Narrow-diameter versus regular-diameter dental implants for mandibular overdentures: A systematic review and meta-analysis.

PURPOSE: The aim of this systematic review was to compare treatment outcomes in terms of implant survival rate, marginal bone loss, and patient-reported outcome measures (PROMs) between narrow-diameter implants and regular-diameter implants (RDIs) for mandibular implant overdentures (MIOs). METHODS: This study was based on the methodology adapted as per Cochrane. Medline, Embase, the Cochrane Central Register of Controlled Trials, Web of Science, and Scopus were searched for pertinent studies published by July 22, 2022. Outcome parameters included in this meta-analysis were implant survival rate, marginal bone loss, visual analogue scale score for patient satisfaction, and value of oral health impact profile. RESULTS: A total of 782 non-duplicate articles and 83 clinical study registrations were identified from database and hand searches, of which 26 were eligible for full-text searches. Finally, 12 publications reporting on 8 independent studies were included in this review. In the meta-analysis, implant survival rate and marginal bone loss did not significantly differ between narrow-diameter implants and RDIs. Regarding RDIs, narrow-diameter implants were associated with significantly better outcomes in general patient satisfaction and oral health-related quality of life than RDIs for mandibular overdentures. CONCLUSIONS: Narrow-diameter implants have competitive treatment outcomes compared to RDIs in terms of implant survival rate, marginal bone loss, and PROMs. [Correction added on July 21, 2023, after first online publication: The abbreviation RDIs was changed to PROMs in the preceding sentence.] Thus, narrow-diameter implants might be an alternative treatment option for MIOs in situations with limited alveolar bone volume.

Immediately loaded single-implant mandibular overdentures compared to conventional complete dentures: A cost-effectiveness analysis.

BACKGROUND: In recent years, the single-implant mandibular overdenture (SIMO) has been proposed as an alternative to more complex overdenture designs as a simplified implant intervention for edentulous patients. OBJECTIVE: The aim of this study was to run a cost-effectiveness analysis alongside a randomized clinical trial comparing the SIMO and the conventional complete denture (CCD) treatment. Imediately loaded external hexagon implant and ball attachment were used for the overdenture goup. Direct costs related to therapies were identified and valuated throughout a 1-year period after delivery, in Brazilian currency (R$) and converted into international dollars (I$) using purchase power parity exchange rates. Treatment effectiveness was measured using the OHIP-Edent and satisfaction scores for calculation of incremental cost-effectiveness ratios (ICER). RESULTS: Outcomes were assessed at the 1-year follow-up for 65 patients (CCD=34; SIMO=31). Overall OHIP-Edent and satisfaction scores improved significantly in the SIMO group, while remained unchanged in the CCD group. The mean overall costs were R$1,179.04 (I$590.99) for the CCD group and R$2,127.91 (I$1,068.20) for the SIMO group - 80.7% incremental cost for SIMO. The ICER calculation for SIMO treatment showed a mean cost of I$48.20 for 1-point reduction in OHIP-Edent scores, and I$12.56 for 1-point increase in satisfaction score. CONCLUSIONS: Findings support the effectiveness of this simplified and low-cost implant intervention for edentulous patients. SIMO also seems a cost-effective alternative to the CCD and the relatively low incremental cost may potentially increase the utilization of dental implants among older subjects, especially those with limited financial resources. CLINICAL SIGNIFICANCE: The immediately loaded single-implant mandibular overdenture was superior to the conventional complete denture in terms of patient-reported outcome measures at a low incremental cost.

Outcomes of Mandibular Overdentures Supported by Four Short Implants Combined with Photobiomodulation Therapy.

PURPOSE: The aim of this study was to clinically and radiographically evaluate mandibular overdentures supported by four short implants combined with two different doses of photobiomodulation (PBM). MATERIALS AND METHODS: A split-mouth design was applied; six completely edentulous male subjects received four short implants in the canine and second premolar area. Short implants were inserted via a digital fully guided approach with a stereolithographic surgical guide. All patients received five PBM sessions immediately after surgery and every 48 hours. Group A (n = 6) implants on the right side received a dose of 3.75 J/cm2, and group B (n = 6) implants on the left side received a dose of 7.5 J/cm2. Evaluation of peri-implant probing depth (PIPD), modified Gingival Index (MGI), and vertical bone loss was performed at the time of prosthetic loading and 6 and 12 months later. The implant stability quotient (ISQ) was also assessed 6 and 12 months after loading. RESULTS: There was no significant difference between both groups regarding PIPD values. However, a minor but significant increase from the baseline (P < .001) was observed in PIPD values in both groups after 12 months. The MGI scores at the different time intervals were very low for both groups. The mean vertical bone loss after 12 months was minimal for both groups but statistically significant from the baseline (P < .001). ISQ values for both groups after 12 months revealed a significant increase from the baseline, and group B values were significantly higher than those of group A. CONCLUSION: Within the limitations of this study, a mandibular overdenture supported by four short implants is a valid treatment modality for atrophic mandibles, and a PBM dose of 7.5 J/cm2 has a potential positive influence on implant healing and osseointegration.

Single versus two-implant mandibular overdentures using early-loaded titanium-zirconium implants with hydrophilic surface and ball attachments: 1-year randomized clinical trial.

OBJECTIVE: This randomized clinical trial aimed to compare the outcomes of the mandibular overdenture retained by one (1-IOD) or two (2-IOD) implants. MATERIALS AND METHODS: Participants received new complete dentures, were assessed at baseline and randomly assigned to groups. Early loaded single midline implant (1-IOD) or two implants in the canine regions bilaterally (2-IOD). Ball attachments were used for overdenture retention. Post-treatment outcomes (6- and 12-month follow-ups) included patient satisfaction, oral health-related quality of life measures, and chewing function. Data analysis included within- and between-group comparisons, and Generalized Estimating Equations. Both superiority and non-inferiority hypotheses were tested. RESULTS: Forty-seven participants were included (1-IOD = 23; 2-IOD = 24). Significant improvements in OHIP-Edent were observed after insertion of new dentures and at the 1-year follow-up compared with baseline. No differences were found between the 1- and 2-IOD groups for the OHIP-Edent and QoLFAST scores. Patient satisfaction with the mandibular denture improved significantly from baseline to the 6-month follow-up and remained unaltered until 1 year, with no differences between groups. The magnitudes of treatment effect sizes were moderate to large for patient-reported outcomes. Progressive improvement in chewing function occurred in both groups. Non-inferiority testing based on a 15% non-inferiority margin showed inconclusive results for patient-reported outcomes, whilst chewing function in the 1-IOD group was concluded to be not inferior to the 2-IOD group. CONCLUSIONS: Results support the use of both 1- and 2-IOD. The 1-IOD was also an acceptable alternative to the 2-IOD as a secondary option for the treatment of the edentulous mandible.

Endoprótesis total de cadera en personas de 65 años y más con artrosis de cadera con limitación funcional severa: problema de salud N°12 / Total hip stenting in people 65 years of age and older with severe functional limitation hip osteoarthritis. Health Problem AUGE N°12

Objetivo: Favorecer el adecuado manejo clínico integral de las personas de 65 años y más, con diagnóstico de artrosis de cadera con limitación funcional severa que serán sometidos a una artroplastia total de cadera. Tipo de pacientes y escenario clínico: Personas de 65 años y más, con diagnóstico de artrosis de cadera con limitación funcional severa, que reciben atención en el nivel primario, secundario y terciario de salud en el sector público y privado del territorio nacional. Usuarios de la Guía: Todos los profesionales de salud, que trabajan en los distintos niveles de atención, con personas de 65 años y más, con artrosis de cadera con limitación funcional severa. Médicos generales, médicos especialistas (traumatólogos, geriatras, fisiatras, etc.) kinesiólogos, terapeutas ocupacionales, enfermeras, psicólogos, trabajadores sociales, tecnólogos médicos, químicos farmacéuticos. Metodología: Las recomendaciones de esta Guía fueron elaboradas de acuerdo con el sistema "Grading of Recommendations Assessment, Development, and Evaluation" (GRADE). Luego de priorizadas las preguntas a responder, se realizó la búsqueda y la síntesis de evidencia, para finalmente generar las recomendaciones a través del juicio del Panel de Expertos. La búsqueda y selección de la evidencia de esta Guía se basó en un método sistemático, transparente y reproducible. Una vez seleccionada la evidencia, se resumió en un formato claro y conciso que permitiera al Grupo Elaborador realizar los juicios respecto a la calidad de dicha evidencia, el balance entre los riesgos y beneficios asociados a la intervención o calidad de una prueba, un tratamiento, los valores y preferencias de los pacientes, y los costos derivados de su implementación.

Evaluation of the effect of coating vertex denture lining material with plant oils on microbial growth and hardness

Aims: To evaluate the effect of surface coating with natural plant oils (Salvia officinalis, ginger and eucalyptus) on Candida growth and the hardness of Vertex denture lining material. Materials and method: Forty five specimens were prepared from soft acrylic lining material, twenty five of which were 10x10x2mm in size for testing antifungal activity, and twenty samples were 20mm in diameter and 12mm in thickness, for testing shore A hardness after coating samples with three types of natural oils (Salvia officinalis, ginger and eucalyptus oils). Significant differences among the groups at (p≤0.05) level of significance were determined statistically with one way analysis of variance and Duncan's multiple range test Result: Antifungal assay showed a significant difference between five groups regarding Candida albicans growth (p≤ 0.05). For the hardness test, comparing different times of storage in water (1, 7, 14, 30 days) revealed a significant difference within all groups (p≤0. 05). While comparing the groups coated with natural oils with the control group, significant differences were found between different times of storage in water (1, 7, 30 day) (p≤0.05), except at 14 days of water storage there was no significant difference between groups (p>0.05). Conclusion: All tested natural oils were effective as fungicidal agents and increased the softness and duration of soft acrylic lining material.

Effectiveness of immediately loaded single-implant mandibular overdentures versus mandibular complete dentures: A 1-year follow-up of a randomized clinical trial.

OBJECTIVE: This randomized clinical trial (RCT) aimed to assess the 1-year effectiveness of single-implant mandibular overdentures (SIMO) compared to conventional complete dentures (CCD). METHODS: In the first phase of the study, participants received new maxillary and mandibular CCDs. Then, they were randomly allocated to one of the study groups (CCD or SIMO). Participants in SIMO group received an external hexagon implant in the mandibular midline, with the immediate connection of an O-Ring/ball attachment. Oral health-related quality of life (OHIP-EDENT) and patient satisfaction in both groups were assessed before allocation and at 6- and 12-month follow-up visits. Both intention-to-treat (ITT) and per-protocol approaches were used for analyses. Statistical analyses were performed using the Wilcoxon Signed Ranks test and the Generalized Estimating Equations. RESULTS: Eighty-four participants (CCD n = 42; SIMO n = 42) were included, out of which 70 completed the 12-month follow-up (CCD n = 34; SIMO n = 36). ITT analysis showed no changes for the CCD group in the longitudinal assessment compared to baseline. Participants in SIMO group had a significant improvement in OHIP-EDENT scores and satisfaction with the mandibular denture. No changes for the maxillary denture were observed in either groups. Similar results were found when per-protocol analysis was performed. CONCLUSIONS: SIMO treatment resulted in a significant improvement in patient perceived outcomes compared to the CCD. SIMO may be considered as an alternative treatment modality for patients with poorly adapted and/or unstable mandibular dentures (ClinicalTrials.gov NCT03463174). CLINICAL RELEVANCE: The immediately loaded single-implant mandibular overdenture markedly improved patient satisfaction and oral health-related quality of life of conventional denture wearers after a 12-month follow-up.

Mandibular complete denture versus single-implant overdenture: a systematic review of patient-reported outcomes.

The single-implant mandibular overdenture (SIMO) has been proposed as an alternative for edentulous patients who are poorly adapted to their dentures due to low retention and stability of the conventional mandibular complete denture (CD). However, there is a lack of evidence regarding the effectiveness of SIMO, which can be measured by examining patient perception of treatment effects. The aim of this systematic review was to assess the comparative results of CD and SIMO treatments using patient-reported outcome measures. A literature search was carried out in PubMed, Scopus and Cochrane Central databases. The search included studies published up to July 2017. The focus question was: 'Do single-implant mandibular overdentures improve patient-reported outcomes compared to conventional complete dentures in edentulous patients?' Eligible studies were randomised clinical trials (RCT) and prospective studies. After initial screening for eligibility and full-text analysis, 11 studies were included for data extraction and quality assessment (five parallel-group RCTs, two crossover RCTs and four prospective studies). All studies reported marked improvement in satisfaction with the dentures and quality of life measures after SIMO treatment, irrespective of variations in implant treatment protocols and retention systems. Methodological considerations revealed a lack of evidence from RCTs on the comparative effectiveness of the two treatment strategies. Hence, although available evidence suggests considerable improvement in patient-reported outcomes following the insertion of a single implant to retain a mandibular denture, further well-designed comparative studies between SIMO and CD are required to improve the level of evidence and to support the indication of SIMO treatment in routine practice.

Implementation of a patient-centered approach to clinical dental education: a five-year reflection.

The intent of the redesign of the clinical component of the Harvard School of Dental Medicine (HSDM) curriculum from a traditional numerical procedures-based system to a patient-based comprehensive care system was to improve both patient care and student learning. The aim of this retrospective cohort study was to evaluate the outcomes of and students' perspectives on this patient-centered comprehensive care model introduced in 2009. Data were obtained from the school's Office of Dental Education for a study sample consisting of 205 fourth-year dental students in the graduating classes of 2009 through 2014 at HSDM. The results showed that students were completing more than the required number of comprehensive patient cases on average. A survey given to the Class of 2014 found that the respondents (35 of 36 students) were generally satisfied with the new curriculum and the clinical experience in relation to continuation of care and perceptions of comprehensive care. The results of this study suggest that the redesigned patient-centered assessment model of the clinical component of the curriculum helped improve patient care and student learning.

Overdentures on Implants for Better Quality of Life Among the Fully Edentulous Patients - Case Reports.

Global aging population has brought several challenges for their medical systems and total edentulism is one of them. The fabrication of removable acrylic dentures seems to be a simple and cheap treatment solution, but a majority of patients is not satisfied with their functional instability, causing limited diets, mouth soreness, speech and psycho-social problems etc. The results in many studies indicate an impact of oral conditions associated with the full denture wearing on oral-health related quality of life, especially in lower jaw. The reason for improper denture retention could be alveolar ridge bone resorption and numerous studies about this problem are plausible. Bone resorption in lower jaw may turn the alveolar ridge into a flabby soft tissue which is unable to sustain proper denture retention. The implant-retained prosthesis is an alternative treatment option in these situations. Implants will provide retention, stability, function and aesthetics and they are not so expensive solution. The aim of this article is to show solving of retention problems of a lower denture in two different clinical cases using implants and without any special technology.

Treatment planning and dental rehabilitation of a periodontally compromised partially edentulous patient: a case report - Part I.

When planning a prosthetic rehabilitation of a periodontally compromised case, the clinician is often confronted with difficulties and dilemmas related to selecting the appropriate treatment modality that would provide a long-term longevity in terms of function and esthetics. In such cases, a correct diagnosis and prognosis of the intraoral situation supported by evidence-based dentistry is the basis for the establishment of a proper treatment strategy. In this two-part treatment planning series, a systematic approach of patient examination and prognosis of each tooth is presented. Furthermore, different removable and fixed treatment possibilities are described and the rationale governing the decision-making process is revealed. The execution of the final treatment plan as specified by the concept of comprehensive dental care is outlined and the final outcome is discussed according to the literature.

Interdisciplinary treatment of a periodontally compromised adult patient with multiple missing posterior teeth.

This article reports the comprehensive, interdisciplinary treatment of a 50-year-old periodontally compromised adult patient with multiple missing posterior teeth. After initial periodontal treatment, the maxillary first molars and right central incisor were intruded orthodontically. Miniscrews were used to intrude the maxillary first molars by 3 mm. The mandibular arch was restored with a tooth-supported overdenture. Root coverage of the maxillary right central incisor was performed using Alloderm (Biohorizons, Birmingham, Ala). At the end of the interdisciplinary therapy, the results were esthetically pleasing, with the patient's oral functions restored to the optimum. The emphasis of this report is to highlight the importance of integrating various specialties such as periodontics, orthodontics, endodontics, and restorative dentistry toward a common goal of improving the patient's oral health, function, and esthetics.

Patients' perspectives on zirconia and titanium implants with a novel distribution supporting maxillary and mandibular overdentures: a qualitative study.

OBJECTIVES: This qualitative study explored the perceptions of edentulous patients regarding their rehabilitation with maxillary and mandibular implant-supported overdentures employing a protocol that featured novel implant sites and distribution. MATERIAL AND METHODS: In-depth semi-structured interviews were conducted with 16 participants who have taken part in a randomized controlled trial. Each received implant overdentures supported by either titanium or zirconia one-piece implants. Participants received four implants in the maxilla and three implants in the mandible. The implant distribution was: in the maxilla, a mid-palatal implant, and three anterior implants in the incisor and first premolar regions; in the mandible, a mid-symphseal implant, and bilateral distal implants in the first molar region. All interviews were conducted by a researcher not involved with the clinical aspect of the randomized controlled trial and were transcribed verbatim and analyzed using a thematic inductive analysis approach. RESULTS: The perceived advantages of the treatment were functional improvement and increased social confidence. Cost was a significant barrier for edentulous patients seeking implant treatment. Previous experience with complete dentures, age and length of treatment was further factors that influenced decisions regarding prosthodontic rehabilitation. The novel implant protocol was acceptable to patients. CONCLUSIONS: Implant overdentures improve the quality of life of edentulous patients. Acceptance of dental implants may be increased by mitigating the cost of treatment. The mid-palatal implant site may be a potential alternative to extensive surgical procedures during the prosthodontic rehabilitation of atrophic maxillary ridges. The mandibular design offers patients the advantages of a removable prosthesis with increased retention.

Prosthetic rehabilitation of head and neck cancer patients focusing on mandibular dentures in irradiated patients.

PURPOSE: This retrospective study assessed treatment outcomes and patient satisfaction of irradiated head and neck cancer patients treated with mandibular implant overdentures (IODs) or conventional dentures (CDs). MATERIALS AND METHODS: Fifty-one irradiated head and neck cancer patients, out of a total of 158 patients included, completed the standardized questionnaire and underwent a clinical assessment. Nineteen patients were treated with removable CDs and 32 patients received IODs between January 2006 and January 2011. The mean follow-up of patients was 5.75 years (range: 1 to 23 years). RESULTS: A total of 45 (88.3%) mandibular dentures were in function at the time of assessment. The overall denture satisfaction was 7.3 (range: 1 to 10, SD: 2.14). Patients being treated with adjuvant concepts, including surgical tumor ablation, scored worse than patients after radiation therapy alone. Edentulous patients seem to benefit from implants, especially with respect to prosthesis retention. Men take more benefit from IODs compared with women. CONCLUSIONS: The results are comparable to other studies of head and neck cancer patients and also of healthy individuals. Surgical interventions in adjuvant therapy concepts lead to reduced denture satisfaction. The concept of prosthetic rehabilitation as part of oncologic treatment can be judged as successful.

Interforaminal implant placement in oral cancer patients: during ablative surgery or delayed? A 5-year retrospective study.

In a retrospective study, two mandibular prosthetic rehabilitation strategies supported by implants in oral cancer patients were evaluated: implants placed in the non-resected edentulous symphyseal area during ablative surgery (DAS implants); or at a later stage (postponed (P) implants). Medical files of patients from two head-neck oncology groups from 2000 to 2005 were screened for study inclusion. DAS protocol was used in one group and P protocol in the other. After a 5 year follow-up of 261 edentulous patients with oral cancer in the second group, P implants were placed in 27 patients to support an overdenture. Of the 249 edentulous patients in the first group, 82 patients were given an implant supported overdenture using the DAS implant protocol. Regarding implant loss, no statistically significant differences were seen between the DAS and P implants. In the DAS group, more patients benefited from an implant-supported lower overdenture (39 versus 11%, respectively), and they received their overdenture on average 20.0 months sooner (sd=11.01, p<0.001) after ablative surgery. 17.1% of DAS implants and 4.6% of P implants were never loaded due to tumour and patient related factors including unfavourable implant soft tissue, tumour recurrence near the implant, or radiotherapy induced trismus.

Patients' satisfaction with conventional dentures and mini implant anchored overdentures.

UNLABELLED: The aim of this study was to assess complete edentulous patient satisfactionwith two treatment alternatives--conventional dentures and mini implant anchored overdentures. MATERIALS AND METHODS: Study sample comprised 36 patients--18 treated with newly made conventional prosthesis and 18 with mini implants anchored overdentures, with a ball attachment system (from IMTEC Corporation). RESULTS: Patients treated with mini implant anchored overdenture presented a higher satisfaction regarding chewing ability (all of them reported satisfactory mastication, 50% accusing occasionally discontent) compared with the conventional denture group (28% reported impaired masticatory function and 39% occasionally discontent). Denture's retention was better in the mini implant overdenture sample (only 17% reported occasional problems, none of them feel the need to use denture adhesives), compared to the conventional treatment alternative (28% were dissatisfied about this issue). Both treatment alternatives were seen as being highly satisfactory regarding the aesthetic restoration of facial appearance and for performing phonation. Still, in the complete denture group 22% of patients claimed difficulties in articulating certain phonemes. The main reasons why patients refused implant treatment were its higher cost and fear of surgery. CONCLUSIONS: Patients treated with mini implant anchored overdentures were more satisfied than those treated conventionally, due to the increased retention and stability of dentures, mastication efficiency and improved comfort, these having probably a positive effect on the quality of life.

Wear of ceramic and titanium ball attachments in subjects with an implant-retained overdenture: a controlled clinical trial.

STATEMENT OF PROBLEM: Loss of retention of implant-retained overdentures due to wear of the patrix or matrix of the attachment system is a common clinical problem. PURPOSE: The purpose of this controlled clinical trial was to compare the wear of ceramic and titanium ball attachments and their corresponding gold matrices after 1 year of clinical function in subjects with implant-retained mandibular overdentures. MATERIAL AND METHODS: Forty subjects who had been treated with a 2-implant-retained overdenture received either 2 ruby ball attachments (20 subjects) or 2 titanium ball attachments (20 subjects). The diameter of the ball attachments and the thickness of the matrix were measured optically before insertion and after 1 year of clinical function. Differences among groups were then compared with the Wilcoxon rank sum test (α=.05). To estimate any correlation between clinical parameters and wear, the Spearman rank test was used. RESULTS: There was no significant difference (P=.73) in the median wear of ball attachments for the titanium group (5.3 µm; median 1.3 µm) and for the ceramic group (1.3 µm; median 1.3 µm). In the ceramic group, a fracture rate of 30% was observed. The mean wear of the matrices in the titanium group was 3.1 µm (median 6.8 µm) and in the ceramic group 2.1 µm (median 3.4 µm), P=.01. No correlation was found between ball attachment wear and matrix insert wear (Spearman rank test). Wear of matrices was weakly correlated with an increase in divergence between implant axes in the sagittal plane (P=-.28 and P=.021). Ball attachment wear was associated with an increase in divergence between matrix axes in the sagittal plane (P=-.34 and P=.047). CONCLUSIONS: Matrices on ceramic ball attachments showed less wear than those placed on titanium ball attachments. However, the use of ruby ball attachments cannot be recommended because of a high fracture rate.

Telescopic crowns: extra-oral and intra-oral retention force measurement--in vitro/in vivo correlation.

OBJECTIVE: This study deals with the determination of the retentive forces of telescopic crowns measured extra- and intra-orally and the correlation of these values. BACKGROUND: The telescopic denture is a well-documented solution for prosthetic rehabilitation for a partially edentulous jaw. Acceptable retention forces are needed to avoid inadvertent removal of the denture during movement of the jaws. Recent literature suggests 3-7 N per attachment to be acceptable. These values are only supported by in vitro studies. In vivo data are scarce, and a correlation of the in vitro and in vivo values is lacking. MATERIAL AND METHODS: Twenty-five combined fixed-removable prostheses with a total of 72 double crowns were used for extra-oral retention force measurement prior to cementation (in vitro). The intra-oral measurement was performed at 72 defined measuring points of the dentures 4-6 weeks after prosthetic rehabilitation (in vivo). A specifically designed measuring device was used. RESULTS: The rank correlation showed that the in vitro and in vivo values correlate with each other (Spearman's ρ = 0.5052). Additionally, it was found that the median values measured before (1.97N) insertion of the dentures were significantly lower than after (4.70N) insertion (Mann-Whitney test, p ≤ 0.0001). CONCLUSION: The retention forces measured before and after insertion of the denture correlate with each other although their dimension is significantly higher after insertion. The reason for this behaviour might be some tilting during removal. Nevertheless, the correlation allows a prediction of the clinically relevant forces by a measurement of the extra-orally measured retentive values.

The influence of mandibular implant-retained overdentures in masticatory efficiency.

OBJECTIVE: To evaluate the masticatory efficiency of patients rehabilitated with conventional dentures (CDs) or implant-retained mandibular overdentures. BACKGROUND: Despite the evident benefits of implants on mastication as assessed by subjective patient-based outcomes, the extent of implant overdenture treatment effect on food comminution is not well established. MATERIALS AND METHODS: A randomised clinical trial was carried out with 29 completely edentulous patients divided into two groups. The first group was rehabilitated with a mandibular overdenture retained by two splinted implants with bar-clip system, while the second group was rehabilitated with a mandibular CD. Both groups also were rehabilitated with maxillary CDs. Masticatory efficiency and patient satisfaction were assessed 3 months after denture insertion. Masticatory efficiency was evaluated through the colorimetric method with the beads as the artificial test-food. Comparisons for masticatory efficiency and patient satisfaction were performed using Student's t-test (α = 0.05). RESULTS: No significant statistical difference was found for masticatory efficiency (p = 0.198). Patient overall satisfaction was significantly higher for the mandibular overdenture (p < 0.001). In addition, mandibular overdenture patients were significantly more satisfied with chewing experience (p < 0.05) and retention of the lower denture (p < 0.005). CONCLUSION: The results of this study suggest that mandibular overdenture significantly improves chewing experience, although limited effect on masticatory efficiency has been observed.