ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title A Two Implant Retained Mandibular Over-Denture Will Improve Oral Quality Of Life, But Benefits to General Quality Of Life Are Still Uncertain
Clinical Question In patients who are completely edentulous does a two implant retained mandibular over-denture improve quality of life as compared to a traditional denture?
Clinical Bottom Line A two implant retained mandibular over-denture may improve oral quality of life, but benefits to general quality of life are still uncertain. Evidence shows a statistical increase in satisfaction for a two implant over-denture; however, the magnitude of this benefit remains uncertain. (See Comments on the CAT below)
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) 19515032Emami/2009Ten publications with 7 RCT’sMeta-Analysis
Key resultsIn 6 studies, 588 participants rated their satisfaction with the conventional denture vs. the implant over-dentureon on a VAS or Likert-type scale. The effect size was 0.80 in favor of the implant over-denture (P < .00001). 3 studies were specifically looking at the effect of implant over-dentures on “oral health quality of life.” Using multiple scales, all three studies combined showed an effect size of 0.41 in favor of the implant over-denture (P =.003). The data was re-evaluated with patients from the general population (not including people with significant medical problems sent to specialty clinics) and the effect size increased to 0.71 in favor of the implant over-denture (P <.00001). There is insufficient evidence to support a claim that an implant over-denture will improve general “quality of life” as compared to a traditional complete denture.
Evidence Search ("Denture, Complete"[Mesh] AND "Dental Prosthesis, Implant-Supported"[Mesh] AND "Quality of Life"[Mesh] ...view in PubMed
Comments on
The Evidence
On the hierarchy of evidence a systematic review with meta-analysis is paramount. This systematic review only used Randomized Controlled Trials; producing a relatively small sample size but with the highest form of Evidence-Based Research.
Applicability This article is applicable to patients who are completely edentulous and practitioners treating this patient population wishing to choose between a traditional denture and one that is retained by two implants in the edentulous mandible.
Specialty/Discipline (General Dentistry) (Oral Surgery) (Periodontics) (Prosthodontics) (Restorative Dentistry)
Keywords Implant; overdenture; denture; locator; quality of life; edentulous
ID# 2107
Date of submission: 09/08/2011spacer
E-mail sheridan@uthscsa.edu
Author Ryan Sheridan
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Stephan Haney, DDS
Faculty mentor/Co-author e-mail HANEYS2@UTHSCSA.EDU
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
post a rationale
None available
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Comments on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
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by Walter C. Daniels (Aurora, CO) on 11/11/2011
There is a growing consensus that the implant retained over denture is an effective treatment for the edentulous mandible. It has been suggested that this treatment is in fact the standard of care (McGill Consensus; Int J Prosthodont, 2002). However, when the available evidence is restricted to meta-analysis of randomized clinical trials using CONSORT guidelines, that conclusion becomes less clear. This meta-analysis found that although patients may be more satisfied with implant retained over dentures as compared to conventional prostheses, the magnitude of the effect and implications for general health is not known. Additionally, the authors suggest that evidence for the cost-effectiveness of the implant retained over denture is lacking.
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