Within‐subject comparisons of maxillary fixed and removable implant prostheses

Abstract

Dental implants provide patients with restorative options for the edentulous maxilla. Both fixed and removable prostheses can be attached to the edentulous maxilla, but the efficacy of different designs has not been determined. In this two-session within-subject crossover trial we compared maxillary implant retained fixed prostheses with removable implant overdentures opposed by mandibular implant-supported overdentures. Sixteen patients, who had previously received mandibular implants, entered the study and received four to six maxillary implants. After dropouts as a consequence of a lack of osseointegration and general health problems, 13 remained. Of these, five received the removable prosthesis first and eight the fixed prosthesis. After 2 months, the prostheses were exchanged and the second was also worn for 2 months. Psychometric measurements of general satisfaction with the prostheses as well as comfort, ability to speak, stability, esthetics, ease of cleaning and occlusion were obtained once each prosthesis had been worn for 2 months. Chewing ability was assessed for seven types of food. Removable long-bar overdentures received significantly higher ratings of general satisfaction than fixed prostheses (P = 0.003). Patients also rated their ability to speak and ease of cleaning significantly better with the removable overdentures. Nine patients chose to keep the removable prosthesis and four preferred to keep the fixed prosthesis. The results suggest that maxillary removable overdentures on multiple implants may provide patients with better function than fixed prostheses.

Early and Immediate Loading Protocols for Overdentures in Completely Edentulous Maxillas: A Comprehensive Review of Clinical Trials

“…This improvement is comparable to what has been reported with the conventional loading protocol using overdentures with different retention/support systems. 47,48 Although these findings are encouraging, it would be interesting to investigate the chewing ability during the first few months of implant loading, when both the hard and soft tissues are healing/ remodeling, the implant stability is challenged, and the patient is adjusting to the new denture and retention/support system.…”

Partial edentulism and treatment options

“…21 Dental implants may be an alternative treatment to RPDs. [22][23][24] In this study, dental implants were less common treatment option for Kennedy I and II in both maxilla and mandible (15-20% and 25-26%, respectively). This result is in accordance with the study preformed in Kazakhstan, in which dental implants were the least common treatment choice.…”

Clinical aspects in the treatment planning for rehabilitation with overdenture and protocol-type prosthesis

“…In situations when it is possible to place a sufficient number of dental implants of an adequate length, the prosthetic superstructure can be implant-supported, and it is called protocol-type prosthesis [19][20]22 .…”

“…However, most studies indicate that protocol-type prostheses appear to have a negative effect on the satisfaction of the patients rehabilitated with this type of prosthesis since the most important aspects to patients are aesthetics and phonetics [21][22] .…”

“…With regard to psychosocial factors, it was found that comfort, stability, and aesthetics are some of the factors that demonstrate the satisfaction of patients rehabilitated with implant prosthesis as compared to conventional dentures [19][20][21][22] . However, most studies indicate that protocol-type prostheses appear to have a negative effect on the satisfaction of the patients rehabilitated with this type of prosthesis since the most important aspects to patients are aesthetics and phonetics [21][22] .…”