing teeth receiving dental implants and conventional treatment. METHODS: A total of 97 patients with missing teeth, of whom 59 received dental implants and 38 received conventional treatment, were included in this study. The patients were divided into two age groups for a more detailed analysis: a 30- to 59-year age group (young) and a >60-year age group. The changes in oral condition, mental health, and health utility level before and after (pre- and post-, respectively) the procedures were assessed using an original questionnaire, the General Health Questionnaire 12 (GHQ12), and Health Utilities Index Mark 3. RESULTS: Responses to the GHQ12 indicated that treatment with implants significantly improved the oral health of patients in all treatment groups, except for the young group receiving partial dentures (PD). The mental state improved with a lower GHQ score; in terms of pre- versus post-procedure, mental state improved after the procedure in the young group receiving full dentures (FD) (1.75 ± 2.12 vs. 0.88 ± 2.10, p < 0.05), in the old group receiving PD (2.61 ± 3.91 vs. 0.72 ± 1.71, p < 0.05), and in the old group receiving FD (2.63 ± 3.12 vs. 0.44 ± 0.27, p < 0.05). The sleep score also improved by implant in FD of the old group (2.00 vs. 1.00, p < 0.05); it also is better with a lower score. CONCLUSIONS: Recovery of oral function and oral stability in middle-aged people who did not receive implants was possible with PD. However, the results suggest that implant treatment in edentulous denture cases and particularly in elderly people with dentures has a certain efficacy on the physical condition mediated through an improvement in aspects of the mental state.