Masticatory function improvement with the use of mandibular single-implant overdentures in edentulous subjects: a systematic literature review

Influence of denture-bearing conditions on masticatory function and patient-reported outcomes measures

PURPOSE

To investigate the influence of different denture-bearing conditions on the masticatory function and patient-reported outcome measures (PROMs) of complete denture wearers.

METHODS

Sixty edentulous patients were selected and allocated into two groups according to the American College of Prosthodontics' (ACP) classification: non-atrophic (NAT) (Classes I and II) (n = 24) and atrophic (AT) (Classes III and IV) (n = 36). All patients received new complete dentures (CDs). The objective variables (masticatory performance and swallowing threshold) were assessed as well as the PROMs (oral health-related quality of life (OHIP-EDENT), patient satisfaction) and quality of the prosthesis, at baseline (using the old CD) and after 4 months new prostheses use. Data were analyzed by Mann-Whitney test followed by the Generalized Equations Estimation (GEE), linear regression and Chi-square test.

RESULTS

Higher masticatory performance was observed in the NAT group (p < .05) for both time points, baseline and after 4 months. However, compared to baseline, both groups showed significant masticatory improvement after 4 months (p < .05). Satisfaction and overall quality of life improved after 4 months with no difference between groups (p > .05). Regarding the quality of the CD, baseline results were significantly (p < .05) lower in the AT group, but after 4 months, no significant differences were found between groups and in intragroup analysis (p > .05).

CONCLUSIONS

The denture-bearing conditions seems to impact masticatory function, but the PROMs are barely affected.

The effect of single-implant overdentures on cognitive function in older adults: A 3-year follow-up report

OBJECTIVE

To investigate the occurrence of mild cognitive impairment in edentulous patients up to 3 years after they received single-implant overdentures (1-IODs).

METHODS

This was a follow-up study for a crossover randomized controlled trial comparing 1-IODs and conventional complete dentures, with patient satisfaction as the primary outcome. In the present study, the cognitive function of the patients, measured with the Japanese version of the Montreal cognitive assessment (MoCA-J), was evaluated as the secondary outcome at baseline and 2 months, 1 year, 2 years, and 3 years after 1-IOD placement. The total and domain (memory, executive function, visuospatial skills, language, attention, and orientation) MoCA-J scores of the patients at each timepoint were analyzed and compared.

RESULTS

Twenty-two patients with edentulous mandibles received 1-IODs. Within-group comparisons revealed that the total MoCA-J scores at 1 year and 3 years after 1-IOD placement were significantly increased compared with baseline scores. Additionally, the memory domain scores at all timepoint were significantly increased compared with the baseline scores, and the executive function domain scores at the 2-month, 2-year and 3-year timepoint were significantly increased compared with the baseline scores.

CONCLUSION

Patients with edentulous mandibles who underwent 1-IOD placement showed significantly improved total scores of MoCA-J after 1 year and 3 years of wearing 1-IODs. In addition, they showed significantly improved memory domain scores at 2 months, 1 year, 2 years, and 3 years after 1-IOD placement and executive function domain scores at 2 months, 2 years, and 3 years after 1-IOD placement.

CLINICAL SIGNIFICANCE

The results of this study suggest that 1-IOD treatment for older adults, especially those with edentulous mandibles, may prevent cognitive decline regardless of the condition of the maxilla.

Association between masticatory performance and oral conditions in adults: A systematic review and meta-analysis

OBJECTIVES

To give an overview of the evidence on the associations between oral condition factors and masticatory performance of adults, and to evaluate the direction and level of the associations.

DATA/SOURCES

Medline (PubMed), Embase (Ovid) and CINAHL Plus (EBSCOhost) were searched up to May 2022 for cross-sectional studies on oral conditions and masticatory performance in adults. Methodological quality of the included studies was independently evaluated based on the Joanna Briggs Institute critical appraisal checklist for analytical cross-sectional studies. Data on the associations between oral condition factors and masticatory performance were extracted. Meta-analysis was conducted on correlation coefficients.

STUDY SELECTION

Of the 8,035 records identified, 97 articles (88 studies) were included in the qualitative synthesis, and 18 studies were included in the meta-analyses. Among the oral condition factors that had associations with masticatory performance, the number of natural/remaining teeth or functional tooth pairs was reported by the largest number of studies, followed by perioral muscle status, dental prosthetic status, oral moisture status and periodontal status. Results of the meta-analyses showed that the positive association with the number of natural/remaining teeth was the strongest (pooled correlation coefficient: 0.51, 95%CI: 0.48 to 0.54), followed by the number of functional tooth pairs, maximum tongue force/pressure, while the association with the oral moisture status was the weakest.

CONCLUSIONS

Number of natural/remaining teeth and functional tooth pairs, perioral muscle status, oral moisture status, dental prosthetic status and periodontal status are the main oral condition factors influencing masticatory performance. Based on the limited evidence available, among these factors, the number of natural/remaining teeth has the strongest positive association, with a very low quality of evidence.

CLINICAL SIGNIFICANCE

This study provides valuable information on the oral condition factors associated with masticatory performance, which would be important for policymakers and clinical practitioners when deciding on the strategies for improving the masticatory performance of adults. This review highlights the need for standardization of measures and classifications of masticatory performance and oral conditions.

REGISTRATION

PROSPERO (registration number: CRD42021256824).

Associations of general health conditions with masticatory performance and maximum bite force in older adults: A systematic review of cross-sectional studies

OBJECTIVES

To give an overview of the current evidence on the associations of general health conditions with masticatory performance and maximum bite force in older adults.

DATA/SOURCES

Three electronic databases (Medline via PubMed, Embase via Ovid and CINAHL Plus via EBSCOhost) were searched up to September 2021 for cross-sectional studies on general health conditions and masticatory performance or maximum bite force in older adults. Methodological quality of the included studies was independently evaluated based on Joanna Briggs Institute critical appraisal checklist for analytical cross-sectional studies. Data on the associations between general health conditions and masticatory performance or maximum bite force were extracted.

STUDY SELECTION

Of the 5133 records identified, 39 studies (43 articles) were included in this review. Significant negative associations were found between masticatory performance and stroke, sarcopenia, amyotrophic lateral sclerosis, chronic obstructive pulmonary disease, dyspepsia, dysphagia, anorexia, and carotid atherosclerosis. Significant negative association was found between maximum bite force and sarcopenia. There were equivocal results on the association between masticatory performance and diabetes mellitus, and between maximum bite force and stroke, and amyotrophic lateral sclerosis. There was no significant association between masticatory performance and metabolic syndrome, and between maximum bite force and progress of Parkinson's disease. Most studies revealed positive associations of physical function with masticatory performance and maximum bite force.

CONCLUSIONS

Negative associations between masticatory function of older adults and presence of several systemic diseases have been reported in a number of studies while there are positive associations between masticatory function and some physical function indicators.

CLINICAL SIGNIFICANCE

This study provides valuable information on the association of masticatory function with general health, which draws clinicians' attention to the masticatory function of older adults who suffer from certain systemic diseases or physical dysfunction, and to the need to improve their masticatory ability to achieve healthy aging.

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.