A randomized clinical trial comparing the efficacy of mandibular implant-supported overdentures and conventional dentures in diabetic patients. Part IV: Comparisons of dietary intake

Statement of problem. It is unclear whether the replacement of conventional mandibular dentures with implant-supported overdentures alters the diet an d thus improves the nutritional intake of edentulous persons. Purpose. The purpose of this study was to compare the pretreatment and post treatment diets of edentulous diabetic patients who received new dentures w ith either a conventional complete mandibular denture (CD) or a mandibular implant-supported overdenture (IOD). Material and methods. New dentures were made for 89 edentulous diabetic pat ients with acceptable metabolic control without insulin (NIT) or with insul in (IT). A randomized approach was used to assign 37 patients a mandibular CD and 52 patients a mandibular IOD supported by 2 cylindrical implants. Of the 89 patients, 58 submitted a dietary log for 7 consecutive days before treatment (PT) and 6 months after treatment completion (PTC). An average da ily intake of 28 essential nutrients was determined for each patient at eac h time interval. Separate 2 x 2 x 2 repeated analysis of variance (ANOVA) t ests were performed for each nutrient to compare the means of the 2 denture groups (CD and IOD), 2 diabetic groups (NIT and IT), and 2 time intervals (PT and PTC). The intakes were also compared with the recommended daily all owance (RDA). Results. ANOVAs for all 28 nutritional variables showed no main effect for either denture type or dia betic treatment. Time effects were seen for magn esium, potassium, copper, and monounsaturated fats. The PTC mean intake of the total sample (N = 58) decreased for all 3 minerals and increased for mo nounsaturated fats with study dentures. Post hoc tests showed the differenc es between PT and PTC means to be statistically significant for only magnes ium (P=.043) and potassium (P=.015). The percent age of patients with PT in take 25% or more below the RDA ranged from 33% to 85% in the CD group and f rom 24% to 100% in the IOD group for the same 11 nutrients. PTC fiber intak e deficiency was noted in almost all participants. Carbohydrate consumption was markedly lower than that recommended by the American Diabetic Associat ion. Conclusion. As is often the case with elderly groups, this group of edentul ous diabetic patients showed highly comprised nutritional intakes of fiber, vitamins, and minerals. The replacement of old dentures with new dentures that included either a mandibular CD or IOD did not alter patient diets suc h that the patients improved their nutritional intakes of essential micronu trients and macronutrients.