Masticatory function and oral health‐related quality of life of patients with atrophic and non‐atrophic mandibles using implant‐retained mandibular overdentures: 3‐year results of a prospective clinical study

Abstract

Background Long‐term changes in masticatory function, oral health‐related quality of life (OHRQoL) and prosthetic complications in implant‐retained mandibular overdenture (IMO) wearers as a function of bone atrophy require detailed investigations. Objective Investigating the evolution of masticatory function, OHRQoL and prosthetic occurrences of IMO wearers according to mandibular bone atrophy over 3 years of usage. Methods This study evaluated 26 IMO wearers after 2 and 3 years of IMO loading categorised according to mandibular resorption degree into atrophic mandible (AM) and a non‐atrophic mandible (NAM) group. Masticatory function was assessed by the Masticatory Performance (MP) and Swallowing Threshold (ST) tests; OHRQoL and satisfaction via the Dental Impact on Daily Living (DIDL) questionnaire; and the prosthetic maintenance requirements and complications were monitored. Results After the second year, the AM Group performed 32% more cycles (P = .047) than the NAM Group during the ST test. The DIDL questionnaire showed no significant difference for all domains, except for a moderate effect size in the General Performance domain after the third year. AM Group had more prosthetic occurrences (n = 109) than NAM Group (n = 60) in the first year, mainly due to Equator attachment dislodgment. During the third year, NAM Group presented a greater number of events (n = 45) than AM Group (n = 21) due to the greater number of O‐ring exchanges. Conclusion Masticatory function and OHRQoL are not related to mandibular bone atrophy until 3 years after IMO rehabilitation. The prosthetic complications profile differs between groups, mainly in the first year.

Patient satisfaction and oral health-related quality of life 10 years after implant placement

“…Sligthly lower subjective satisfaction of patients were found in a retrospective study from Germany with 37 hypodontia patients recruited 0.5-16 years after implantation, however the results were then improved by using objective assessments [33]. Despite of the small sample size of patients with implant-supported removable prostheses in our study (only five patients), a great OHRQoL among the patients with implant-supported removable prostheses could also be confirmed, even though none of the removable prostheses were free from clinical complications and require more prosthetic maintenance [34].…”

Factors and clinical outcomes for standard and mini-implants retaining mandibular overdentures: A systematic review and meta-analysis

“…Those results might be related to the prosthesis design (reinforcement, resin thickness), implant number or position, and degree of residual ridge resorption. 2,3,6 In the event of overdenture fracture, the use of a thin layer of acrylic resin surrounding the metal housing of standard implants can result in stress concentration, crack formation, and ultimately prosthesis fracture. 4 Because the components associated with mini-implants are smaller, a thicker resin layer would be present around them, and consequently fracture may be mitigated.…”

“…Consistent with previous studies, the change of retention inserts was reported to be the most frequent prosthetic maintenance in patients with IODs. 2,5,22,25,26 These results might be related to the implant design, but mostly to the load distribution in the prosthesis, in which the occlusion forces might not only be concentrated in the nylon component. Consequently, because IODs retained by mini-implants have a large mucosal support area, this structure can act as a stress-breaking element, explaining the fewer changes of retention inserts.…”

“…1-10 Among the possible treatment choices, the implant-retained mandibular overdenture (IOD) can differ depending on the design, position, and implant number and according to the patients' clinical presentation. 2,[11][12][13][14] Despite the benefits of IODs, patients might decline the treatment because of cost, fear of oral surgery, or psychological issues. 15,16 Moreover, standard-diameter implants might not always be clinically possible for anatomic or financial reasons.…”

Oral health‐related quality of life of patients rehabilitated with fixed and removable implant‐supported dental prostheses

“…The question arises as to whether bone atrophy has an impact on the oral health‐related quality of life of patients treated with implant‐retained overdentures, foremost in the mandibular region. A 3‐year prospective study compared patients treated with implant‐retained mandibular overdentures with and without atrophic mandibles and, interestingly, did not reveal any statistical significant differences 56 . More recent studies support the finding that retention and therefore better stability of prostheses appears to be an important factor for patients’ oral health‐related quality of life 57,58 .…”