title: Patients' perspectives on zirconia and titanium implants with a novel distribution supporting maxillary and mandibular overdentures: a qualitative study.
abstract: OBJECTIVE
  This qualitative study explored the perceptions of edentulous patients regarding their rehabilitation with maxillary and mandibular implant-supported overdentures employing a protocol that featured novel implant sites and distribution.
  
  
  METHODS
  In-depth semi-structured interviews were conducted with 16 participants who have taken part in a randomized controlled trial. Each received implant overdentures supported by either titanium or zirconia one-piece implants. Participants received four implants in the maxilla and three implants in the mandible. The implant distribution was: in the maxilla, a mid-palatal implant, and three anterior implants in the incisor and first premolar regions; in the mandible, a mid-symphseal implant, and bilateral distal implants in the first molar region. All interviews were conducted by a researcher not involved with the clinical aspect of the randomized controlled trial and were transcribed verbatim and analyzed using a thematic inductive analysis approach.
  
  
  RESULTS
  The perceived advantages of the treatment were functional improvement and increased social confidence. Cost was a significant barrier for edentulous patients seeking implant treatment. Previous experience with complete dentures, age and length of treatment was further factors that influenced decisions regarding prosthodontic rehabilitation. The novel implant protocol was acceptable to patients.
  
  
  CONCLUSIONS
  Implant overdentures improve the quality of life of edentulous patients. Acceptance of dental implants may be increased by mitigating the cost of treatment. The mid-palatal implant site may be a potential alternative to extensive surgical procedures during the prosthodontic rehabilitation of atrophic maxillary ridges. The mandibular design offers patients the advantages of a removable prosthesis with increased retention.
authors.affiliation: Oral Implantology Research Group, Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand; Department of Prosthetic Dentistry, Cairo University, Cairo, Egypt.
authors.forename: Reham B
authors.initials: RB
authors.lastname: Osman
authors.forename: Kate C
authors.initials: KC
authors.lastname: Morgaine
authors.forename: Warwick
authors.initials: W
authors.lastname: Duncan
authors.forename: Michael V
authors.initials: MV
authors.lastname: Swain
authors.forename: Sunyoung
authors.initials: S
authors.lastname: Ma
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003758:Dental Implantation, Endosseous / Q000379:methods*; D019094:Dental Prosthesis, Implant-Supported; D003828:Denture, Overlay; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008334:Mandible / Q000601:surgery; D008437:Maxilla / Q000601:surgery; D008875:Middle Aged; D017060:Patient Satisfaction; D036301:Qualitative Research; D011788:Quality of Life; D014025:Titanium; D016896:Treatment Outcome; D015040:Zirconium
chemical_list: D015040:Zirconium; D014025:Titanium; C028541:zirconium oxide
keywords: implant and overdentures; mandible; maxilla; patient perceptions