Psychometric Analysis and Masticatory Efficiency of Elderly People with Single-Implant Overdentures

Purpose: The aim of this paired clinical study was to evaluate psychometric parameters (patient satisfaction and masticatory ability) and masticatory efficiency in elderly people before and after oral rehabilitation by a single-implant overdenture. Materials and Methods: This study included elderly individuals with residual alveolar bone height classified as Class III or IV according to the American College of Prosthodontics, and who wore clinically unsatisfactory complete dentures. Subjects first received new maxillary and mandibular conventional complete dentures. After 2 months of patient adaptation to the new complete dentures, subjective and objective variables were measured. Satisfaction with the new complete dentures was verified by applying a visual analog scale to rate patient satisfaction with stability, comfort, ability to chew, ability to speak, ease of cleaning, esthetics, and general satisfaction of their new complete dentures. Masticatory ability was assessed by asking participants to rate on a visual analog scale their ability to chew foods with different roughness and consistencies. Masticatory efficiency was measured by the sieving method using a siliconebased artificial test food. After evaluations were completed, each participant received one implant, which was placed in the symphysis region. After 3 months of implant osseointegration, the conventional complete dentures were transitioned to mandibular single-implant overdentures through placement of a low-profile attachment on the intaglio surface of the prostheses. Subjects used the single-implant overdentures for 2 months, and then all variables were reevaluated. Parametric t test and nonparametric Wilcoxon statistical tests were used to analyze data. Results: Participants reported increased satisfaction with stability of their mandibular single-implant overdentures compared with their new conventional complete dentures. However, satisfaction with the esthetics decreased when the new complete denture was converted into the singleimplant overdenture (P .05). Masticatory ability with the rehabilitation was not different between the new conventional complete dentures and the single-implant overdentures; however, transition to the single-implant overdenture greatly increased masticatory efficiency (P .0001). Conclusion: Single-implant overdentures changed the patient perceptions, improving their satisfaction with stability, although decreasing satisfaction with esthetics. Despite that, masticatory efficiency of elderly individuals with decreased residual bone height was greatly improved after single-implant overdenture use. Keywords: edentulous mandible, implant, mastication, overdenture, patient satisfaction