A RANDOMIZED CLINICAL-TRIAL COMPARING THE EFFICACY OF MANDIBULAR IMPLANT-SUPPORTED OVERDENTURES AND CONVENTIONAL DENTURES IN DIABETIC-PATIENTS - PART I - METHODOLOGY AND CLINICAL OUTCOMES

Statement of problem. Scientific evidence is lacking to support the ge neral application of implant-supported mandibular overdentures. Purpos e. This randomized clinical trial was undertaken to compare the effica cy of conventional mandibular and implant-supported overdentures in di abetic edentulous patients with clinically acceptable metabolic contro l. Method. A total of 102 diabetic patients, treated with or without i nsulin, were randomized to receive a new maxillary denture and either a conventional or an implant-supported removable mandibular overdentur e. Treatment was completed for 89 patients, 37 with the conventional a nd 52 with implant-supported dentures. Detailed examinations, tests, a nd questionnaires were given before and at 6- and 24-months after trea tment completion. Comparisons between the two treatment groups were ma de for treatment Failures based on prespecifed criteria and the type a nd amount of maintenance care provided. Results. The insulin and nonin sulin treated groups were collapsed because of the lack of significant differences at entry The conventional denture and implant-supported o verdenture groups were similar in terms of general demographics, medic al status, quality of their original dentures and denture support, sev eral functional measures, and patient satisfaction. Treatment was judg ed to be successful in 56.9% of patients with conventional dentures an d 72.1% with overdentures. This difference in success rate was not sta tistically significant (p > 0.05). Patients with treatment failures in both groups required excessive maintenance care. Those with conventio nal dentures needed frequent denture base adjustments and relines, whe reas those with overdentures required frequent clip replacements and r epairs. Although significant improvements were seen with both treatmen t modalities, a higher percentage of patients with implant-supported o verdentures than those with conventional dentures reported improvement s in chewing comfort and moderate-to-complete overall satisfaction.