Effect of implant-supported or retained dentures on masticatory performance: A systematic review

Removable Partial Denture Prosthodontics, Tokyo Medical and Dental University, Tokyo, Japan.
Journal of Prosthetic Dentistry (Impact Factor: 1.42). 01/2008; 98(6):470-7. DOI: 10.1016/S0022-3913(07)60147-4
Source: PubMed

ABSTRACT While subjective patient-based measures have been increasingly recognized as critical outcomes for prosthodontic treatment, there continues to be a need to validate for patients what changes in masticatory function can be expected with the provision of new implant-supported or retained dentures.
The purpose of this review was to evaluate the critical factors impacting change in masticatory performance following the provision of new implant-supported or retained dentures.
Information retrieval followed a systematic approach using PubMed and the Cochrane Library. English articles published from 1966 to June 2007, in which the masticatory performance of subjects with implant-supported or retained dentures was assessed by objective methods and compared to performance with conventional dentures, were included. Ratings of the evidence provided in each article followed United States Agency for Healthcare Research and Quality recommendations.
From 281 articles identified, 18 peer-reviewed articles met prespecified criteria for inclusion. Specific outcomes of significance identified by these articles rated as level II are: (1) fixed implant-supported partial dentures do not provide significant improvement in masticatory performance compared to conventional removable partial dentures for Kennedy Class I and II partially edentulous mandibles; (2) the combination of a mandibular implant-supported or retained overdenture (IOD) and maxillary conventional complete denture (CD) provides significant improvement in masticatory performance compared to CDs in both the mandible and maxilla for a limited population having persistent functional problems with an existing mandibular CD due to severely resorbed mandible; and (3) the type of implant and attachment system for mandibular IODs has a limited impact. Specific outcomes of significance identified by articles rated as having a moderate level of evidence (level III) are: (1) mandibular fixed implant-supported complete dentures provide significant improvement in masticatory performance compared to mandibular CDs in subjects dissatisfied with their CDs; and (2) implant-supported mandibular resection dentures have an advantage over conventional dentures in masticatory performance on the defect side of the mouth.
Objective benefits in masticatory performance of implant-supported or retained dentures compared to conventional dentures are limited to a mandibular IOD in edentulous patients with a resorbed mandible and/or difficulty adapting to CDs.

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    • "To overcome these problems, implants have been increasingly used to retain complete dentures and have demonstrated to be a successful treatment alternative for edentulous patients with mandibular denture predicament (Fueki et al., 2007, Rashid et al., 2011, Barao et al., 2013). Despite these clear benefits, there have been reports concerning severe residual ridge resorption associated with implant-retained overdentures (Jacobs et al., 1992, Blum and McCord, 2004). "
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    ABSTRACT: Although implant-retained overdenture allows edentulous patients to take higher occlusal forces than the conventional complete dentures, the biomechanical influences have not been explored yet. Clinically, there is limited knowledge and means for predicting localized bone remodelling after denture treatment with and without implant support. By using finite element (FE) analysis, this article provides an in-silico approach to exploring the treatment effects on the oral mucosa and potential resorption of residual ridge under three different denture configurations in a patient-specific manner. Based on cone beam computerized tomography (CBCT) scans, a 3D heterogeneous FE model was created; and the supportive tissue, mucosa, was characterized as a hyperelastic material. A measured occlusal load (63N) was applied onto three virtual models, namely complete denture, two and four implant-retained overdentures. Clinically, the bone resorption was measured after one year in the two implant-retained overdenture treatment. Despite the improved stability and enhanced masticatory function, the implant-retained overdentures demonstrated higher hydrostatic stress in mucosa (43.6kPa and 39.9kPa for two and four implants) at the posterior ends of the mandible due to the cantilever effect, than the complete denture (33.4kPa). Hydrostatic pressure in the mucosa signifies a critical indicator and can be correlated with clinically measured bone resorption, pointing to severer mandibular ridge resorption posteriorly with implant-retained overdentures. This study provides a biomechanical basis for denture treatment planning to improve long-term outcomes with minimal residual ridge resorption. Copyright © 2014 Elsevier Ltd. All rights reserved.
    Journal of Biomechanics 12/2014; 48(3). DOI:10.1016/j.jbiomech.2014.11.043 · 2.50 Impact Factor
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    • "Implant treatment has recently become a prosthodontic treatment option for missing teeth. Rehabilitation of oral function by an implant-supported prosthesis can restore jaw and oral functions to a dentate jaw to their previous level or even better [14] [15] [16] [17] [18]. Because osseointegration cannot restore the periodontal membrane, the stimulus delivered to the trigeminal nerve via the periodontal membrane decreases. "
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    ABSTRACT: The present study was carried out to identify how gum chewing with and without occlusal support by implant prostheses affects brain function as well as chewing function. Twenty-four subjects rehabilitated with implant-supported fixed prostheses were evaluated. An electroencephalograph (EEG) (ESA-Pro) and mandibular kinesiograph (Bio PAK(®)) wear used to measure brain function and chewing function, respectively, before and after gum chewing with and without an implant superstructure. Based on brain function estimated by the Dα values derived from measurement data, the subjects were divided into the normal region group (including the sub-normal region group) (n=15; Dα≥0.952) and the impaired region group (n=9; Dα<0.952). All the data were statistically analyzed using the Wilcoxon test (α=0.05). Brain function in the normal region group showed no change after gum chewing, whether or not an implant superstructure was in place (p>0.05). However, brain function in the impaired region group showed significant improvement after gum chewing (p<0.05). Seven of 9 subjects using an implant superstructure in impaired region group indicated an increase or no change in brain function compared to the results without an implant superstructure. In the impaired region group, there was a high positive correlation between brain function and masticatory movement (γ=0.75). Subjects in the impaired region group revealed a strong positive correlation between brain function and masticatory movement, indicating that occlusal support by implant-supported fixed prostheses has the potential to enhance brain function.
    02/2011; 55(4):206-13. DOI:10.1016/j.jpor.2011.01.003
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    • "While a number of studies on masticatory performance have been conducted in patients with various designs of implant dentures, high-level evidence supporting advantages in masticatory performance of implant restorations over conventional dentures is limited. Objective benefits in mastication compared with conventional dentures have been substantiated for mandibular implant dentures in edentulous patients with resorbed mandibles and/or difficulty adapting to conventional removable complete dentures (Fueki et al. 2007). In the present investigation, however, three-quarters of the sample were convinced of the advantages of fixed dentures over their removable alternatives (same rate as in 2003). "
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    ABSTRACT: Little is known about the level of information on implant dentistry in the public. A representative opinion poll on dental implants in the Austrian population was published in 2003 (Clinical Oral Implants Research 14:621-642). Seven years later, the poll was rerun to assess the up-to-date information level and evaluate recent progress and trends in patients' mindset on dental implants. One thousand adults--representative for the Austrian population--were presented with a total of 19 questionnaire items regarding the level and the sources of information about dental implants as well as the subjective and objective need for patient information. Compared with the survey of 2003, the subjective level of patient information about implant dentistry has significantly increased in the Austrian population. The patients' implant awareness rate was 79%. The objective level of general knowledge about dental implants was still all but satisfactory revealing unrealistic patient expectations. Three-quarters trusted their dentists for information about dental implants, while one-quarter turned to the media. The patients' wish for high-quality implant restorations was significantly higher than in 2003, yet the majority felt that only specialists should perform implant dentistry. This representative survey reveals that dentists are still the main source of patient information, but throws doubt on the quality of their public relations work. Dentists must improve communication strategies to provide their patients with comprehensible, legally tenable information on dental implants and bridge information gaps in the future.
    Clinical Oral Implants Research 11/2010; 22(2):223-9. DOI:10.1111/j.1600-0501.2010.02035.x · 3.12 Impact Factor
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