Evaluation of Bite Force and Masticatory Performance: Complete Denture vs Mandibular Overdenture Users

Abstract

This cross-sectional observational study with 24 patients evaluated differences in bite force (BF) and masticatory performance (MP) between conventional complete denture (CCD) and implant mandibular overdenture (IMO) users and the correlation between these variables. The BF test was performed bilaterally with an occlusal force device. During the MP test, patients were asked to chew Optocal particles for 40 cycles. The Shapiro Wilk test was employed to verify the normality of the data, the student t test to identify differences between groups, and Pearson’s correlation to investigate interrelationships between variables. A multiple linear regression was subsequently performed via the stepwise method. P values ≤0.05 were considered statistically significant. Unlike IMO users, CCD users presented a significant difference (25.6%) in BF between the dominant and non-dominant chewing side (p=0.04). IMO users presented significantly higher BF (p=0.01) without presenting a dominant side (p=0.38), and also performed significantly better for the following MP parameters: MPX50 values decreased by 27.25% in IMO users (p=0.01), MPB decreased by 48.38% (p=0.01), and ME 5.6 decreased by 53.25% (p=0.02), while ME2.8 increased by 151.57% (p=0.01). The BF and MPX50 in the IMO wearers group were negatively correlated (-0.57; p=0.05); this correlation coefficient was the only parameter included in the multivariate regression model. IMO users have higher BF and better masticatory performance than CCD users, especially in terms of chewed particles size reduction. MP is correlated with a higher BF in IMO users through better particle trituration.

The Effect of Patient Specific Factors on Occlusal Forces Generated: Best Evidence Consensus Statement

“…79,80 Cohort studies (1 RCT) (n = 80/41/31/16/68) have investigated how dental implants improve occlusal force in edentulous subjects with conventional complete dentures. [81][82][83][84][85] As the values of occlusal forces generated in edentulous patient are small and limited by oral mucosa, improvement of occlusal force equated in patient reported outcomes means at least doubling the force where one arch is restored with dental implants and partial support for a mucosal based prosthesis. In cases where complete implant support is employed, this equates to an even larger degree of force.…”

Clinical Versatility of the Facility-Equator Implant System as Mandibular Overdenture Retainers

“…It is clear that MO retained by 3 or 4 NDI loaded with conventional, immediate, progressive, and hybrid loading protocols can promote improvements in masticatory function, OHRQoL, and MBL of totally edentulous patients with limited bone availability. However, since a longitudinal clinical study [28] demonstrated that MO retained by three implants have similar survival rates as those retained by four implants and because our case report illustrates that using 4 implants can lead to suboptimal results in some cases, we emphasize that using 2 and 3 implants appears to reduce retention and stability problems of complete dentures sufficiently in many cases [9][10][11][12], while avoiding overtreatment and reducing financial costs for the patient, thus constituting treatment options with better cost-effectiveness.…”

“…Its prosthetic system uses a screwless button-type fitting system that is installed with the help of a hammer (Facility Equator attachment; transmucosal heights range from 1.5 to 4.5 mm) [8]. Previous studies that investigated the predictability and success of the Facility-Equator system [3,[8][9][10][11] show that the use of 2 implants leads to excellent clinical and functional performance for the rehabilitation of totally edentulous individuals. However, younger edentulous patients using MO retained by only 2 implants still complain about retention in the posterior region.…”

Implant-Retained Maxillary and Mandibular Overdentures - A Solution for Completely Edentulous Patients

“…In May 2002, at McGill University in Montreal, Canada, prosthodontic symposium was held where numerous relevant experts who worked in the field of removable prosthodontics stated that the current available evidence suggested the restoration of the completely edentulous mandible using conventional complete denture is no longer the first choice in prosthodontic treatments and instead it should be a two-implant overdenture, regardless of the type of attachment system used (bar, ball or magnet) [41,42]. According to the available literature patients find mandibular implant-retained overdentures to be superior over conventional ones in retention, ability to chew and speak, comfort, and satisfaction and in oral health related quality of life [43][44][45][46]. In April 2009.…”