Treatment outcomes of fixed or removable implant-supported prostheses in the edentulous maxilla. Part I: Patients' assessments

Statement of problem. Distinct clinical parameters determine whether fixed or removable implant-supported prostheses are indicated to restore the eden tulous maxilla. However, there is a strong belief that fixed implant prosth eses meet with greater patient acceptance and satisfaction, but this may di ffer from the patients' perceptions, their psychological responses to treat ment, and their assessments of the treatment out come. Purpose. This prospective clinical study compared the treatment outcomes of fixed and removable implant-supported restorations in the edentulous maxil la with the main emphasis on the patient's point of view. Material and methods. Twenty patients who requested an implant-supported su perstructure to restore the edentulous maxilla were asked to complete a que stionnaire measuring their satisfaction with the present situation and the psychologic impact of their oral health status with their responses marked on a Visual Analog Scale (VAS). Ten patients were treated with a fixed, scr ew-retained implant prosthesis (group 1), and 10 were treated with a remova ble, implant-supported and bar-retained overdenture (group 2). Six months a fter prosthetic rehabilitation, patients were again given the questionnaire to assess their psychologic well-being and satisfaction with the implant-s upported restoration. Results. Both prosthesis designs were associated with significant improveme nts in comfort and retention, function, esthetics and appearance, taste, sp eech, and self-esteem. No difference was found between the 2 groups with re spect to how the patients assessed the implant therapy. However, the result s indicated that patients in group 2 experienced greater differences betwee n pretreatment and posttreatment scores for the parameters esthetics, taste , and speech. Treatment costs per unit were significantly higher in group 1 than in group 2. Conclusion. Patients in groups 1 and 2 were similarly satisfied with their implant-supported prostheses in the: edentulous maxilla with regard to thei r well-being and the cost-utility, irrespective of whether the restoration was fixed or removable.