Treatment outcomes of fixed or removable implant-supported prostheses in the edentulous maxilla. Part I: patients' assessments.
BACKGROUND
Distinct clinical parameters determine whether fixed or removable implant-supported prostheses are indicated to restore the edentulous maxilla. However, there is a strong belief that fixed implant prostheses meet with greater patient acceptance and satisfaction, but this may differ from the patients' perceptions, their psychological responses to treatment, and their assessments of the treatment outcome.


OBJECTIVE
This prospective clinical study compared the treatment outcomes of fixed and removable implant-supported restorations in the edentulous maxilla with the main emphasis on the patient's point of view.


METHODS
Twenty patients who requested an implant-supported superstructure to restore the edentulous maxilla were asked to complete a questionnaire measuring their satisfaction with the present situation and the psychologic impact of their oral health status with their responses marked on a Visual Analog Scale (VAS). Ten patients were treated with a fixed, screw-retained implant prosthesis (group 1), and 10 were treated with a removable, implant-supported and bar-retained overdenture (group 2). Six months after prosthetic rehabilitation, patients were again given the questionnaire to assess their psychologic well-being and satisfaction with the implant-supported restoration.


RESULTS
Both prosthesis designs were associated with significant improvements in comfort and retention, function, esthetics and appearance, taste, speech, and self-esteem. No difference was found between the 2 groups with respect to how the patients assessed the implant therapy. However, the results indicated that patients in group 2 experienced greater differences between pretreatment and posttreatment scores for the parameters esthetics, taste, and speech. Treatment costs per unit were significantly higher in group 1 than in group 2.


CONCLUSIONS
Patients in groups 1 and 2 were similarly satisfied with their implant-supported prostheses in the edentulous maxilla with regard to their well-being and the cost-utility, irrespective of whether the restoration was fixed or removable.
Zitzmann
N U
NU
University of Basel, Basel, Switzerland. zitzmann@ubaclu.unibas.ch
Marinello
C P
CP
D000328:Adult; D000368:Aged; D001294:Attitude to Health; D019094:Dental Prosthesis, Implant-Supported / Q000191:economics / Q000523:psychology; D003779:Denture Design / Q000191:economics; D003781:Denture Retention; D003827:Denture, Complete, Upper / Q000191:economics / Q000523:psychology; D003828:Denture, Overlay / Q000191:economics; D004955:Esthetics, Dental; D005260:Female; D005500:Follow-Up Studies; D017048:Health Care Costs; D006304:Health Status; D006801:Humans; D007575:Jaw, Edentulous / Q000534:rehabilitation*; D008297:Male; D008437:Maxilla; D008875:Middle Aged; D009909:Oral Health; D017060:Patient Satisfaction; D011446:Prospective Studies; D012649:Self Concept; D013060:Speech / Q000502:physiology; D011795:Surveys and Questionnaires; D013649:Taste / Q000502:physiology; D016896:Treatment Outcome