Maire Brennan

To assess and compare patient satisfaction and oral health-related quality of life (OHQOL) in patients treated with implant-supported overdentures and complete implant fixed prostheses. From a database of patients who had undergone implant treatment over a 6-year period, a study population of 62 patients was identified; every patient had at least four implants placed in one edentulous arch and was restored with either an overdenture or a fixed prosthesis. Patients were examined and a self-administered, structured multiple-response questionnaire, including the Oral Health Impact Profile-14 measurement tool and a patient satisfaction survey, was used to evaluate patient-centered treatment outcomes. Generally, patient satisfaction was very high in both the implant overdenture and fixed prosthesis groups, although the subjects in the overdenture group, who had mostly maxillary prostheses, reported significantly lower overall satisfaction and lower satisfaction with chewing capacity and esthetics. In just three categories--cost, satisfaction with treating doctor, and ability to perform oral hygiene measures--the fixed prosthesis group was less satisfied than the removable overdenture group, but the difference was not significant. Similarly, the overall OHQOL was high, although patients receiving a fixed prosthesis demonstrated significantly lower psychologic discomfort and psychological disability compared to the overdenture group. Among all patients who had similar numbers of implants placed, those who received an implant overdenture were less satisfied and had lower OHQOL than the patients who had a fixed prosthesis. Since patient and dentist preferences influenced the type of prosthesis provided, it is likely that subjective, patient-related factors are major determinants of satisfaction and treatment outcomes.

Little has been reported about the demographics of implant placement in the Irish population and the complications that occur. This is important in terms of service planning and providing patient information. The purpose of this study was to construct a database of patients who had implants placed in the Dublin Dental School et Hospital from 2000 to 2006. Also, we wanted to compare the complications that occurred in patients who had overdentures to those with a fixed prosthesis. Hospital records were searched for all patients who had implants placed over a seven-year period and we recorded demographic information, as well as details of the implant site, implant type and restoration. Patients who had four or more implants placed for an implant-supported overdenture or fixed prosthesis were invited to attend for a clinical examination. A total of 1,111 implants were placed in 452 patients over the study period--half of the implants supported single crowns, while the other half supported mainly overdentures and full arch fixed prostheses, with few fixed partial dentures. The 40- to 60-year-olds had the greatest number of implants placed of any age group and most implants were placed in the anterior region. Patients with implant-supported overdentures recorded more complications (52%) compared to those with fixed prostheses (32%). The most common complications associated with both treatments were gingival inflammation and peri-implant mucositis. Overdentures additionally had a significant number of retentive clip fractures. Implant-supported overdentures and fixed prostheses were both clinically successful. However, patients and clinicians should be aware that soft tissue and mechanical complications are common.