Strategic implant placement under removable dentures improves quality of life

Objectives: Patients with complete dentures and patients with removable partial dentures (RPDs) with a low number of remaining abutments are often discontent with their oral situation. For these patients implant placement under the existing denture often seems to be a reasonable treatment option. One of the aims of this study was to measure the effect of these additional abutments on oral health-related quality of life (OHRQoL). Material and Methods: Eighteen patients (7 women, 11 men; mean age: 63±6 years) participated in this prospective clinical study. They had either complete dentures (group_A, n=8)) or RPDs retained by 1-2 telescopic crowns with natural abutments (group_B, n=10) in the study arch (maxilla: 5x, mandible: 13x). The total number of abutments was increased to 6 in the maxilla and to 4 in the mandible by placing implants (Screw-Line-Implants, Camlog, Switzerland) in strategically advantageous regions. Spherical head attachments (Dalbo-plus, Cendres&Metaux, Switzerland) were integrated into the existing denture. The Oral Health Impact Profile (OHIP-49) was completed by participants before implant placement (pre-treatment), six weeks (6wks) and six months (6m) after integration of the spherical head attachments. Statistical analysis was performed with the Wilcoxon rank sum test (within group comparison) and the Wilcoxon signed rank test (inter group comparison) both adjusted according to Bonferroni-Holm. Results: Medians of the OHIP total-scores were in Group_A: 91.5 (pre-treatment), 19.0 (6wks), and 7.0 (6m), and in Group_B: 48.5 (pre-treatment), 9.5 (6wks), and 9.5 (6m). Differences between pre-treatment and 6wks or 12m (P≤0.05) were significant in both groups, but they were not significant between 6wks and 12m (P>0.05). Between denture groups no significant differences could be shown for any observation time (P>0.05). Conclusion: A strategic placement of implants under the existing denture seems to be useful to improve OHRQoL, even in telescopic crown retained RPDs with 1-2 natural abutment teeth.