Patient-reported outcome measures (PROMs) and maintenance events in 2-implant-supported mandibular overdenture patients: A 5-year prospective study

Clin Oral Implants Res. 2019 Mar;30(3):261-276. doi: 10.1111/clr.13412. Epub 2019 Feb 18.


Objective: To prospectively evaluate patient-reported outcome measures (PROMs) and treatment outcomes of mandibular two-implant retained overdentures (IOD) in an edentulous geriatric cohort with history of deficient complete dentures (CD).

Materials and methods: A total of 103 patients with deficient CD received new optimal CD. After a period of 3 months, 80 of the patients voluntarily received IOD. Outcomes collected at pre-, post-CD/post-IOD treatment annually up to 5 years, included (a) Clinical outcomes: denture-quality (Woelfel's index), complications, and maintenance events, (b) PROMs: patient complaints (maxillary, mandibular functional complaint scores, generic aesthetic complaint scores, frequency, and intensity of complaints) and patient satisfaction, and (c) Maintenance events: technical complications and adverse events.

Results: Five-year data were collected from 67 patients (mean age at initiation = 71.3 years, mean observation = 5.9 years) with cumulative implant survival rate = 98.72%. Multiple comparisons for 8 time points showed significant improvements in denture quality and PROMs after new CD and IOD delivery. Further significant improvements were only after IOD delivery in: mandibular denture-quality, mandibular and generic functional complaints, frequency, intensity of complaints, and overall patient satisfaction score. Thereafter, denture-quality and PROMs remained stable. Maintenance events clustered on 1st year and within a minority of patients. Technical complications and overall maintenance events significantly correlated with overall patient satisfaction score at 1st year.

Conclusions: Mandibular IOD was a beneficial treatment option for seniors with history of deficient CD, improving denture-quality, patient satisfaction, and reducing patient complaints up to 5 years. Maintenance events clustered on 1st year, showing no significant impact on long-term patient satisfaction and other PROMs.

Keywords: dental implant; implant-supported overdenture; oral health-related quality of life health; overdenture; patient-reported outcome measures.

MeSH terms

  • Aged
  • Dental Prosthesis, Implant-Supported
  • Denture Retention
  • Denture, Complete, Lower
  • Denture, Overlay*
  • Esthetics, Dental
  • Humans
  • Mandible
  • Patient Reported Outcome Measures*
  • Patient Satisfaction
  • Prospective Studies
  • Treatment Outcome