Implant-Supported Removable Partial Denture Improves the Quality of Life of Patients with Extreme Tooth Loss

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Abstract

Abstract: This study aimed to evaluate oral health-related quality of life (OHRQoL) in partially dentate subjects, presenting extreme tooth loss in posterior region with missing post-canines, comparing the use of conventional removable partial dentures (RPDs) and implant-supported RPDs. OHRQoL was measured using the Brazilian version of the Oral Health Impact Profile. Twelve subjects presenting maxillary total and mandibular Kennedy Class I edentulism (mean age 62.6±7.8 years) first received complete maxillary dentures and conventional mandibular free-end RPDs. After two months, the subjects had their OHRQoL assessed. Osseointegrated implants were inserted bilaterally in the mandibular first molar regions, and after four months ball abutments were placed to support the free-end RPD. Two months later, the patients had their OHRQoL reassessed. Wilcoxon signed-rank test was used to evaluate differences in OHRQoL (α=0.05). Results showed improvement in all OHIP-49 domains (p<0.05) after associating implants to the RPD. The mandibular implant-supported free-end RPD significantly improved OHRQoL.

Translated abstract

Resumo: Este estudo avaliou a qualidade de vida relacionada à saúde bucal (QVRSB) em indivíduos parcialmente dentados, apresentando perda extrema de dentes na região posterior com ausência de dentes pós-caninos, comparando a reabilitação por meio de próteses parciais removíveis convencionais (PPRs) e PPRs implanto-suportadas. A QVRSB foi mensurada utilizando a versão brasileira do Oral Health Impact Profile (OHIP-49). Doze indivíduos apresentando edentulismo total maxilar e Classe I de Kennedy mandibular (idade média 62,6±7,8 anos) receberam primeiramente próteses totais maxilares e PPRs mandibulares convencionais de extremidade livre. Após dois meses de uso destas próteses, a QVRSB dos voluntários foi avaliada. Implantes osseointegrados foram bilateralmente instalados na região de primeiros molares inferiores e, após quatro meses, pilares do tipo bola foram instalados para suportar a extremidade livre da PPR. Após dois meses a QVRSB dos voluntários foi reavaliada. O teste pareado de Wilcoxon foi utilizado para avaliar as diferenças de QVRSB (α=0,05). Os resultados mostraram melhora em todos os domínios do OHIP-49 (p<0,05) após a associação dos implantes à PPR. PPRs de extremidade livre mandibulares implanto-suportadas melhorou significativamente a QVRSB.

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Most cited references 24

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Development and evaluation of the Oral Health Impact Profile.

G D Slade, A J Spencer (1994)

The capacity of dental clinicians and researchers to assess oral health and to advocate for dental care has been hampered by limitations in measurements of the levels of dysfunction, discomfort and disability associated with oral disorders. The purpose of this research was to develop and test the Oral Health Impact Profile (OHIP), a scaled index of the social impact of oral disorders which draws on a theoretical hierarchy of oral health outcomes. Forty nine unique statements describing the consequences of oral disorders were initially derived from 535 statements obtained in interviews with 64 dental patients. The relative importance of statements within each of seven conceptual subscales was assessed by 328 persons using Thurstone's method of paired comparisons. The consistency of their judgements was confirmed (Kendall's mu, P < 0.05). The reliability of the instrument was evaluated in a cohort of 122 persons aged 60 years and over. Internal reliability of six subscales was high (Cronbach's alpha, 0.70-0.83) and test-retest reliability (intraclass correlation coefficient, 0.42-0.77) demonstrated stability. Validity was examined using longitudinal data from the 60 years and over cohort where the OHIP's capacity to detect previously observed associations with perceived need for a dental visit (ANOVA, p < 0.05 in five subscales) provided evidence of its construct validity. The Oral Health Impact Profile offers a reliable and valid instrument for detailed measurement of the social impact of oral disorders and has potential benefits for clinical decision-making and research.

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Effect of implant-supported or retained dentures on masticatory performance: a systematic review.

Katsuhiko Kimoto, Takahiro Ogawa, N. Garrett … (2007)

While subjective patient-based measures have been increasingly recognized as critical outcomes for prosthodontic treatment, there continues to be a need to validate for patients what changes in masticatory function can be expected with the provision of new implant-supported or retained dentures. The purpose of this review was to evaluate the critical factors impacting change in masticatory performance following the provision of new implant-supported or retained dentures. Information retrieval followed a systematic approach using PubMed and the Cochrane Library. English articles published from 1966 to June 2007, in which the masticatory performance of subjects with implant-supported or retained dentures was assessed by objective methods and compared to performance with conventional dentures, were included. Ratings of the evidence provided in each article followed United States Agency for Healthcare Research and Quality recommendations. From 281 articles identified, 18 peer-reviewed articles met prespecified criteria for inclusion. Specific outcomes of significance identified by these articles rated as level II are: (1) fixed implant-supported partial dentures do not provide significant improvement in masticatory performance compared to conventional removable partial dentures for Kennedy Class I and II partially edentulous mandibles; (2) the combination of a mandibular implant-supported or retained overdenture (IOD) and maxillary conventional complete denture (CD) provides significant improvement in masticatory performance compared to CDs in both the mandible and maxilla for a limited population having persistent functional problems with an existing mandibular CD due to severely resorbed mandible; and (3) the type of implant and attachment system for mandibular IODs has a limited impact. Specific outcomes of significance identified by articles rated as having a moderate level of evidence (level III) are: (1) mandibular fixed implant-supported complete dentures provide significant improvement in masticatory performance compared to mandibular CDs in subjects dissatisfied with their CDs; and (2) implant-supported mandibular resection dentures have an advantage over conventional dentures in masticatory performance on the defect side of the mouth. Objective benefits in masticatory performance of implant-supported or retained dentures compared to conventional dentures are limited to a mandibular IOD in edentulous patients with a resorbed mandible and/or difficulty adapting to CDs.

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Oral health-related quality of life in patients treated with fixed, removable, and complete dentures 1 month and 6 to 12 months after treatment.

Mike John, Gary D Slade, András Szentpétery … (2004)

This study described oral health-related quality of life (OHRQoL) before and after treatment in patients with fixed, removable, and complete dentures. OHRQoL was measured using the German version of the Oral Health Impact Profile (OHIP-G) in a convenience sample of 107 prosthodontic patients at baseline and 1 and 6 to 12 months after treatment. The sum of OHIP-G item responses (OHIP-G49, range 0 to 196) characterized OHRQoL impairment in 42 patients treated with fixed prosthodontics, 31 patients treated with removable dentures, and 34 patients treated with complete dentures. OHIP-G49 medians were compared with the OHRQoL level in a general population sample (n = 2,026). A multivariable binomial regression analysis, controlling for the effects of baseline OHRQoL and follow-up wave, was used to compare the level of impaired OHRQoL in different prosthodontic treatment groups at follow-ups. OHRQoL improved in 96% of the subjects. OHIP-G49 medians reached the level of OHRQoL in the general population 1 month after treatment (fixed prosthodontics patients 6 OHIP-G units; general population subjects 5 units; removable denture patients 23 units, 15 units in general population subjects; complete denture patients 13 units, 23 units in general population subjects). OHIP-G49 medians were below population norms 6 to 12 months after treatment. In patients treated with removable/complete dentures, the expected posttreatment OHIP-G49 problem rate was 1.9 times the problem rate in patients treated with fixed prosthodontics, holding baseline OHIP-G49 and follow-up wave constant. OHRQoL changed substantially comparing pretreatment scores with 1 and 6 to 12 months of follow-up in patients treated with fixed, removable, and complete dentures.

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Author and article information

Contributors

Camila Heitor Campos: Role: ND

Thais Marques Simek Vega Gonçalves: Role: ND

Renata Cunha Matheus Rodrigues Garcia: Role: ND

Journal

Journal ID (publisher): bdj

Title: Brazilian Dental Journal

Abbreviated Title: Braz. Dent. J.

Publisher: Fundação Odontológica de Ribeirão Preto (Ribeirão Preto )

ISSN: 1806-4760

Publication date (Print): October 2015

Volume: 26

Issue: 5

Pages: 463-467

Affiliations

[1 ] Universidade Estadual de Campinas Brazil

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Publisher ID: S0103-64402015000500463

DOI: 10.1590/0103-6440201300097

SO-VID: 7bad0ebc-7bf8-4e7d-84ff-1736135da178

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http://creativecommons.org/licenses/by/4.0/

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SciELO Brazil

Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=0103-6440&lng=en

Implant-Supported Removable Partial Denture Improves the Quality of Life of Patients with Extreme Tooth Loss

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Abstract

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SciELO Brazil

Most cited references 24

Development and evaluation of the Oral Health Impact Profile.

Effect of implant-supported or retained dentures on masticatory performance: a systematic review.

Oral health-related quality of life in patients treated with fixed, removable, and complete dentures 1 month and 6 to 12 months after treatment.

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