Effectiveness of three treatment modalities for the edentulous mandible - A five-year randomized clinical trial

Currently 3 treatment options are available for patients with denture compl aints and an edentulous mandible with a height of at least 15 mm: meticulou s construction of a new set of dentures (CD), construction of a new set of dentures following preprosthetic surgery to enlarge the denture-bearing are a (PPS), and construction of an implant-retained mandibular overdenture (IR O). The aim of this study was to evaluate patient satisfaction and subjecti ve chewing ability of edentulous patients treated with one of these treatme nt modalities. Ninety edentulous patients (Ca-wood class IV and V, mean man dibular height 20.7 mm) were randomly assigned to receive 1 of these 3 grou ps. Denture satisfaction and chewing ability were assessed using questionna ires focusing on denture-related complaints and problems chewing different types of food were assessed before treatment, and 1- and 5-years after trea tment. At the 1-year evaluation, significantly better scores were observed in the 2 surgical groups (IRO, PPS) than in the CD group. At 5-year evaluat ion the "complaints of the lower denture" showed a significantly better sco re in the IRO group when compared to the PPS and CD groups. No significant differences were observed between the PPS and CD group. From this study it is concluded that both in the short and long term denture satisfaction appe ars most favourable in the IRO group when compared to the PPS and CD groups . Implant-retained overdentures are therefore a satisfactory treatment moda lity for edentulous patients with problems with their lower denture, even i n cases of not severely resorbed mandibles.