Impact of the extension of the anterior-posterior spread on quality of life and satisfaction of patients treated with implant-retained mandibular overdentures - a randomized clinical trial

Abstract

ObjectivesTo compare the degree of satisfaction (SD) and the impact on oral health-related quality of life (OHRQoL) of edentulous patients treated with conventional complete dentures (CCDs) and mandibular overdentures (IODs) with a short anteroposterior spread (S-APS) or a large antero-posterior spread (L-APS). Materials and methodsEdentulous patients were treated with CCDs and subsequently randomly allocated to receive a bar clip mandibular overdenture retained by 2 interforaminal implants (Control) or 4 (Test: 2 additional implants distal to the mental foramen). The Oral Health Impact Profile Edent questionnaire (OHIP-20E) and the Visual Analogue Scale (VAS) were applied at a mean follow-up of 38.5 months to assess the impact on OHRQoL and DS, respectively. Comparisons between the type of prosthesis and the extension of the AP spread were made with Student's t test for paired samples and for independent samples, respectively, at a significance level of 5%. ResultsThe IODs had significantly lower OHRQoL values ​​in the dimensions “functional limitation” (p=0.03), “physical pain” (p=0.02), “psychological discomfort” (p<0.01), “disability physical” (p<0.01) and “general score” (p<0.01) (n=20 patients). The IODs presented DS values ​​significantly for “aesthetics” (p=0.04), “stability” (p=0.03), “masticatory capacity” (p<0.01), “function” (p<0.01) and "oral condition" (p=0.03). The S-APS group (control) resulted in significantly lower values ​​in the dimensions “physical pain” (p<0.01) and “general score” (p<0.01) and no domain with statistical difference in the VAS scale. ConclusionsIODs significantly improved OHRQoL and DS. The increase in AP spread did not result in benefits for the patient's OHRQOL and DS in this clinical study. (Study Protocol Number: 1.452.492) Clinical SignificanceImplantology has experienced in the last 20 years a permanent evolution that aim at increasing predictability and improving long-term clinical performance. Placement of short implants distally to the mental foramen, for instance, and the resulting increase of the anterior-posterior spread, is a promising approach and is worthy of investigation.