Implant-Supported Fixed Dentures Versus Implant-assisted Over-Dentures: A Prospective Follow up Study of the ability of Prosthetic Rehabilitation in the Mandible to Achieve Patient satisfaction

Background: Clinical experiences showed that most patients prefer the fixed prosthetic replacement of their missing teeth over the removable modalities, therefore this study was conducted to compare implants survival rate, prosthetic rehabilitation results and patient satisfaction in two groups of patients using lower conventional complete dentures which were replaced by either implant supported fixed dentures or implant assisted over-dentures. Patients and methods: Fifty patients with edentulous mandible were studied. An approval of the different treatment conditions and types for replacement of their lower missing teeth was obtained from all studied patients and the study protocol was approved by the ethical committee of the royal medical services armed forces in Jordan. An implant-supported fixed dentures (ISFDs) were made to half of them, and implant assisted over-denture (IODs) to the other. The implant fixtures were selected with the same length and diameter and inserted by the same clinician. All the delivery of the prosthesis was done after 6 weeks period of the insertion time. The radio-graphical examination and patients' satisfaction were performed after 6 months, 1 year and 3 years. Results: The survival rate of all implants used for rehabilitation was (100 %). The mean crestal bone resorption was 1.1 (SD = 0.7) after 3 years examination period in patients using ISFDs and 1.5mm (SD = 0.7) in patients using IODs. Unsurprisingly, patient's satisfaction with ISFDs was higher than that with IODs. Conclusion: Both the treatment modalities are efficient prosthetic option for mandibular rehabilitation of edentulous mandible. Although many patients still prefer the fixed option, both modalities improved patient satisfaction and oral health quality of life.