Effects of new implant-retained overdentures on masticatory function, satisfaction and quality of life

The aim of this study is to evaluate the effects of replacing poorly fitting dentures on patient’s masticatory function, satisfaction and oral healthrelated quality of life. Fourteen patients with conventional maxillary complete dentures and mandibular overdentures retained by two implants bar clip system had their dentures replaced. The laboratory tests for the analysis of masticatory performance were conducted using an “Optocal” food simulator test. Questionnaires were used to evaluate patient satisfaction with dentures and impact of oral health on quality of life. Tests were conducted and questionnaires were administered before and 1, 3 and 6 months after the patient had adapted to the new dentures. Masticatory performance data and satisfaction with dentures (Visual Analogic Scale) were statistically analyzed by ANOVA and Tukey b test, satisfaction with dentures (SATs P) and impact of oral health on quality of life were evaluated using the Wilcoxon and Friedman tests (a=.05). There was no statistically significant improvement in masticatory function after denture replacement, although better outcomes were observed. Satisfaction with dentures and total score obtained using the OHIPedent showed significant improvement. It can be suggested that the potential for grinding food, patient satisfaction and aspects of quality of life improved immediately after denture replacement.

Avaliar os efeitos da substituição de próteses mal adaptadas na função mastigatória, satisfação e qualidade de vida relacionada à saúde bucal do paciente. Quatorze pacientes com próteses totais convencionais maxilares e overdentures retidas por dois implantes mandibulares sistema barra clip e tiveram suas próteses substituídas .Os testes laboratoriais para análise da performance mastigatória foram realizados utilizando um simulador de alimento “Optocal”. Foram utili za dos questionários para avaliar a satisfação com a prótese eo impacto da saúde bucal na qualidade de vida. Os testes foram realizados e os questionários foram aplicados antes, 1, 3 e 6 meses após o paciente ter adaptado às novas próteses. Os dados da performance mastigatória e satisfação com a prótese (EscalaAnalógica Visual) foram analisados estatistica mente por análise de variância e teste de Tukey b, a satisfação com próteses (SATs P) e o impacto da saúde bucal na qualidade de vida foram avaliados pormeio dos testes de Wilcoxon e Friedman (a = 0,05). Não houve melhora estatisticamente significativa na função mastigatória após a troca das próteses, embora melhores resultados foram observados após a substituição. Satisfação com a prótese e a somatória total obtida utilizando o OHIPEdent mostraram melhora significativa. Pode se sugerir que o potencial de trituração dos alimentos, a satisfação do paciente com as novas próteses e aspectos da qualidade de vida melhoraram imediatamente após a substituição da prótese.

Masticatory performance with different types of rehabilitation of the edentulous mandible

Abstract Aim: To compare the masticatory performance associated with different rehabilitation strategies for patients with edentulous mandibles. Methods: one portion of the test food "Optocal" was provided to groups: Natural Dentition (n = 15), Mandibular Fixed Implant-Supported Prosthesis with Maxillary Fixed Prosthesis (n = 8), Mandibular Fixed Implant-Supported Prosthesis with Maxillary Removable Prosthesis (n = 14), Mandibular Implant-Retained Overdenture with Maxillary Removable Prosthesis (n = 16), and Complete Dentures (n = 16). The portion was collected after 40 chewing strokes, and then passed through a stack of eight sieves with decreasing apertures. Masticatory performance was determined by weighing the portion of food on each sieve. Results: the masticatory performance was: 71.00% for Natural Dentition, 41.57% for Mandibular Fixed Implant-Supported Prosthesis with Maxillary Fixed Prosthesis, 31.44% for Mandibular Fixed Implant-Supported Prosthesis with Maxillary Removable Prosthesis, 27.70% for Mandibular Implant-retained Overdenture, and 14.33% for Complete Dentures. The data were statistically compared using Student's t-test (p < 0.05). Natural Dentition and Complete Denture groups were statistically different from all other groups, with the Natural Dentition and Complete Denture groups exhibiting the highest and lowest masticatory performance values, respectively. Conclusions: Osseointegrated implants improved the masticatory performance of all implant-supported groups compared to the Complete Dentures group.

Mandibular overdentures with immediate loading: satisfaction and quality of life.

PURPOSE: The aim of this study was to verify quality of life related to oral health and satisfaction with dentures. Conventional mandibular complete dentures were converted to overdentures retained by two implants with immediate loading (bar-clip system, n = 16). MATERIALS AND METHODS: The Brazilian short version of the Oral Health Impact Profile (OHIP-14Br) was used to evaluate the impact of oral health on quality of life. Satisfaction with the prostheses was obtained by means of a questionnaire addressing satisfaction with the present prostheses and through use of a visual analog scale (VAS). RESULTS: The results of the OHIP-14Br questionnaire were verified at 3 and 6 months after conversion from complete dentures to a mandibular overdenture. The satisfaction questionnaire for the mandibular prostheses obtained 43.75% satisfaction before conversion and 100% satisfaction at 1 week and 3 and 6 months after conversion. The satisfaction results of the prostheses, both maxillary and mandibular, were 68.75% before conversion, 93.75% at 1 week and 3 months after conversion, and 87.5% at 6 months. There was an immediate improvement in patients' satisfaction with the mandibular overdenture prostheses regarding stability and retention (Friedman test, P = .000) and quality of life (Friedman test, P = .001). CONCLUSION: The improvement seen justifies the immediate loading approach used in this study.

Overdenture with immediate load: mastication and nutrition.

Lower conventional complete dentures were converted to overdentures retained by two implants with an immediately loaded bar-clip system (n 16). The masticatory performance test was carried out using 'Optocal' after forty chewing strokes. Nutritional condition was evaluated by means of a Mini-Nutritional-Assessment questionnaire. No individual was classified as malnourished. The masticatory performance test demonstrated a statistically significant difference before conversion (baseline) and 3 and 6 months after conversion of the lower conventional complete denture to an implant-retained overdenture (paired-samples t test; P < 0·05). A statistically significant difference before and after 6 months of conversion for nutritional condition (Wilcoxon test; P < 0·05) was also observed. The association between masticatory performance and nutritional assessment demonstrated that a statistically significant difference between masticatory performance of the subgroups classified at baseline as nourished (22·43 %) and those at risk of malnutrition (3·9 %) was only evidenced before conversion (P = 0·006). After the conversion from a lower conventional complete denture to an implant-retained overdenture, at 3 months, the risk of malnutrition and nourished at baseline did not present significant differences in masticatory performance. Nonetheless, the mean masticatory performance potential was 19·86 and 31·98 % for subgroups classified at baseline as at risk of malnutrition and nourished, respectively (P = 0·187). The results before conversion were less favourable for masticatory performance and nutritional condition. The increased retention of the mandibular prosthesis allowed improvement in masticatory performance and nutritional condition.

Comparison of masticatory function between subjects with three types of dentition.

PURPOSE: The aim of this study was to evaluate the effect of an oral rehabilitation program on masticatory performance and ability as a function of the number of masticatory cycles. Subjects with a mandibular fixed implant-supported prosthesis (ISP), complete dentures (CDs), or a natural dentition (ND) were evaluated. MATERIALS AND METHODS: Masticatory performance was tested with an artificial test food (Optocal). Optocal was provided to subjects in two portions of 17 cubes and collected after both 20 and 40 masticatory cycles. The particles were collected on stacks of eight sieves. The geometric mean diameter of the chewed particles was calculated using the sieves. Questionnaires were used to assess masticatory ability before and after the fixed mandibular rehabilitation program. The geometric mean diameter of the chewed particles was compared by two-way analysis of variance followed by the Tukey test (P < .05). RESULTS: The geometric mean diameter for all groups was lower after 40 cycles versus 20 cycles. When compared to the ND group, masticatory performance for the CD and ISP groups was 12% and 28% after 20 cycles and 31% and 61% after 40 cycles, respectively. The data for the masticatory ability of the ISP group before and after fixed mandibular rehabilitation were compared by the McNemar test (P < .05), and showed that 100% of these subjects were satisfied with their chewing capacity after fixed mandibular rehabilitation. CONCLUSIONS: These results quantify the differences in masticatory function among different types of dentition. Greater masticatory function for fixed mandibular rehabilitation versus CDs was demonstrated.