Page 115 - Peri-implant health: the effect of implant design and surgical procedure on bone and soft tissue stability

IMPROVEMENT OF QUALITY OF LIFE WITH IMPLANT-SUPPORTED MANDIBULAR OVERDENTURES AND THE EFFECT OF IMPLANT TYPE AND SURGICAL PROCEDURE ON BONE AND SOFT TISSUE STABILITY
■ INTRODUCTION
Edentulousness is widely spread worldwide. According to the WHO the prevalence in the elderly population is 26% in the USA and between 15% and 78% in European countries. Among the edentulous population, a strong negative impact of poor oral conditions on daily life has been described. Edentulism could lead to diet changes where food rich in saturated fats and cholesterol are preferred. Besides diet changes, edentulousness is an independent risk factor for weight loss and could lead to social handicaps related to communication.1
The support of a dental prosthesis by two implants could improve the chewing ability, retention, and stability of the prosthesis, which could lead to higher satisfaction and health-related quality of life. Dental implants have been used since the early sixties to replace missing teeth by fixed or removable prostheses. Nowadays, this yields a predictable treatment outcome with success over 95% after 10 years of function.2
To measure the improvement in health-related quality of life, the Oral Health Impact Profile (OHIP) is a widely used tool to assess currently applied dental procedures. It has also been used for evaluating the quality of life in more invasive surgical interventions in oral surgery.3 The tool consists of a questionnaire to measure the impact of medical care on functional and social wellbeing.4 Allen and McMillan reported significant improvement in satisfaction and health-related quality of life for patients who received implant-retained prostheses compared to those who received conventional dentures.5 A panel of experts published a consensus statement where they described overwhelming evidence for a 2-implant supported overdenture as the first choice of treatment for the edentulous mandible instead of a conventional denture.6
A recent review focusing on the Patient-Reported Outcome Measures (PROMs) showed compelling evidence to support that the fully edentulous patients experience higher satisfaction with an implant-supported overdenture in the mandible compared to a conventional denture.7 These findings were confirmed by several other recent systematic reviews and meta-analyses.8-10
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