title: Patient satisfaction and preference with magnet, bar-clip, and ball-socket retained mandibular implant overdentures: a cross-over clinical trial.
abstract: OBJECTIVE
  The purposes of this study were to: (1) determine patient satisfaction with implant-supported mandibular overdentures using magnet, bar-clip, and ball-socket attachments; and (2) assess the relation between maximum bite force and patient satisfaction.
  
  
  METHODS
  In a cross-over clinical trial, 18 edentulous patients with mandibular denture complaints received two mandibular implants and new mandibular and maxillary dentures. The mandibular denture was initially without any kind of attachment system, but it was fitted with one of the attachment types after 3 months. The attachments were changed 3 months thereafter, in random order. A questionnaire on denture complaints was administered at baseline (with the old denture), after 3 months of function with the new denture without attachments, and after 3 months of function with each of the attachments (within-subject comparison). In addition, patients were asked to express their overall appreciation of their dentures on a VAS. Patients' preferences were determined at the end of the experiment. Maximum bite forces were obtained from a previous study with the same population. Five scales of denture complaints were constructed. Mean scale and VAS scores at the five evaluation points were compared among the groups. Pearson correlation was calculated between maximum bite force and scale and VAS scores.
  
  
  CONCLUSIONS
  Mandibular implant-supported overdenture treatment reduced various denture complaints. The VAS score better reflected patients' preferences than did scale score. Patients strongly preferred bar-clip (10/18 subjects) and ball-socket attachments (7/18 subjects) over magnet attachments (1/18 subjects). Patients' preferences could not be predicted on the basis of baseline observations. Maximum bite force was not correlated to scale or VAS score. Hence, patients with higher maximum bite forces were not necessarily more satisfied.
authors.affiliation: Department of Oral-Maxillofacial Surgery, Prosthodontics and Special Dental Care, University Medical Center, Utrecht, The Netherlands. m.s.cune@med.uu.nl
authors.forename: Marco
authors.initials: M
authors.lastname: Cune
authors.forename: Frits
authors.initials: F
authors.lastname: van Kampen
authors.forename: Andries
authors.initials: A
authors.lastname: van der Bilt
authors.forename: Frits
authors.initials: F
authors.lastname: Bosman
mesh_terms: D000328:Adult; D001294:Attitude to Health; D001732:Bite Force; D018592:Cross-Over Studies; D019094:Dental Prosthesis, Implant-Supported; D003819:Denture Bases; D003779:Denture Design; D003781:Denture Retention; D003826:Denture, Complete, Lower; D003828:Denture, Overlay; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007575:Jaw, Edentulous / Q000534:rehabilitation; D008280:Magnetics / Q000295:instrumentation; D008297:Male; D008334:Mandible; D008409:Mastication / Q000502:physiology; D008875:Middle Aged; D017060:Patient Satisfaction; D016896:Treatment Outcome