A Within-subject Comparison of Mandibular Long-bar and Hybrid Implant-supported Prostheses: Psychometric Evaluation and Patient Preference

Abstract

Although it has been shown that patients are more satisfied with prostheses supported by implants than with conventional dentures, there have been few direct comparisons of the various designs of implant-supported prostheses. This within-subject crossover clinical trial was designed to compare two forms of removable prostheses which are frequently prescribed for the edentulous mandible: a long-bar overdenture supported by 4 implants and a two-implant hybrid overdenture. Sixteen completely edentulous subjects were given a new maxillary conventional denture: Ten of them received the mandibular long-bar prosthesis first and six the hybrid. After a two-month adaptation period, psychometric measures of various aspects of the prostheses and physiological tests of masticatory efficiency were carried out over three weeks. The mandibular prostheses were then changed and the procedures repeated. At the end of the study, subjects were asked to choose the mandibular prosthesis that they wished to keep, and final psychometric measures were taken. In this paper, the results of the psychometric assessment and patient preference are presented. Subjects assessed factors such as general satisfaction, quality of life, stability, retention, comfort, esthetics, ease of cleaning, speaking, and chewing, and how well-chewed foods were before being swallowed. Most of the factors except ease of cleaning and speaking were rated significantly better with long-bar overdentures than with hybrid ones. These results are consistent with the fact that all subjects chose long-bar overdentures, reporting stability, ease of chewing, and comfort as the most important factors influencing their choice. These results suggest that, although subjects assign high ratings for most factors to hybrid overdentures, they find long-bar overdentures to be significantly more stable, comfortable, and easier for chewing.

Measuring patient-based outcomes: Is treatment satisfaction associated with oral health-related quality of life?

“…12 Their use in prosthodontics is also justified, since it has been shown that patient satisfaction instruments are sensitive enough to capture clinically significant differences between various prosthodontic treatments. 8,13 One of the advantages of using patient satisfaction as a treatment outcome is its simplicity and comprehensibility for clinical practitioners. However, some disadvantages have been associated with these measures.…”

The Influence of Implant Number on Peri-Implant Marginal Bone Level and Implant Failures in Mandibular Implant Overdentures. A Systematic Review With Meta-Analysis.

“…Further, related outcomes could not be extracted from nine articles [11][12][13][14][15][16][17][18][19] , one article compared different implant systems and opposing dentition was not reported 20 . In one article 21 27 corresponding to (Visser et al 35 ), Batenburg et al 28 , and de Jong et al…”

Effect of Cantileverd Bar Length on Strain Around Two and Four-Implants Supporting A Mandibular Over-Denture

“…The increased prosthesis rigidity creates a stable occlusal plane, reduces loading of denture-bearing areas [31], and decreases posterior mandibular ridge resorption [28]. Moreover, it improves chewing [32], decreases the incidence of prosthodontic maintenance [33], reduces soft tissue irritation, protects mental nerve, and diminishes problems of high muscle attachment and prominent mylohyoid ridge [20]. The supporting area of bars with distal cantilevers also was found to be greater than straight or slightly bent bars without distal cantilevers [19].…”