Randomized clinical trial comparing the efficacy of mandibular implant-supported overdentures and conventional dentures in diabetic patients. Part III: Comparisons of patient satisfaction

Statement of problem. There is insufficient evidence to indicate the functi onal superiority of mandibular implant-supported overdentures to justify th eir use in edentulous patients. Purpose. This study compared the benefits perceived by patients who receive d a new maxillary denture and a mandibular conventional denture (CD) and an implant-supported overdenture (IOD). Method. New maxillary and mandibular dentures were delivered to 89 diabetic denture wearers with clinically acceptable metabolic control mho treated t heir diabetes either with insulin (IT) or without insulin (NIT). Of the: 89 patients, 37 received maxillary and mandibular CDs and 52 received a. maxi llary CD and an IOD. Two questionnaires with categorical responses were use d; the first contained 13 questions to ascertain a. patient's absolute asse ssments of original dentures at entry and study dentures at 6- and 24-month s after treatment completion; the second questionnaire had 11 questions tha t assessed the relative change perceived by patients with study dentures. O f the 78 patients who completed the posttreatment (PT) assessments at 6 mon ths, 65 patients provided longitudinal data for questionnaire I and cross-s ectional data For questionnaire II. In addition, 46 patients (18 CD and 28 IOD) also provided PT assessments at 24 months. Results. Both mean scores and percentage distributions of longitudinal data for questionnaire I showed perceptual improvements with both types of stud y dentures. Improvements mere higher in the IOD than in the CD group. Mean scores failed to show any significant differences between the 2 treatment g roups. The only significant difference was found in the change in percentag e distributions for perceptual chewing ability in favor of the IOD group. E ven this advantage was lost at 24 months. With the comparative questionnair e, a. higher percentage of patients in the IOD group than in the CD group p erceived improvements with study dentures from their original dentures in c hewing ability , chewing comfort, and denture security. However, mean diffe rences were statistically significant in favor of the IOD group only for ch ewing ability and less difficulty to chew hard foods. Conclusion. The mandibular implant-supported overdenture offers same advant age in terms of perceived chewing function over the conventional denture.