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The International Journal of Oral & Maxillofacial Implants



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Int J Oral Maxillofac Implants 26 (2011), No. 2     15. Apr. 2011
Int J Oral Maxillofac Implants 26 (2011), No. 2  (15.04.2011)

Page 415-426, PubMed:21483895

Comparison of Three-Implant-Supported Fixed Dentures and Two-Implant-Retained Overdentures in the Edentulous Mandible: A Pilot Study of Treatment Efficacy and Patient Satisfaction
De Kok, Ingeborg J. / Chang, Kuang-Han / Lu, Tsui-Shan / Cooper, Lyndon F.
Purpose: The mandibular two-implant overdenture has been shown to be a highly successful treatment. However, overdenture patients who desire a fixed prosthesis may not be satisfied with a removable overdenture. This prospective study sought to compare prosthetic outcomes, patient satisfaction, and survival rates of implants between two-implant-supported overdentures (IODs) and three-implant-supported fixed dentures (ISFDs).
Materials and Methods: Twenty completely edentulous patients were randomly and equally assigned to two groups. New conventional complete dentures were made, and the mandibular denture was used as a surgical guide during implant placement. Implants were placed in one stage, followed by a mandibular denture soft reline (provisional loading). Ball attachments were inserted at 8 weeks, and ISFDs were delivered at 16 weeks. IODs were connected to the attachments at 8 weeks, using each patients's existing denture. The definitive ISFDs were fabricated using computer-aided design/computer-assisted manufacture milled titanium frameworks and acrylic resin base and teeth. Patient satisfaction and panoramic radiographs were investigated at 6 and 12 months.
Results: Both treatments had significant and positive effects on patient satisfaction and quality of life. None of the 50 implants placed had failed at 12 months of follow-up; therefore, the implant survival rate was 100%. Prosthetic complications were generally rare and easily manageable.
Conclusions: Both the treatment modalities-the ISFD supported by three implants and the IOD supported by two implants-significantly and similarly improved patient satisfaction and oral health-related quality of life, and prosthetic complications were relatively rare for both treatments. Three implants can be used to support a mandibular fixed prosthesis; however, a longer observation period is needed to validate this treatment modality.

Keywords: dental implant, mandibular fixed denture, mandibular overdenture, patient satisfaction, prosthetic outcome