Does mandibular condition affect prosthetic treatment success in edentulous elders?

Objectives: The aim of this study is to determine whether mandibular condition affects patients' ratings of satisfaction and function with mandibular implant overdentures and conventional dentures.

Methods: 214 edentulous elders were randomly allocated into 2 groups and treated with maxillary conventional dentures and either mandibular overdentures supported by two implants with ball attachments or mandibular conventional dentures. Classification of mandibular bone height and alveolar resorption was carried out on panoramic radiographs using 4 published methods. Maxillomandibular relationship, mandibular ridge form and soft tissue quality were also recorded. At baseline and at 6 months after delivery, all participants rated their satisfaction with their prostheses using the McGill Denture Satisfaction Instrument. Independent t-tests and a linear multivariable regression model were used.

Results: Mandibular condition has no effect on ratings of general satisfaction with prostheses, nor on satisfaction with ability to chew, stability, comfort, aesthetics and ability to speak at 6 months (p>0.05, linear regression). There were significant between-treatment differences in ratings of general satisfaction in all mandibular condition categories, with greater general satisfaction ratings assigned to implant overdentures. These differences were also seen for comfort, stability and ability to chew (p<0.01, t-tests). For general satisfaction, as well as satisfaction with ability to chew, stability, comfort, aesthetics and ability to speak, results confirm that, at 6 months after delivery, treatment with implant overdentures contributes to higher satisfaction ratings (p<0.001, linear regression).

Conclusion: The results of this study do not support the assumption that the condition of the mandible has an effect on elderly edentulous patients' satisfaction with their prostheses. Therefore, the condition of the mandible may not be an appropriate criterion for choice of prosthesis type. No matter what mandibular condition, elderly patients will experience greater satisfaction with implant overdentures than with conventional dentures.