Page 130 - Peri-implant health: the effect of implant design and surgical procedure on bone and soft tissue stability

CHAPTER 5
functional limitation, physical disability and handicap the effect size was moderate. For the other four domains, a large effect size was observed and most expressed for physical pain with an effect size of 1.04. The latter is logically given the fact that improved denture retention results in less mucosal irritation and consequently fewer complaints related to pain suffering.
Table 5. Mean OHIP score and the mean difference for each of the seven domains before surgery and three months after connection with the calculated effect-size.
Domain
mean-OHIP (SD)
Paired difference
Effect-size
Before surgery
3-months after connection
Mean dif
95% CI
P
Functional limitation
Physical pain
Psychological discomfort
Physical disability
Psychological disability
Social disability Handicap
2.30 (1.85)
3.37 (2.06) 2.52 (2.35)
2.12 (2.16) 2.21 (1.91)
1.67 (1.49) 1.42 (1.48)
1.14 (1.42)
1.21 (1.55) 0.65 (1.43)
0.44 (0.85) 0.58 (0.93)
0.16 (0.49) 0.26 (0.66)
The current paper focuses
completely edentulous in
problem in this category of patients, especially in the mandible as compared to the maxillary denture. The denture in the mandible is less retentive because of a smaller crestal bone support, a more expressed degree of bone resorption, and unfavorable distribution of occluding forces, as well as additional pressure of the tongue yielding dislocating forces. Often this results in functional discomfort and pain, the latter because of the absence of keratinized mucosa. In the maxilla, the denture is supported on the crest and on the hard structure of the palate, which is covered by keratinized tissue. A vacuum present during mastication, between the palatal coverage of the denture and the underlying tissues, improves the retention. Consequently, fully edentulous patients have more complaints with mandibular dentures and an overdenture retained on two implants has therefore been suggested as of minimal care in order to provide functional comfort [6].
■ DISCUSSION
128
1.16 (0.540,1.785)
2.16 (1.440,2.886) 1.87 (1.034,2.687)
1.68 (0.971,2.378) 1.63 (0.930,2.326)
1.51 (1.007,2.016) 1.16 (0.683,1.642)
0.001 0.63
<0.001 1.04 <0.001 0.80
<0.001 0.78 <0.001 0.85
<0.001 1.01 <0.001 0.78
on implant treatment outcome in patients, which were both jaws. Retention of the lower denture is a typical