Within‐subject comparison of maxillary long‐bar implant‐retained prostheses with and without palatal coverage: patient‐based outcomes

Abstract

Although maxillary implant overdentures are used in oral rehabilitation, different designs have not been compared previously in clinical trials. This crossover trial was designed to measure differences in patient satisfaction with maxillary long-bar implant overdentures with and without palatal coverage opposed by a fixed mandibular implant-supported prosthesis. Data were also gathered on new conventional dentures and on maxillary conventional dentures opposed by mandibular fixed prostheses. Sixteen participants were selected from a population wearing conventional dentures. Fifteen received new upper and lower dentures (1 drop-out). Four implants were placed in the maxilla and mandible (2 drop-outs). A mandibular fixed prosthesis was inserted in 13 participants, who were then divided into 2 groups. One group (n = 7) received long-bar overdentures with palate, then long-bar overdentures without palate. The other group (n = 6) received the same treatments in the reverse order. Mastication tests and psychometric evaluations using Visual Analog Scales and Categorical Scales were performed throughout the study. General satisfaction was very high with both maxillary implant-supported prostheses, as were ratings of almost all psychosocial and functional variables. There were no significant differences between treatments, suggesting that patients are equally satisfied with long-bar overdentures with and without palate when these are opposed by mandibular fixed prostheses. However, the ratings given to the maxillary implant prostheses were not significantly higher than for new conventional maxillary prostheses. This suggests that maxillary implant prostheses should not be considered as a general treatment of choice in patients with good bony support for maxillary conventional prostheses.

Clinical evaluation of submerged and non-submerged implants for posterior single-tooth replacements: a randomized split-mouth clinical trial

“…The VAS, for which patients are asked to mark a point on the line that best represents their opinion, has been shown to be a valid, reliable, and reproducible instrument to measure patient satisfaction in clinical studies. 34,35 The VAS evaluation revealed that patients were more satisfied with their non-submerged implants than with their submerged implants for all aspects. While some questions such as those on aesthetic satisfaction and cleaning or chewing ability appear non-relevant to the surgical technique, the higher patient satisfaction for non-submerged implants may reflect the significant advantages of the one-stage implant insertion technique.…”

Comparative study of splinted and unsplinted implant-retained maxillary overdentures without palatal coverage: A literature review

“…It seems that the minimum favorable number in the literature to support an IOD without palate coverage is four maxillary implants [14,20,35] connected to a long bar to improve retention and stability of the prosthesis, as well to increase hygiene and pharyngeal reflex control [12,16,27].…”

“…Some studies presented a variable number of dental implants rating to four to six implants per patient [20][21][22][23][24][25][26] and others employed a fixed number like four [27,28] or six dental implants [29,30]. The same variation occurred to anchorage design.…”

“…The general variation noted was 86.1% [30] to 100% [21][22][23][24][25] on the survival rate of maxillary dental implants. The maxillary implants survival rate in implant-supported overdentures (PR4) by four dental implants ranged from 96.7% [27] to 100% [21][22][23][24][25] and implant-retained and mucosupported (PR5) by four implants ranged from 95,5% [20] to 100% [21,25,26].…”

Maxillary implant overdentures: current controversies

“…4,[27][28][29] In patients with good bony support and those who are satisfied with their maxillary complete dentures, it has been shown that no significant improvements in masticatory ability, stability, retention, function and speech result from subsequent treatment with maxillary implant overdentures. 4,6,28,30 In patients with concerns over their current or proposed maxillary complete denture, Zitzmann and Marinello 29 demonstrated that treatment with maxillary implant overdentures provided significant improvements in patient satisfaction, although the study was limited to 10 overdenture patients. The reasons for seeking an improvement in satisfaction and the level of dissatisfaction require careful assessment in order to provide appropriate case specific advice.…”