Improvement of Patient’s Satisfaction and Oral Health-Related Quality of Life by the Implant and Prosthodontic Treatment

This review attempted to identify published articles describing the effect of implant and prosthodontic treatment on patient satisfaction and OHRQoL outcomes. The data and conclusions of the high level evidence publications were collected and summarized with the aim to establish the general treatment benefits in comparison to other therapy solutions and to confirm it as a reliable and superior treatment option. Patient-centered approaches to the assessment of treatment efficacy are highly relevant to today's prosthodontist, whose goals are the improvement of function and quality of life for their patients. The implementation of implant therapy has further induced the number of studies to assess the patient's opinion about this treatment option. It was hypothesized that the number of studies based on high level evidence, using patient-based outcomes in some areas is small and that some treatment possibilities haven't been investigated. The high number of publications from this area confirms progression in the last decades. Despite a huge number of OHRQoL studies, only few of them assessed specific prosthodontic treatments in edentulous areas and particular effects on the improvement of the OHRQoL in elderly population. Most studies on the OHRQoL investigated similar types of dentures (egg mandible 2 implants and bar or ball) and include middle-age groups. Methodically more specified studies are required to assess the outcomes of some specific fields of OHRQoL. While improvement of OHRQoL has been reported for both treatment options (IOD and IFD), it is also important to demonstrate their superiority over the conventional treatments for every edentulous possibility in completely or partially edentulous arch. Therefore, all studies should include control group and patients should be observed for a longer period of time. The effect of the technical correctness and quality of prosthetic restorations has also been scarcely investigated. This should be included as well to properly assess the advantages and cost-benefit of a specific treatment. Furthermore, to establish a direct comparison between the studies it would be necessary to standardize the sampling methodologies, meaning questionnaires and follow-up periods. Within the limitation of the literature review, it can be concluded that most of the studies confirmed higher patient satisfaction and OHRQoL improvement using 2 implant bar and ball attachment mandibular IOD in comparison with CD. Four implants connected by a bar were showed as a reliable option for edentulous maxilla. In contrast to common belief, based on the results collected, placing IFD has not been confirmed as a superior treatment to IOD. This result was not expected, since the IFD treatment was stated as most likely to be physiologically and psychologically incorporated into the oral cavity. Since most of the information available is limited to outcomes of IOD therapy in mandibular edentulous jaw, more randomized controlled trials studies are needed to obtain IFD effectiveness data, regardless of the jaw and number of the teeth that are missing. The data presented should help future researchers to develop and improve study designs with broader outcome measures that will support dentist to make appropriate therapeutic decisions for every individual patient.