CHANGES IN ORAL-HEALTH IMPACT PROFILE (OHIP) OF IMPLANT SUPPORTED MANDIBULAR PARTIAL OVERDENTURES IN RELATION TO IMPLANT POSITION AND SUPPORT

Background: Complete and partial tooth loss have been reported to have an adverse impact on patient appearance, phonetics, masticatory function, in addition to affecting the patient’s quality of life and general health. Removable partial denture have been the most commonly used treatment option for the replacement of missing teeth, yet it offers disadvantages with regard to retention and stability. The use of dental implants especially in free end saddle cases using the overdenture approach, have improved both retention and stability. The clinical success of implant supported prosthesis have been documented but its impact on the quality of life needs to be investigated. The OHIP-49 was used to determine the impact of oral health conditions on aspects of daily function, social interactions in seven domains. The aim of this clinical trial is to evaluate the changes in the oral health related quality of life of partially edentulous patients in relation to implant position and implant support, by installing two implants in a free end saddle and using an implant supported removable partial overdenture.
Materials and Methods: 14 partially edentulous patients of Kennedy class II modification 1 were selected from the outpatient of the Prosthodontics clinic –Cairo University. All patients were ranging from age 45-65 years old. All patients in the study were seeking implant installation with their remaining dentition in good periodontal health to receive a metal framework removable partial denture after all necessary operative procedures carried out. Patients with any contra-indications to implant placement were excluded from the study. All patients have received two implants in the pre-molar and molar regions of free end saddle region. After three month from implant installation, a secondary stage surgery was carried out and the two implants have received a healing abutment. A metal framework partial denture was then fabricated and delivered to all patients, supported by two healing abutments which was considered to be the base line group. After three month from delivery of the metal partial denture all patients were asked to fill the OHIP-49 chart, and then the patients were randomly divided into two groups the first group received a ball attachment at the premolar region, and the second group received a ball attachment at the molar region. The OHIP-49 was translated into Arabic and then filled by both groups after a 3 month follow up.
Results: There was no statistically significant difference of the total mean score of the OHIP-49 chart among the three groups of patients; base line group, first group and second group. The base line group have shown a non-significant decrease in the quality of life which was then improved by installation of a ball attachment in the first and second group, having the most non-significant improvement in the second group of patients. There was also a non-statistically significant difference of the seven subscales of the OHIP-49. The functional limitation, and physical pain of the OHIP-49 chart have shown the most improvement in the second group of patients when compared to the rest. Physical disability and Handicap subscales of the OHIP-49 chart were similar for the first and second groups, only the handicap encountering great improvement in the quality of life for base line group than the other two groups. While the Psychological discomfort, Physiological disability and Social disability were similar for all the three groups of patients.
Conclusion Implant supported removable partial denture with a ball attachment installed would improve the patient’s quality of life when compared to an implant tooth-tissue removable partial denture supported by healing abutments. There was no statically significant difference in the quality of life total scores with installation of a ball abutment at either the pre-molar or molar region, but a non-significant improvement in the quality of life have been encountered at the ball attachment installed in the molar region.