How does mandibular bone atrophy influence the masticatory function, OHRQoL and satisfaction in overdenture wearers? Clinical results until 1‐year post‐loading

Abstract

This longitudinal clinical study investigated the differences in the masticatory function (MF), satisfaction and oral health-related quality of life (OHRQoL) between atrophic patients (AP) and non-atrophic patients (NAP) before and after rehabilitation with mandibular overdenture (MO). Twenty-six complete denture (CD) wearers were categorised into two groups, according to the mandibular bone atrophy (MBA) degree. MF was evaluated before and after 1, 3, 6 and 12 months of the MO loading via 2 standardised tests: (i) MP, masticatory performance (MP_X50, MPB, ME 5·6, ME 2·8) and (ii) ST, swallowing threshold (time, number of cycles, ST_X50, STB, ME 5·6, ME 2·8). The dental impact on daily living (DIDL) questionnaire measured changes in the satisfaction level and OHRQoL. MP comparisons showed significant difference only for ME 5·6 12 months after MO loading (AP=33·79 ± 23·6; NAP=17·58 ± 20·1). ST presented significant differences before MO loading for: ST_X50 (AP=5·48 ± 0·83; NAP=4·31 ± 1·44), ME 5·6 (AP=53·17 ± 24·71; NAP=29·83 ± 31·45) and ME 2·8 (AP=8·76 ± 6·91; NAP=18·61 ± 10·71). One month after MO loading, NAP performed the ST test 21% faster than AP. After 3 months, significant improvements in STB (AP=4·93 ± 4·82; NAP=2·73 ± 1·27) and ME 2·8 (AP=17·15 ± 10·00; NAP=24·69 ± 7·82) also were observed. DIDL evaluation showed significant differences in the oral comfort domain after 3 months (AP=0·66 ± 0·29; NAP=0·87 ± 0·16) and after 6 months (AP=0·79 ± 0·22; NAP=0·98 ± 0·08), with lower satisfaction levels in the AP. MBA negatively affects the MF mainly the ST. After 6 months, differences between AP and NAP disappeared and ST results were equalised. AP initially has lower satisfaction levels reaching similar levels of satisfaction as NAP after 1 year.

Mini‐implants and narrow diameter implants as mandibular overdenture retainers: A systematic review and meta‐analysis of clinical and radiographic outcomes

“…One study used bar attachments, one study locator attachments, 19 studies used ball attachments, and three studies used bar and ball attachments . The NDI group comprises three retrospective longitudinal clinical studies, six prospective longitudinal clinical studies and three randomised clinical trials . The follow‐up time of the MI studies varied from 1 day to 7 years, while the follow‐up of NDI studies varied from 3 months to 10 years .…”

“…The follow‐up time of the MI studies varied from 1 day to 7 years, while the follow‐up of NDI studies varied from 3 months to 10 years . Ten studies used conventional loading, 1 study used immediate loading, and one study did not report this information . One study used bar attachments, two studies used ball attachements, and six used locator or equator attachments, one study used magnetic and ball attachements and one study used locator and ball attachments.…”

“…The survival rate of the NDI studies ranged from 80% to 100%. Only one study did not provide data on survival rates . The MI studies evaluated a total of 2277 MI (implant unit), and 90 of these were lost.…”

“…Of the 24 MI studies, 12 were classified as poor, 10 as fair and two were classified as good . Of the 12 NDI studies, two were classified as poor, seven were classified as fair, and three were classified as good . The main problems were the absence of information on (i) distributions of major confounders in each group, (ii) unplanned analyses and (iii) adjustment for confounding factors in the analysis.…”

“…None were classified as excellent, and only five of 36 were classified as good. The NDI studies reported more methodological details, so there was proportionately a greater number of studies classified as fair (n = 7) and good (n = 3) …”