Patient satisfaction and oral health-related quality of life (OHRQoL) of conventional denture, fixed prosthesis and milled bar overdenture for All-on-4 implant rehabilitation. A crossover study

Objectives: This study aimed to evaluate patient satisfaction and oral health-related quality of life (OHRQoL) of conventional denture, fixed prosthesis and milled bar overdenture for All-on-4 implant rehabilitation. Materials and methods: Sixteen completely edentulous patients with ill-fitted mandibular dentures received new mandibular dentures (CDs). After 3 months, 4 implants were installed according to the “All-on-4 concept” and immediately loaded with mandibular dentures. Three months after osseointegration, patients received either fixed prosthesis (FP) or milled bar overdenture (MB) in a crossover design. Patient satisfaction was evaluated using a visual analog scale (VAS). OHRQoL was evaluated using the OHIP-14. Questionnaires of VAS and OHIP-14 were measured 3 months after wearing each of the following prostheses: CD, FP, and MB. Results: For all questions of VAS and OHIP-14, CD showed significant lower satisfaction compared to FP and MB (p <.00025). FP recorded significant higher VAS scores than MB regarding retention and stability (p <.00007). MB recorded significant higher scores than FP regarding general satisfaction, comfort, ease of cleaning, and handling (p <.00008). Regarding OHIP-14, no significant differences in OHIP scores between FP and MB were observed for all domains of OHIP. Conclusion: “All-on-4” implant rehabilitation of edentulous mandible with FP and MB achieves high patient satisfaction and OHRQoL compared to CD. No significant difference in OHRQoL between FP and MB was observed. Regarding VAS, FP rated greater satisfaction with retention, stability, and chewing compared to MB. However, MB rated greater satisfaction with ease of cleaning and handling compared to FP.