ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Edentulous Patients' Satisfaction and Quality of Life Is Similar for Fixed Implant-Supported Prostheses and Implant-Supported Overdentures
Clinical Question For edentulous patients, how does a fixed implant-supported prosthesis compare with an implant-supported overdenture, in terms of patient satisfaction and quality of life as measured by the Oral Health Impact Profile?
Clinical Bottom Line Edentulous patients report similar quality of life with a fixed implant-supported prosthesis as compared to those with implant-supported overdentures. This conclusion is supported by two observational studies that collectively include 86 research subjects. The diversity of available implant denture treatments can complicate the matter of choosing the most appropriate option. Patient outcomes may therefore be used to guide treatment planning decisions for edentulous patients seeking implant therapy.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 25346286Oh/201456 edentulous patients (mean age 55.1 years) Case Control Study
Key resultsSubjects were treated with a fixed or removable full-arch prosthesis at least 6 months prior to the survey date. OHIP-14 scores improved for the fixed prosthesis (FP) group by a mean of 23 points, while scores for the removable prosthesis (RP) group improved by a mean of 21 points, as compared to 1 year before treatment. There were no significant differences between the FP and RP groups in all dimensions of OHIP-14 survey (P > 0.017).
#2) 20032605Zani/200930 edentulous patients (mean age 63.78 years) treated with fixed or removable implant supported dentures at least two years prior to the survey date.Cross Sectional Study
Key resultsSubjects were treated with fixed or removable implant-supported dentures at least 2 years prior to the survey date. Subjects treated with implant-supported total prostheses, whether fixed or removable, experienced high oral health satisfaction and quality of life. The mean OHIP-EDENT score for the overdenture group was 1.13 (±2.26), while that of the fixed prosthesis group was 2.13 (±2.41). This difference is not statistically significant (P ≤ 0.05).
Evidence Search "Oral Health Impact Profile edentulous implant prosthesis”
Comments on
The Evidence
Both studies were conducted using relatively small sample sizes. Zani/2009 did not report their sample size calculation, but Oh/2014 exceeded their minimum sample size of 26, as determined by standard statistical criteria. Both studies were conducted outside the United States, introducing the possibility of bias due to cultural differences in the role of dentistry in subjects’ self-reported quality of life. Nevertheless, unlike prior research these studies measure patient satisfaction using a validated survey tool, the Oral Health Impact Profile. Because Oh/2014 is a retrospective study, recall bias may have influenced its results. Furthermore, both studies employ an observational study design, and neither could be blinded due to the nature of treatment. This fact makes it difficult to assess the presence of confounding variables. Further research will be necessary to fully assess the relationship between edentulous patients’ quality of life and their choice in implant prostheses.
Applicability Advances in technology and technique have made implant treatment more accessible to edentulous patients in recent years. It is fairly well established that patients report greater satisfaction with implant-supported dentures than with complete removable dentures. However, it has so far been unclear whether patients experience a more favorable outcome with a fixed or removable implant-supported prosthesis. If, as these studies suggest, an equally favorable quality of life is possible with either treatment, the patient and clinician are then free to determine the most appropriate option based on other factors, such as cost, convenience, durability, cleansibility and personal preference.
Specialty/Discipline (General Dentistry) (Prosthodontics)
Keywords overdenture, hybrid, satisfaction, dentures, edentulous, implant-supported, full-arch prosthesis, OHIP, quality of life, implants
ID# 3260
Date of submission: 06/20/2017spacer
E-mail finneya@livemail.uthscsa.edu
Author Alicia Finney
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Eldon Matthew Lamb, DDS, FACP
Faculty mentor/Co-author e-mail lambem@uthscsa.edu
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