Within-subject Comparisons of Implant-supported Mandibular Prostheses: Choice of Prosthesis

Abstract

Although previous studies have demonstrated that implant-supported prostheses are more satisfactory and efficient for edentulous patients than are conventional prostheses, until now no investigation has directly compared different types of implant-supported prostheses. We carried out a within-subject cross-over clinical trial with fixed and long-bar removable implant-supported mandibular prostheses. Fifteen subjects were randomly divided into two groups. One group received the fixed prosthesis first, while the other first received the removable. After a two-month adaptation period, psychometric measurements of various aspects of the prostheses and physiological tests of masticatory efficiency were carried out. The prostheses were then changed, and the procedures repeated. At the end of the study, subjects chose the prosthesis they wished to keep. In this paper, we report on the data gathered at this last appointment. Eight subjects chose the fixed (F group), and seven chose the removable (R group). Both groups rated stability and ability to chew with the fixed as significantly better than with the removable. However, the R group rated ease of cleaning as the most important factor governing their decision, followed by esthetics and stability. The F group considered stability to be the most important factor in their decision, followed by chewing ability and ability to clean. There was a tendency for the removable to be chosen by older subjects (+50 years). These results suggest that patients choose fixed or removable implant-supported prostheses for specific reasons, and that patient attitudes should be considered when the design of a prosthesis is being planned for an individual patient.

Oral health impact profile and prosthetic condition in edentulous patients rehabilitated with implant-supported overdentures and fixed prostheses

“…Generally, the conventional total prosthesis has been compared with one of these two types of total implant-supported prosthesis (23)(24)(25). Feine et al (26) and Grandmont et al (27) selected 15 patients, of whom 8 were initially treated with implantsupported fixed prostheses and 7 were given implantsupported overdentures (removable). After 2 months, patient perception of prosthesis utilization was assessed using the visual analogue scale (VAS) and the category scale (CAT), then the prostheses were changed and the procedures repeated.…”

Two‐center clinical trial of implant–retained mandibular overdentures versus complete dentures – chewing ability

“…In partially edentulous patients he compared the effectiveness of fixed par tial prostheses retained by a blade-vent implant with removable partial prosthe ses dentures (Kennedy Class I). Only de G r a n d m o n t et a l and F ein e et ai (18) reported about treatment with implants in a clinical trial with edentulous pa tients. They compared different types of implant-retained prostheses: fixed and removable prostheses.…”

Prevention of distal extension cantilever fracture in mandibular overdentures

“…14 Randomized, within-subject, crossover trials on mandibular two-implant-supported prostheses indicated similar patient satisfaction with either a mandibular long-bar implant overdenture or even a fixed fulldental prosthesis. 15,16 Therefore, a two-implant supported overdenture is considered 'the standard of care' for edentulous lower jaws 5,17 , except for individuals who consider a removable denture as a foreign body. 15 Although initial reports suggested increased failure rates for implants supporting an overdenture, compared to partial/full fixed bridges (for review see Berglundh et al 2002 18 ), more recent clinical trials clearly proved the opposite.…”

“…15,16 Therefore, a two-implant supported overdenture is considered 'the standard of care' for edentulous lower jaws 5,17 , except for individuals who consider a removable denture as a foreign body. 15 Although initial reports suggested increased failure rates for implants supporting an overdenture, compared to partial/full fixed bridges (for review see Berglundh et al 2002 18 ), more recent clinical trials clearly proved the opposite. The cumulative survival rate for implants supporting a mandibular overdenture remains above 96% after 10 years, with minimal marginal bone loss.…”