Journal of Oral Rehabilitation 1999 26; 195 – 202 A 5-year prospective randomized clinical trial on the influence of splinted and unsplinted oral implants retaining a mandibular overdenture: prosthetic aspects and patient satisfaction I. NAERT*, S. GIZANI*, M. VUYLSTEKE † & D. VAN STEENBERGHE ‡ *Department of Prosthetic Dentistry, School of Dentistry, Oral Pathology and Maxillofacial Surgery, Faculty of Medicine, Catholic University Leuven; † Department of Statistics, Computing Centre, Catholic University Leuven; and ‡ Department of Periodontology, School of Dentistry, Oral Pathology and Maxillofacial Surgery, Faculty of Medicine, Catholic University Leuven, Leuven, Belgium SUMMARY Prosthetic outcome and patient satisfac- After 5 years of observation, the Bar group pre- sented the highest retention capacity and the least tion were evaluated in order to investigate prosthetic complications but revealed more mu- whether there is a need or advantage to splint two cositis and gingival hyperplasia. Patient satisfac- implants in the mandible retaining a hinging over- denture. This study included 36 fully edentulous tion rated similar for all groups although the Magnet group showed lower retention forces. All patients randomly divided into three groups ac- cording to the attachment system they received: patients would repeat the same treatment even though the majority of the Magnet group would magnets, ball attachments or straight bars (refer- ence group). None of the implants failed during prefer a more retentive solution because of limited denture stability. the whole observation period in any of the groups. Introduction Full edentulism can substantially affect oral and gen- eral health as well as overall quality of life (Gift & Redford, 1992; Marcus et al., 1996). Patient satisfaction with dentures is influenced by various factors including denture quality, the available denture bearing area, the quality of dentist – patient interaction, previous experience with dentures, pa- tient’s personality and psychologic well-being (Boer- rigter et al., 1995). Replacing the lost tissues by means of complete den- tures is challenging both for the dentist and the patient (Zarb, 1982; Davis, 1990). Nevertheless, some people do not succeed in acquiring new skills with their den- tures and thus suffer psychologically because of im- paired function, comfort, self-image and social interaction. Because of the good prognoses of some endosseous implant systems, these patients can be successfully treated with implant-retained overdentures. Several studies reported the clear benefits of overdenture treat- ment, versus the conventional denture for a number of aspects such as: aesthetics, speech, chewing, fit and retention, function and quality of life (Burns et al., 1994; Cune, Putter & Hoogstraten, 1994; de Grand- mont et al., 1994). The impact on these aspects of different attachment systems retaining the overden- tures is lacking so far. Therefore, a 5-year randomized clinical trial was set up to investigate the prosthetic outcome and patient satisfaction with mandibular hinging overdentures on different attachment systems. The peri-implant out- come is discussed in a separate paper (Naert et al., 1998). © 1999 Blackwell Science Ltd 195