Influence of facial patterns on the masticatory function and quality of life of completely edentulous patients during the transition to implant-retained mandibular overdentures.

ABSTRACT

STATEMENT OF PROBLEM: Although implant-retained mandibular overdentures (IMOs) provide functional benefits, the influence of the vertical facial pattern (FP) and the anteroposterior skeletal discrepancy (ASD) on the masticatory function and patient-centered outcomes during the transition to IMOs is still uncertain. PURPOSE: The purpose of this interventional clinical study was to evaluate the influence of the FP and ASD on the masticatory function, oral health-related quality of life (OHRQoL), and satisfaction of completely edentulous patients before and after transition to IMOs. MATERIAL AND METHODS: Cephalometric analysis was performed on 42 participants before treatment. Ricketts analysis was used to classify the FP, and the maxillomandibular relationship to the base of the skull determined the ASD. Masticatory performance (MP) and swallowing threshold (ST) test results were evaluated by the multiple sieve method by using artificial test food (Optocal cubes) to determine the median particle size (×50), homogenization index (B), and masticatory efficiency based on sieves 5.6 (ME 5.6) and 2.8 (ME 2.8). OHRQoL and satisfaction were evaluated by using the Dental Impact on Daily Living questionnaire. The data were analyzed using mixed-effects linear regression models to estimate the effect of time, FP, ASD, age, and sex on MP, ST, and OHRQoL. RESULTS: The MP, ST, OHRQoL, and satisfaction improved significantly after IMO loading, irrespective of FP and ASD. However, MP outcomes were most negatively affected mainly among dolichofacial (B and ME 2.8), class II, and class III (×50, B, and ME 2.8) participants. The ST test showed that class II participants still showed inferior ×50 values and performed a lower number of cycles than class I and class III participants. Women presented reduced masticatory function for all MP and ST outcomes and reported lower coefficients for appearance and general performance domains than men. CONCLUSIONS: The MP test detected more subtle improvements than the ST test, especially in class III participants. The class II participants benefited the least from the IMO installation according to the ST test. The IMO treatment improved the OHRQoL and satisfaction of edentulous patients, irrespective of the FP or ASD.