Short-term quality of life change perceived by patients after transition to mandibular overdentures

Tooth-Supported Overdentures Revisited

The goal of prosthodontics is to provide a functional prosthesis to restore aesthetics, functions, and masticatory efficiencies. Tooth-supported overdentures are one of the treatment options for removable dentures. This article aims to discuss the advantages and disadvantages of tooth-supported overdentures and the principles of using various overdenture attachments, including non-attachment overdentures. The common treatment options in preparing the overdenture abutment are either with or without abutment coping with or without attachment systems, which were discussed and illustrated. A range of tooth-supported overdenture systems were addressed, from low to high financial implications and treatment complexities. The clinician can choose a system that best fits the patient's condition and expectations. This allows clinicians to decide and consider tooth-supported overdentures as a treatment option before full edentulism. A well-executed tooth-supported overdenture ensures the preservation of alveolar bone, optimizes patient satisfaction in denture treatment, and eventually improves the patient's adaptation when transitioning to complete dentures.

Immediate versus conventional loading of mandibular implant-retained overdentures: a 3-year follow-up of a randomized controlled trial

OBJECTIVES

There is a scarcity of randomized clinical trials (RCT) that report medium- and long-term results and a lack of consensus in the literature on the predictability of immediately loaded unsplinted narrow diameter implants supporting mandibular overdentures. This RCT compared the performance of conventional (CL) and immediate loading (IL) of mandibular overdentures retained by two narrow-diameter implants for 3 years.

MATERIALS AND METHODS

Patients from an RCT treated with CL or IL were invited to attend to 2- and 3-year follow-ups. Clinical, radiographic, functional, and oral health-related quality of life parameters were evaluated. Prosthetic maintenance events, biological complications, and success and survival rates were also recorded. The data were tested by multilevel mixed-effects linear regression analysis and chi-squared tests.

RESULTS

The 1-year survival rates of 90% in the CL group and 85% in the IL group were maintained as no implants were lost between 1 and 3 years. The marginal bone loss (MBL) in the IL group was significantly lower after year 3 (-0.04; p < 0.01). Significant changes were found only for the intra-group comparisons in the third year of function: (i) CL and IL presented similar progression of implant stability, MBL, and posterior bone area resorption; (ii) while CL started deteriorating of masticatory function, IL still exhibited functional evolution and (iii) oral comfort domain in the CL and pain domain in the IL were improved.

CONCLUSION

Although IL experienced the lowest MBL after 3 years, the outcomes showed that both loading protocols result in predictable medium-term rehabilitation when monitored annually.

CLINICAL RELEVANCE

It can be expected that in the third year of function, patients with immediate loading may present more complaints related to general performance even with acceptable masticatory function and self-reported improvements in oral comfort.

Functional performance and impact on the quality of life of three treatment strategies for mandibular edentulism: Results of a parallel 3-group cross-sectional study

OBJECTIVES

This parallel cross-sectional study compared masticatory function and patient-centered outcomes among 3 removable treatment strategies for mandibular edentulism.

METHODS

Thirty-six edentulous participants rehabilitated using 3 removable treatment strategies for mandibular edentulism were allocated to one of the three groups (n=12): CCD (control), 2-IMO, and 3-IMO. Narrow diameter implants were installed using single-stage surgery and conventionally loaded with stud abutments. After 3 months of usage, the quality of life, maximum bite force, and masticatory function were evaluated. Data were analyzed with the Kruskal-Wallis test and post hoc pairwise Mann-Whitney tests with Bonferroni correction (α=0.05).

RESULTS

The 2-IMO and 3-IMO wearers did not show significant differences in any outcome, except for the 2 domains of 3-IMO wearers quality of life that obtained better Pain and General Performance scores. Both IMO groups presented significantly higher maximum bite force than CCD wearers. The 2-IMO wearers showed superior outcomes to the CCD group in all outcomes of the masticatory performance test and the X50, B and ME5.6 outcomes of the swallowing threshold test (p = 0.01), while 3-IMO participants only showed superior masticatory performance in terms of lower X50 values (19.86%, p = 0.02) and higher ME 2.8 (141.15%, p = 0.04) than CCD wearers.

CONCLUSIONS

Compared to 2-IMO wearers, 3-IMO wearers report superior impact of treatment on daily living activities in the Pain and General Performance domains. 2-IMO and 3-IMO wearers showed no significant differences between them for all evaluated bite force and masticatory function parameters.

CLINICAL SIGNIFICANCE

Although overdentures retained by 3 implants (3-IMO) provide biomechanical advantages over those retained by 2 implants (2-IMO), superior clinical and functional effectiveness is not yet proven.

Effect of mandibular bone atrophy on maxillary and mandibular bone remodeling and quality of life with an implant-retained mandibular overdenture after 3 years

STATEMENT OF PROBLEM

The medium-term effect of an implant-retained mandibular overdenture on bone remodeling in the maxilla and posterior mandible of edentulous patients and the effects on quality of life have not been established.

PURPOSE

The purpose of this prospective observational clinical study was to evaluate the 3-year effects of implant-retained mandibular overdentures on oral-health-related quality of life (OHRQoL) and bone remodeling in different regions of the maxilla and mandible in participants with atrophic or nonatrophic mandibles.

MATERIAL AND METHODS

Twenty-six edentulous participants received 2 narrow-diameter implants in the anterior mandible. Mandibular bone atrophy was categorized from presurgical panoramic radiographs according to the Cawood and Howell criteria. OHRQoL was assessed by using the OHIP-EDENT questionnaire. Participants were evaluated annually for 3 years to measure the marginal bone loss and bone area of the posterior mandible, and the anterior and posterior regions of the maxilla were assessed annually through panoramic radiographs. The data were analyzed by using a mixed-effects linear regression to estimate time-dependent trends and a mixed-effect linear regression model to verify differences between groups. The Pearson correlation coefficients between bone variables and 3-year OHIP-EDENT outcomes were calculated.

RESULTS

In the third year, atrophic participants had a significantly lower marginal bone loss (0.02 mm) than nonatrophic participants (-0.39 mm) (P=.030). Differences were also found in the functional limitation (nonatrophic=1.82 ±1.75, atrophic participants=1.92 ±1.54; P=.018) and handicap domains (nonatrophic=0.36 ±0.54, atrophic participants=0.08 ±0.27; P=.003). For nonatrophic participants, comparisons between baseline and 3-year outcomes showed significant bone resorption as indicated by the area ratio in the anterior maxilla (P=.035), posterior maxilla (P=.022), and posterior mandible (P=.009). Conversely, the bone area of the anterior maxilla (P=.019) decreased in atrophic participants between baseline and year 1, while the bone area of the anterior maxilla and posterior mandible increased (P<.001) between years 1 and 3. Higher effect sizes were observed in the OHRQoL domains of the atrophic participants.

CONCLUSIONS

Bone atrophy influenced both the OHRQoL profile and bone remodeling profile in different regions of the mandible and maxilla in mandibular overdenture users. In atrophic participants, bone tissue in both jaws responded positively to overdenture use, with bone apposition after the first year and bone area preservation in the anterior maxilla, posterior mandible, and peri-implant regions after 3 years of follow-up.

Prosthetic complications and quality of life among wearers of mandibular overdenture with the Facility-Equator system

This longitudinal study aimed to assess the performance of the Facility-Equator system as mandibular overdenture (MO) retainers from a prosthetic perspective during 2 years of loading and to investigate the oral health-related quality of life (OHRQoL) and whether prosthetic events can affect the OHRQoL. Twenty-four patients (68.1 ± 7.51 years) reported their OHRQoL through the Geriatric Oral Health Assessment Index (GOHAI) and Oral Health Impact Profile (OHIP-EDENT) questionnaires before MO loading and after 1 and 2 years of usage. Prosthetic occurrences were recorded during this period. Data were analyzed using the Wilcoxon test, Mann-Whitney test, and Spearman correlation coefficients. Of the 127 prosthetic events that occurred in the first year, the most frequent events were prosthesis adjustments (16.5%), dislodgement of the Equator attachment (14.17%), and O-ring replacement (11.8%). Eighty-seven prosthetic events were recorded in the second year, the most frequent events being prosthesis adjustments (27.6%), O-ring replacement (20.7%), and recapturing the female matrix (11.5%). All domains of the GOHAI and OHIP-EDENT questionnaires exhibited a significant difference (p < 0.05) between the baseline and 1- and 2-year evaluations, except in the Social Disability and Psychological Discomfort domains (p > 0.05) of OHIP-EDENT after 1 year. Complications related to prosthetic maintenance, such as fracturing of the prosthesis, Equator dislodgement, prosthesis rebasing, and new overdenture confection, affect the OHRQoL (p < 0.05), primarily the Physical Pain and Discomfort domains, especially in the first year of MO loading.

Impact of rehabilitation versus edentulism on systemic health and quality of life in patients affected by periodontitis: A systematic review and meta-analysis

AIM

To investigate the effect of rehabilitation in fully/partially edentulous patients with stage IV periodontitis on oral-health-related quality of life (OHRQoL) and systemic health.

MATERIALS AND METHODS

A systematic electronic and manual search was conducted. Three authors independently reviewed, selected, and extracted the data. Outcomes were OHRQoL (Oral Health Impact Profile 14 [OHIP-14] and OHIP-49, General Oral Health Assessment Index [GOHAI], visual analogue scale, symptoms registration) and systemic health-related outcomes (incidence and prevalence of systemic diseases, values of systemic disease indicators). Qualitative data were synthesized for OHRQoL and systemic health-related outcomes. Meta-analysis was conducted on available quantitative data.

RESULTS

The search identified 59 articles (6724 subjects in total). OHRQoL improved across all the studies, irrespective of the number of missing teeth, their location, or treatment modality. Meta-analysis showed significant improvement of OHIP-49 (36.86, p < .01) in manuscripts including subjects affected by periodontitis, consistently with the remaining literature (reduction of score points post rehabilitation: OHIP-14 = 10.52, OHIP-49 = 56.02, GOHAI = 5.40, p < .01 for all). Non-rehabilitated subjects exhibited inferior cognitive status, higher medication intake, and frailty. However, our data are limited and should be interpreted with caution.

CONCLUSIONS

Oral rehabilitation improves OHRQoL and, potentially, systemic health in edentulous patients. It is unclear whether these findings may be extrapolated to patients with stage IV periodontitis.

Prosthetic aftercare, mastication, and quality of life in mandibular overdenture wearers with narrow implants: A 3-year cohort study

OBJECTIVES

This cohort study investigated clinical, functional, and quality of life outcomes, along with prosthetic maintenance events in mandibular overdenture (MO) wearers for 3 years.

METHODS

Thirty MO wearers with narrow diameter implants (NDIs) and locking taper stud abutments (Facility-Equator system) were annually monitored by registering the visible plaque index (VPI), peri‑implant inflammation (PI), calculus presence (CP), probing depth (PD), bleeding on probing (BOP), secondary implant stability (ISQ), marginal bone loss (MBL), masticatory performance and dental impact in daily life (DIDL) questionnaire domains. Multilevel mixed-effects linear regression was performed to analyse changes over time. Chi-square tests were performed to analyse the relationship between the appearance of prosthetic complications and maintenance occurrences. The survival rate of patients with NDIs was calculated using the Kaplan-Meier test.

RESULTS

Twenty-six individuals attended all follow-ups, the survival rate of 83.3% in the first year was maintained, and no one implant was lost over the 3-year period. There were significant differences for PD between 1 and 3 years (p ≤ 0.01) and between 2 and 3 years for PI (p ≤ 0.01), GI (p ≤ 0.01), ISQ (p = 0.02), and MBL (p ≤ 0.01). All masticatory performance outcomes showed significant differences (p ≤.01). Prosthetic maintenance events decreased significantly over time. Appearance, general performance, and eating and chewing domains presented high effect sizes.

CONCLUSION

Continued changes were observed in the clinical parameters of MO users over the 3-year period. In addition, most functional parameters, except for particle homogenization, improved significantly over time. The positive impact on quality of life is likely related to the significant reduction in prosthetic maintenance events.

CLINICAL SIGNIFICANCE

Periodic returns to assess peri‑implant tissues and MO maintenance should be performed to ensure the success of rehabilitation to assure improvements in masticatory function and oral health-related quality of life.

Masticatory Ability for a Single Implant Mandibular Overdenture Retained by Two Different Attachments: A Randomized Controlled Trial

Objective

The aim of this randomized clinical trial was to compare the masticatory ability subjectively between ball and Cendres+Métaux Locator (CM-LOC) attachment for a single implant retained mandibular overdenture throughout a 24-month follow-up period.

Materials and Methods

Eighty completely edentulous patients were recruited. All patients received new complete dentures, and masticatory ability was recorded using a questionnaire (baseline record). All patients received a single implant in the midline of the completely edentulous mandible. After 3-month healing period, patients were randomized using sealed envelopes into two groups: ball or CM-LOC attachment. The same masticatory ability questionnaire was used to record masticatory ability for both groups after 2 weeks of pickup and 3-, 6-, 9-, 12-, and 24-month follow-up. Comparison between the study groups was done using Mann–Whitney U test for independent samples. Two-sided P values less than 0.05 were considered statistically significant.

Results

The mean masticatory scores improved for both attachments, with no statistically significant difference between them throughout the 24-month follow-up. The CM-LOC attachment group showed a greater improvement change in masticatory ability after 6- and 12-month follow-up (−12.47 ± 12.006, −11.46 ± 14.625; P=0.826), while the ball attachment group showed a slight improvement after the 24-month follow-up (−11.72 ± 12.368, −10.88 ± 11.963; P=0.778).

Conclusion

Single implant retained mandibular overdenture improved masticatory ability subjectively with no significant difference between both attachments used although the ball attachment showed better masticatory ability scores after 24-month follow-up.

Oral Health Related Quality of Life of Patients Using Conventional Dentures versus Implant-Supported Overdentures

Objectives:

This study aimed to compare the oral health related quality of life (OHRQoL) of patients using conventional dentures versus implant-supported overdentures.

Materials and Methods:

This study evaluated the OHRQoL of 90 patients between 35 to 75 years who were selected from several public and private dental clinics in Tehran in 2018. Of all, 45 had conventional dentures of both jaws, and 45 had a mandibular overdenture supported by two implants at the site of mandibular canine teeth and a conventional maxillary denture. The OHRQoL of patients was determined using the Oral Health Impact Prfile-20 (OHIP-20). The questionnaire was translated to Persian, and its content validity and internal consistency were confirmed. Data were analyzed by one-way ANOVA, Mann-Whitney test, and independent t-test.

Results:

In the conventional denture group, 46.7% had good, 46.7% had moderate, and 6.6% had poor OHRQoL. These values were 55.6%, 37.8% and 6.6% in the overdenture group, respectively. Level of education had a significant correlation with the total score of OHIP-20 in both groups (P<0.05). But no significant association was noted between the residential status and gender of patients with different domains of OHRQoL (P>0.05) except for the psychological disability domain, which had a higher mean value in males with conventional dentures (P<0.05).

Conclusion:

Patients with a mandibular overdenture supported by two implants at the site of canine teeth and a conventional maxillary denture had higher OHRQoL than patients with conventional dentures of both jaws.

Influence of Facial Morphology on Masticatory Function and Quality of Life in Elders Using Mandibular Overdentures: 3-Year Results

Background: Facial types may interfere in the oral health-related quality of life (OHRQoL) and masticatory performance of implant-retained mandibular overdenture (IMO) wearers.

Purpose: Investigate the medium-term changes in the masticatory function (MF) and OHRQoL parameters of IMO users, as a function of facial pattern, anteroposterior skeletal discrepancy, and sex.

Methods: Forty IMO users, most of them Caucasian (90%) with average age of 69.17 years were classified according to their facial pattern and antero-posterior discrepancy prior to rehabilitation. MF was evaluated by the multiple sieves method to determine the average particle size (X50), heterogeneity (B) and masticatory efficiency (ME, calculated as the percentage of material retained in the 5.6 and 2.8 mm sieves), using Masticatory performance (MP) and swallowing threshold (ST) tests. OHRQoL was measured by applying the dental impact on daily life (DIDL) questionnaire. The data were analyzed by Wilcoxon-paired tests to analyze changes in MF parameters over time, and mixed-effect multilevel regression models were employed to verify differences between groups.

Results: Significant changes were still observed in the 3rd year for the ST test with improvements in B for Mesofacial and in time for Dolichofacial individuals, while ME_2.8 deteriorated for Brachyfacial participants. B values of Class I and male individuals improved and brachyfacial individuals still presented worse homogenization (B) than Mesofacial participants in both masticatory tests. Class II and III participants still showed improvements in ME_5.6 and time compared to Class I despite increases in X50. Class II individuals needed less cycles than Class I in the 3rd year. Brachyfacial participants scored lower in the Appearance domain than Mesofacial ones in the 3rd year. Dolichofacial participants and Class III patients scored lower in the Oral Comfort domain than Mesofacial and Class I, respectively. In addition, age influenced the Pain, Oral Comfort and General Performance domains in the 3rd year.

Conclusions: Differences in facial morphology continue to influence the MF and OHRQoL outcomes in the 3rd year, and age influenced some OHRQoL domains. Brachyfacial individuals continue to benefit least from rehabilitation with IMO according to masticatory parameters.

Clinical Versatility of the Facility-Equator Implant System as Mandibular Overdenture Retainers

The use of mandibular overdentures (MO) for the rehabilitation of totally edentulous individuals with limited bone availability is widespread and has proven clinical success. Narrow diameter implants (NDI) are available on the market as MO retainers to solve problems related to limited bone availability and bone thickness, providing a low-cost, minimally invasive treatment option. This technique evolved over the years, and changes frequently involved the number of implants used as MO retainers, as the adoption of a smaller number of implants can generate biomechanical disadvantages, contributing to the increased stress in peri-implant tissues, which may accelerate marginal bone loss (MBL), in addition to reducing masticatory capacity and satisfaction with rehabilitation. Some studies pointed out that the use of 3 or more implants as MO retainers improves the biomechanics. Thus, the objective of this study was to report 3 different clinical cases where 3 or more NDI were adopted to retain mandibular overdentures in association with diverse loading protocols: (i) 3 implants adopting conventional loading, (ii) 4 implants using progressive loading, and (iii) 4 implants with hybrid loading. The case with 4 implants and progressive loading showed a slight worsening of masticatory function at 1 year, in addition to a more pronounced MBL compared to other cases, but with improvements in satisfaction and oral health-related quality of life. Thus, NDI can be used as MO retainers with predictability and clinical success, using different numbers of implants and loading protocols.

Masticatory function and oral health-related quality of life of patients with atrophic and non-atrophic mandibles using implant-retained mandibular overdentures: 3-year results of a prospective clinical study

BACKGROUND

Long-term changes in masticatory function, oral health-related quality of life (OHRQoL) and prosthetic complications in implant-retained mandibular overdenture (IMO) wearers as a function of bone atrophy require detailed investigations.

OBJECTIVE

Investigating the evolution of masticatory function, OHRQoL and prosthetic occurrences of IMO wearers according to mandibular bone atrophy over 3 years of usage.

METHODS

This study evaluated 26 IMO wearers after 2 and 3 years of IMO loading categorised according to mandibular resorption degree into atrophic mandible (AM) and a non-atrophic mandible (NAM) group. Masticatory function was assessed by the Masticatory Performance (MP) and Swallowing Threshold (ST) tests; OHRQoL and satisfaction via the Dental Impact on Daily Living (DIDL) questionnaire; and the prosthetic maintenance requirements and complications were monitored.

RESULTS

After the second year, the AM Group performed 32% more cycles (P = .047) than the NAM Group during the ST test. The DIDL questionnaire showed no significant difference for all domains, except for a moderate effect size in the General Performance domain after the third year. AM Group had more prosthetic occurrences (n = 109) than NAM Group (n = 60) in the first year, mainly due to Equator attachment dislodgment. During the third year, NAM Group presented a greater number of events (n = 45) than AM Group (n = 21) due to the greater number of O-ring exchanges.

CONCLUSION

Masticatory function and OHRQoL are not related to mandibular bone atrophy until 3 years after IMO rehabilitation. The prosthetic complications profile differs between groups, mainly in the first year.

Do implant-retained mandibular overdentures maintain radiographic, functional, and patient-centered outcomes after 3 years of loading?

OBJECTIVES

Analyzing whether radiographic, functional, and oral health-related quality of life (OHRQoL) outcomes are maintained over 3 years of implant-retained mandibular overdenture (IMO) function and investigating the bite force associations in the 3rd year of function.

MATERIAL AND METHODS

A longitudinal clinical study in which 24 IMO users were evaluated during a 3-year follow-up period. Patients' posterior area index, masticatory function, OHRQoL and bite force were assessed. The masticatory function parameter ST_X50 reflects the opening through which 50% of the crushed particles would pass, ST_B describes the homogeneity of the bolus, and the masticatory efficiency parameters ME_5.6 and ME_2.8 represent the % of material retained in the 5.6 and 2.8 mm sieves, respectively.

RESULTS

A significant increase in posterior area index (p ≤ .01) was found in all evaluated periods. Minor deteriorations in ST_X50 (p ≤ .01) and ME_5.6 (p ≤ .01) between the 2nd and the 3rd year coincided with improvements in ST_B (p ≤ .01), number of cycles (p ≤ .01), and cycle time (p = .02). The global OHIP-Edent score (p = .02) and the scores in the functional limitation (p = .02), psychological discomfort (p ≤ .01), and handicap domains (p ≤ .01) increased significantly between the 2nd and the 3rd year. Correlations between bite force and cycle time (p = .03) and between posterior area index and ST_X50 (p ≤ .01) and ME_2.8 (p = .02) were also found.

CONCLUSION

Changes in posterior area index, masticatory function, and OHRQoL are still ongoing during the 3rd year of IMO function. Bite force and posterior area index influence the masticatory function outcomes in the 3rd year of IMO function.

Functional oral health-related quality of life impact: A systematic review in populations with tooth loss

Patients perceive the impact of oral disorder in four major areas, the dimensions of oral health-related quality life (OHRQoL) Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact. The functional aspect is essential given the need of chewing, biting, speech and swallowing. The objective of this study was to identify OHRQoL information for dental subjects with functional oral health problems. In a systematic review, distinct and clinically relevant groups of dental subject samples, in this study called "population groups," with such functional OHRQoL information based on the Oral Health Impact Profile (OHIP) were identified (PROSPERO registration: CRD42017064033). The search strategy was "Oral Health Impact Profile" or OHIP. Searches were conducted in the PubMed interface of the Medline database, EMBASE, Cochrane, CINAHL and PsyINFO on 8 June 2017 and updated on 14 January 2019. Published OHIP domain data of different versions were recalculated into OHIP-14`s Physical Disability domain score, characterising the subject's Oral Function impact. 3,653 potentially abstracts were screened. We identified 78 publications reporting dimensional information on 154 subject samples with 52 populations. A typical mean functional impact for partially dentate subjects was 1.6 units on a 0 to 8 unit metric, while for edentate subjects, the mean functional impact was 2.6 units. The functional impact score ranged from 0 to 7.9 units with 50% of the patient samples located between 0.8 and 2.6 units. For the first time, we provide normalised and therefore comparable metric information about the functional OHRQoL impact for a substantial number of functional oral conditions.

Influence of facial patterns on the masticatory function and quality of life of completely edentulous patients during the transition to implant-retained mandibular overdentures

STATEMENT OF PROBLEM

Although implant-retained mandibular overdentures (IMOs) provide functional benefits, the influence of the vertical facial pattern (FP) and the anteroposterior skeletal discrepancy (ASD) on the masticatory function and patient-centered outcomes during the transition to IMOs is still uncertain.

PURPOSE

The purpose of this interventional clinical study was to evaluate the influence of the FP and ASD on the masticatory function, oral health-related quality of life (OHRQoL), and satisfaction of completely edentulous patients before and after transition to IMOs.

MATERIAL AND METHODS

Cephalometric analysis was performed on 42 participants before treatment. Ricketts analysis was used to classify the FP, and the maxillomandibular relationship to the base of the skull determined the ASD. Masticatory performance (MP) and swallowing threshold (ST) test results were evaluated by the multiple sieve method by using artificial test food (Optocal cubes) to determine the median particle size (×50), homogenization index (B), and masticatory efficiency based on sieves 5.6 (ME: 5.6) and 2.8 (ME: 2.8). OHRQoL and satisfaction were evaluated by using the Dental Impact on Daily Living questionnaire. The data were analyzed using mixed-effects linear regression models to estimate the effect of time, FP, ASD, age, and sex on MP, ST, and OHRQoL.

RESULTS

The MP, ST, OHRQoL, and satisfaction improved significantly after IMO loading, irrespective of FP and ASD. However, MP outcomes were most negatively affected mainly among dolichofacial (B and ME: 2.8), class II, and class III (×50, B, and ME: 2.8) participants. The ST test showed that class II participants still showed inferior ×50 values and performed a lower number of cycles than class I and class III participants. Women presented reduced masticatory function for all MP and ST outcomes and reported lower coefficients for appearance and general performance domains than men.

CONCLUSIONS

The MP test detected more subtle improvements than the ST test, especially in class III participants. The class II participants benefited the least from the IMO installation according to the ST test. The IMO treatment improved the OHRQoL and satisfaction of edentulous patients, irrespective of the FP or ASD.