Comparing mandibular two-implant overdentures and conventional dentures: Psychosocial and functional outcomes.

摘要

Using mandibular 2-Implant overdentures is an alternative therapy for edentulous patients. Several studies have been conducted to evaluate the efficacy of this treatment modality compared to conventional dentures. However, most of these studies have emphasized the evaluation of the clinical aspects of the prostheses or did not use standardized specific patient based-outcomes.; Therefore, the main objectives of this research was to investigate the effect of using mandibular 2-implant supported prostheses and conventional dentures on oral health related quality of life, using a randomised controlled clinical trial design. The secondary objectives were to assess the factors that explained patients' satisfaction with their prostheses and to evaluate the association between ratings of satisfaction, ability to chew and laboratory tests of masticatory efficiency according to treatment received. In addition, the association between patients' pretreatment preference and general satisfaction with original prostheses was explored, as well as the possible effect of pretreatment preferences on post treatment satisfaction.; One hundred and two female and male subjects between the ages of 35--65 years responded to a newspaper advertisement for patients who wished to replace their current prostheses. Forty-eight subjects were randomly assigned to receive conventional denture and 54 to the implant group. Prior to treatment, subjects were asked to indicate which treatment they would prefer if given a choice. Patients' ratings of general satisfaction were evaluated with their original prostheses and two months after receipt of the new treatments using 100mm Visual Analogue Scales (VAS). Similarly, subject's quality of life was assessed using the Oral Health Impact Profile (OHIP), prior to and two months after receipt of the new prostheses.; Multivariate regression analysis showed that subjects in the implant group had significantly higher ratings of general satisfaction (p 0.05) as well as, with their general ability to chew, stability and comfort compared to those who received mandibular conventional dentures. In addition, subjects in the implant group were significantly more satisfied with their ability to chew specific foods with different textures. To the contrary, no significant differences were observed between the two groups using laboratory measures of masticatory efficiency.; Furthermore, patients who received implant treatment had significantly lower OHIP scores (p 0.05) indicating better quality of life compared to subjects in the conventional group. In this trial age, gender, level of education, income and marital status were not significantly associated with either ratings of satisfaction or quality of life.; Although patients' preferences were significantly associated with their ratings of satisfaction with original prostheses, preferences did not have a significant effect on post-treatment oral health related quality of life or satisfaction.; Overall, the results of this study suggest that, after two months of adaptation, a prosthesis supported by two osseointegrated implants provided significant improvement in oral health related quality of life and satisfaction compared to a conventional denture.