Objectives To assess the benefits of implant support to Removable Partial Dentures (RPD) in patients with a bilateral free-ending situation in the mandible and to determine the most favorable implant position: the premolar (PM) or the molar (M) region. Methods Thirty subjects with a bilateral unbounded posterior saddle received 2 PM and 2 M implants. A new RPD was placed. Implant support was provided 3 months later. Two PM implants supported the RPD. After 3 months the 2 M implants were used or vice versa. Outcome measures included oral health related quality of life (OHIP-NL49), general health status (SF-36), contentment assessed on a Visual Analogue Scale (VAS) and the number of hours that the RPD was worn. Data were collected prior to treatment, 3 months after having functioned with a new RPD and after 3 and 6 months with implant support. Finally, patients expressed their preferred implant position. Results The general health status (SF-36) was not influenced. OHIP-NL49 values and mean wearing-time were statistical significantly more favorable for ISRPD's, regardless of the implant position. Per day, the ISRPD's were worn 2–3 h more than the unsupported new RPD. Patients’ expectations were met as the VAS-scores of anticipated and realized contentment did not reach a statistical significant level (p > 0.05). VAS scores for ISRPD's with M implant support were higher than for PM implant support. Finally, 56.7% of subjects preferred the M implant support, 13.3% expressed no preference and 30% opted for PM implant support. Conclusions Mandibular implant support favorably influences oral health related patient-based outcome measures in patients with a bilateral free-ending situation. The majority of patients prefer the implant support to be in the molar region. Clinical significance Patients with a bilateral free-ending situation in the mandible opposed by a maxillary denture benefit from implant support to their mandibular removable partial denture. Most patients prefer this support to be in the molar region.
Jensen, C., Raghoebar, G. M., Kerdijk, W., Meijer, H. J. A., & Cune, M. S. (2016). Implant-supported mandibular removable partial dentures; patient-based outcome measures in relation to implant position. Journal of Dentistry, 55, 92–98. https://doi.org/10.1016/j.jdent.2016.10.008