title: Patient satisfaction and dissatisfaction with mandibular two-implant overdentures using different attachment systems: 5-year outcomes.
abstract: BACKGROUND
  Different attachment systems for mandibular two-implant overdentures could influence levels of patient satisfaction. Positive consensus of the majority of patients being satisfied does not preclude the possibility of dissatisfaction for some.
  
  
  OBJECTIVE
  To evaluate patient satisfaction and dissatisfaction before and after 5 years of wearing mandibular two implant overdentures using different attachment systems ; to determine the prognostic relevance of pretreatment complete denture complaints to treatment outcomes.
  
  
  METHODS
  A total of 106 edentulous participants enrolled in a clinical trial completed a preliminary self-report inventory of their original complete denture complaints.New complete maxillary dentures and mandibular two-implant overdentures were provided to each participant using one of six different attachment systems. Patient satisfaction was determined at pretreatment; at baseline with mandibular two-implant overdenture insertion; and then annually for 5 years, using visual analogue and Likert-type scales.
  
  
  RESULTS
  Patient satisfaction with mandibular two-implant overdentures showed significant changes pre- to posttreatment(baseline) in all domains, but these were significant immediately and maintained without further significance for 5 years, other than pain with the overdenture. After 5 years, no significant differences were observed with all the attachment systems. Highly significant differences were found with some social and psychological aspects by the fifth year compared to baseline. Diagnostic and prognostic indicators from a pretreatment inventory identified 12 participants (13.5%) who were dissatisfied. These indicators revealed a maladaptive predisposition to mandibular two-implant overdentures.
  
  
  CONCLUSIONS
  The provision of mandibular two-implant overdentures will, in the majority of patients, significantly enhance levels of patient satisfaction for 5 years, as compared to complete mandibular dentures, regardless of the attachment system. Careful evaluation of pretreatment complaints with conventional dentures can possibly identify patient dissatisfaction with mandibular two-implant overdentures [corrected].
authors.affiliation: Oral Implantology Research Group, Sir John Walsh Research Institute, School of Dentistry, University of Otago, Dunedin, New Zealand.
authors.forename: Mohammed I
authors.initials: MI
authors.lastname: Al-Zubeidi
authors.forename: Nabeel H M
authors.initials: NH
authors.lastname: Alsabeeha
authors.forename: W Murray
authors.initials: WM
authors.lastname: Thomson
authors.forename: Alan G T
authors.initials: AG
authors.lastname: Payne
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D000704:Analysis of Variance; D017268:Dental Prosthesis Retention / Q000295:instrumentation* / Q000523:psychology*; D019094:Dental Prosthesis, Implant-Supported / Q000523:psychology*; D003828:Denture, Overlay / Q000523:psychology*; D006801:Humans; D008334:Mandible; D010147:Pain Measurement; D017060:Patient Satisfaction; D057566:Self Report