What does the research say about quality of life of a full lower denture and a two-implant retained lower denture?

Full denture versus two implant retained denture :  Two implant retained mandibular overdentures are often described as the treatment of choice in the edentulous mandible. This literature review is to analyse the literature with an unbiased approach, assessing the advantages and disadvantages of this treatment modality, and the implications on quality of life.

The consolidated evidence signifies the advantages of a two implant retained mandibular denture and overwhelming improvement in quality of life when compared to a conventional complete mandibular denture.

Introduction of Full denture versus two implant retained denture

Understanding the literature is key to providing the best in Implant Education. At Australasian Restorative and Implant Academy we see the benefit of reviewing the literature, looking at the latest in industry, understanding and leading the way in digital dentistry and educating that to the highest standard.

Edentulism and complete tooth loss is a common clinical finding. Common causes of the tooth loss include: abscess, periodontal disease, trauma, and vertical root fractures. This results in alveolar bone resorption and significant decreased masticatory forces.¹

Edentulous patients often have speaking and eating handicaps. This affects general and oral health, and impedes on a patient’s quality of life.² Despite the fact the percentage of edentulous patients has decreased in industrialised countries, the growth of the population over 65 years of age has led to an increase in edentulous adults.^2,3 It is the instability of conventional complete dentures in the mandible that results in the ongoing bone resorption, pain, soreness and impaired chewing ability.^2,4,5 Best Dental Implant Course. 

Quality of life improvements

A number of factors need to be assessed when considering the advantages and disadvantages of a two implant retained lower overdenture. ‘The overall findings are in agreement with results from randomised clinical trials on the positive impact’ of implant retained dentures on the quality of life for the edentulous patient.^7,15 This research presented in 2013, in the journal Clinical Oral Implant Research, specifically assesses only the oral health-related quality of life of the mandibular two implant overdenture.¹⁵ A total of 203 patients from North America, South America and Europe were followed for a mean time frame of 10.4 years.  “In South America, 100% of participants who received implant overdentures reported improvement in physical pain, compared to 66% in the conventional” denture group.¹⁵ Cultural differences were noted. However, improvement in oral health quality of life was unequivocal when comparing a two implant retained mandibular denture to a conventional complete mandibular denture.^7,15,16,17

CONCLUSION

Loss of the natural dentition may have an immediate impact on the quality of life of an individual. Negative changes can be seen from a masticatory perspective as well as psycho-social wellbeing.²¹ The introduction of the two implant retained mandibular overdenture has repeatedly shown a significant improvement in key quality of life indicators for these patients. In several countries around the world, the two implant retained denture is considered the minimum standard. Although, particular disadvantages may exist and alternative fixed prosthesis options are present.

The two implant retained denture should be considered to be minimum-standard in the edentulous mandible.