WITHIN-SUBJECT COMPARISONS OF IMPLANT-SUPPORTED MANDIBULAR PROSTHESES- CHOICE OF PROSTHESIS

Although previous studies have demonstrated that implant-supported pro stheses are more satisfactory and efficient for edentulous patients th an are conventional prostheses, until now no investigation has directl y compared different types of implant-supported prostheses. We carried out a within-subject cross-over clinical trial with fixed and long-ba r removable implant-supported mandibular prostheses. Fifteen subjects were randomly divided into two groups. One group received the fixed pr osthesis first, while the other first received the removable. After a two-month adaptation period, psychometric measurements of various aspe cts of the prostheses and physiological tests of masticatory efficienc y were carried out. The prostheses were then changed, and the procedur es repeated. At the end of the study, subjects chose the prosthesis th ey wished to keep. In this paper, we report on the data gathered at th is last appointment. Eight subjects chose the fixed (F group), and sev en chose the removable (R group). Both groups rated stability and abil ity to chew with the fixed as significantly better than with the remov able. However, the R group rated ease of cleaning as the most importan t factor governing their decision, followed by esthetics and stability . The F group considered stability to be the most important factor in their decision, followed by chewing ability and ability to clean. Ther e was a tendency for the removable to be chosen by older subjects (+50 years). These results suggest that patients choose fixed or removable implant-supported prostheses for specific reasons, and that patient a ttitudes should be considered when the design of a prosthesis is being planned for an individual patient.