Within‐patient evaluation of chewing efficiency and maximum bite force of conventional dentures, fixed prostheses, and milled bar overdentures used for All‐on‐4 implant rehabilitation of atrophied mandibular ridges: A short‐term randomized trial

Abstract

Purpose: This crossover study aimed to evaluate chewing efficiency and maximum bite force (BF) of conventional dentures, fixed prostheses, and milled bar overdentures (MO) used for All-on-4 implant rehabilitation of atrophied mandibular ridges.Methods: Sixteen edentulous participants with resorbed mandibular ridges received new conventional dentures (CD, control). Four implants were inserted after 3 months in the mandible using the All-on-4 protocol and loaded immediately with acrylic prosthesis. In a crossover manner, each patient had either fixed restoration (FR, 12 occlusal units) or MO (14 occlusal units) randomly in a crossover study design. Chewing efficiency was evaluated using the mixing ability test. The hue deviation (HD) of twocolored gum was calculated after being chewed for 5, 10, 20, 30, and 50 masticatory cycles. Maximum BF was evaluated using a BF device. HD and BF were measured after using CD, FR, and MO prostheses.Results: For all groups, the highest HD (i.e., the lowest chewing efficiency) was noted with 5 strokes, followed by 10, 20, 30 strokes, and the lowest HD (i.e., the highest chewing efficiency) was noted with 50 strokes. For all number of chewing strokes, CD showed the highest HD, then FR, and MO recorded the lowest HD. The highest BF was observed with MO, then FR, and the lowest BF was noted with CD. Conclusion:Within the limitations of this short-term investigation, both FR and MO used for All-on-4 implant rehabilitation of patients with resorbed mandibular ridges improve masticatory efficiency and maximum BFs compared to CD. However, MO was associated with significantly higher chewing efficiency and maximum BFs than fixed prosthesis.

Evaluation of masticatory efficiency and OHRQoL in implant-retained overdenture with different numbers of implant in the edentulous mandible: a one-year follow-up prospective study

“…Milled bar overdentures were found to be associated with significantly higher chewing efficiency compared to fixed prostheses. The blending indices in the overdenture group were significantly better, consistent with the results of the present study [ 30 ].…”

Treatment effect of implant‐supported fixed complete dentures and implant overdentures on patient‐reported outcomes: A systematic review and meta‐analysis

“…The strong positive effect of implant treatment on dPROs, regardless of whether the prosthetic restoration was an IFCD or an IOD, seems to reflect the observed improvements in several objective criteria, such as masticatory efficiency, as described in the literature (ELsyad et al, 2022). Our findings are also concordant with previous literature.…”

Evaluation of Masticatory Efficiency Based on Denture Design, Period of Edentulism and Gender

“…The bite force for edentulous patient revealed good prognosis within the all-on-four and cantilever bar assessment of overdenture. (19,28) The superior statistically significant difference revealed in ME for group I at the first time interval (T1) may be due to the simplicity of the design and more stability non-free posterior portion of the prostheses compared to the CBB group. Ares et al (32) found that people who were satisfied with their chewing ability, mastication, and comfort while eating preferred implant fixed prostheses over removable prostheses.…”

“…The stability and retention gained by the all-on-four assisted overdenture with different suprastructure revealed the improvement of bite force and chewing efficiency within time. (28) This could be explained by the improving of the neuromuscular control of patient after wearing stable overdenture. The instability and looseness of restoration minimize the serviceability of the denture rather than the consistency and type of food.…”