Implant retained or conventional dentures, which give more patients satisfaction?

Abstract

Design This was a randomised controlled trial (RCT) set in a dental hospital. Intervention The implant group (IG) had two implants placed in the interforaminal region of the lower jaw followed (after healing) by a denture fixed to the implants by a ball attachment mechanism. In the conventional dentures group (CG), dentures were constructed using conventional replacement denture techniques. Patients in the IG had conventional upper dentures made in the same fashion. Outcome measure The performance of the dentures was evaluated using an oral health impact profile (OHIP) and a denture satisfaction scale before treatment and 3 months post-treatment. Results Analysis was conducted on an intention-to-treat basis. Substantial improvements in oral-health-related quality of life and denture satisfaction were reported by both groups. There were, however, no significant differences post-treatment between the groups. Patients randomised to the IG who declined implants had significantly lower pretreatment OHIP scores and there were significantly greater pre-/ post-treatment change-scores for individuals who had implants compared with the change-scores of people who declined. Conclusions There were no significant post-treatment differences between the groups, but a treatment effect may be masked by the intention-to-treat analysis. The pre-/ post-treatment OHIP change-scores were significantly greater for people receiving implants than for those who refused. CommentaryThis very interesting study is the first RCT in dentistry where the post-randomised single-consent design described by Zelen in 1979 1 has been used. The rationale for introducing a study design where the participants are randomised before acquiring consent was that it might enhance patient recruitment to clinical trials. Interestingly, not many trials in biomedicine have applied this design, and the majority of those that have suggest that the reason is to avoid bias due to a Hawthorne effect a distortion of the results caused by the response the participants to the special attention they receive from researchers rather than to improve recruitment. 2

The impact of implant treatment on oral health related quality of life in a private dental practice: a prospective cohort study

“…The present work also showed a significant improvement of OHRQoL in retained or fixed complete denture wearers, as previously reported in another study, which used the OHIP and OIDP as evaluation tools [31]. In addition, two studies using the OHIP did not demonstrate any difference in OHRQoL between conventional and implant-retained complete denture wearers [35,36]. On the other hand, before treatment, participants that accepted implant treatment presented an initially poorer OHRQoL than that of conventional full removable denture wearers.…”

A case‐control study assessing oral‐health‐related quality of life after immediately loaded single implants in healed alveolar ridges or extraction sockets

“…1). Hence, it can be concluded that placement of a provisional implant‐supported crown improves “OHRQoL.” This is in agreement with Berretin‐Felix et al (2008) and Jokstad (2006). Whether this is affected by the immediate restoration with a provisional crown, or due to the implant placement alone, cannot be specified because a non‐restored control group was missing.…”

Clinical, Aesthetic, and Patient‐Related Outcome of Immediately Loaded Single Implants in the Anterior Maxilla: A Prospective Study in Extraction Sockets, Healed Ridges, and Grafted Sites

“…29 With a significant increase in all seven domains at 1 year follow-up an overall improvement was clearly demonstrated in this study. 74 An important limitation of the current study is that our results may not fully reflect current practice because no biomaterials were used in conjunction to immediate implant placement. 74 An important limitation of the current study is that our results may not fully reflect current practice because no biomaterials were used in conjunction to immediate implant placement.…”