de Bruyn, Frank (2020) A randomized crossover clinical investigation on the impact of the bar design of implant-supported mandibular overdentures on patients level of satisfaction: a report of preliminary results. thesis, Dentistry.
Full text available on request.Abstract
Introduction Although it has been shown that patients with severe bone loss in the lower jaw experience more favorable treatment results with implant-supported mandibular overdentures compared to a conventional denture, there have been few studies examining the different designs of implant-supported mandibular overdentures. This study examines the differences between two commonly used bar designs. The research question was whether there was a difference in OHRQoL and chewing capacity between the egg-bar without extensions and the u-bar with extensions supporting a mandibular overdenture. The aim was to evaluate the outcome (OHRQoL, chewing capacity and contentment) of the two treatment modalities in order to make a statement about which bar design should be preferred in the context of these findings. Materials and methods A randomized cross-over clinical study was conducted to compare two commonly used design strategies. A design consisting of a bar with a round shape (egg-bar) without extensions was compared to a design consisting of a bar with a rectangular shape (u-bar) with extensions. Due to the limited time available to acquire a large group of test subjects, it was decided to conduct a pilot study. Twelve fully edentulous subjects received a new conventional maxillary full arch denture. Five of these test subjects received an implant-supported mandibular overdenture supported by an egg-bar without extensions. The other seven received an implant-supported mandibular denture supported by a u-bar with extensions. After three months the Oral Health-related Quality of Life (OHRQoL) was measured by means of the Dutch version of the Oral Health Impact Profile (OHIP-NL49), the chewing capacity was measured with the Mixing Ability Index (MAI), and the test subjects’ contentment was expressed using a Visual Analogue Scale (VAS). After these measurements the subjects changed bar design. Three months later the OHRQoL, chewing capacity and contentment were measured again and the test subjects were asked which bar design they preferred and wanted to keep. Results OHIP-NL49 scores, MAI scores and VAS scores were not significantly different between the two bar systems. At the end of the research nine out of twelve test subjects chose to keep the u-bar with extensions. No correlation between OHIP-NL49 scores and MAI scores was found. One test subject chose to keep the egg-bar without extensions and two subjects did not have a predilection for one of the constructions. When asked at the end of the two interventions, the majority of the subjects preferred to have the u-bar with extensions due to the enhanced retention and stability they provide. Discussion Further research is needed to investigate if a larger group, with more statistical power, shows the same results as found in this study. This should be done using adequate methods for determining OHRQoL in patients using an implant-supported mandibular overdenture. Conclusion Having distal extensions on the bar does not favorably influence OHRQoL, chewing capacity and contentment in fully edentulous subjects with an implant-supported mandibular overdenture. However, in situations where it is difficult to choose between an egg-bar without extensions and a u-bar with extensions, this study seems to show a tendency towards more subjects preferring the better retention and stability of the u-bar with extensions.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Slot, dr. J.W.A and Jensen-Louwerse, dr. C. |
| Faculty: | Medical Sciences |
| Date Deposited: | 06 Mar 2023 12:55 |
| Last Modified: | 06 Mar 2023 12:55 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3449 |
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