FUNÇÃO MASTIGATÓRIA E ANÁLISE PSICOMÉTRICA DE IDOSOS REABILITADOS COM OVERDENTURES RETIDAS POR IMPLANTE CENTRAL MANDIBULAR ÚNICO MASTICATORY FUNCTION AND PSICOMETRIC ANALYSIS OF ELDERS REHABILITATED BY SINGLE IMPLANT MANDIBULAR OVERDENTURES

Single implant-retained mandibular overdentures (SIO) may present as a solution for the absence of retention and stability of conventional total dentures (CD), being more accessible and simplified than the gold standard rehabilitation, the overdenture retained by two mandibular implants. Thus, chapter 1, compared clinical psychometric aspects and masticatory efficiency of edentulous elderly rehabilitated with PT and later, transformed into SIO. Chapter 2 analyzed the effects of SIO on oral perception, masticatory function, pattern of masticatory movements and nutritional intake of the same group of elderly. Finally, chapter 3 proposed a technique for making an individualized framework in the anterior region of the mandibular prosthesis, in order to avoid incidence of fractures in SIO rehabilitation. Thus, for the paired clinical study, 12 elderly subjects (mean age = 68.66 ± 5.22 years) with Class III and IV residual borders were selected according to the American College of Prosthodontics and unsatisfactory PT patients, according to Rise criteria. They received new CD with a metallic framework in the anterior region of mandibular prostheses to avoid fractures when transformed into SIO. After 2 months of CD use, the following variables were analyzed: masticatory performance, efficiency, and ability, pattern of mandibular movements, nutritional intake, oral sensory function and volunteers' satisfaction with rehabilitation treatment. In the second stage, the volunteers received a single cylindrical implant in the mandibular central region according to previous tomographic planning of surgical and markers of the framework made. After the osseointegration period, low profile type attachments were installed and the lower CD were transformed into SIO. After proservation and two months of use, the variables were again measured. The Student t test and Wilcoxon were used for the statistical analysis according to the normality of data at a significance level of 5%. Participants reported greater satisfaction with the retention of SIO. However, aesthetic satisfaction decreased when CD were converted to SIO (P <0.05). The masticatory ability showed no difference between CD and SIO; however, the transition to SIO increased masticatory efficiency (P <0.0001). As results of chapter 2, oral stereognosis ability did not present difference between types of prostheses (P <0.05). However, the velocities of opening and closing masticatory movements and masticatory performance improved after insertion of SIO (P <0.05). In addition, sodium intake decreased after SIO therapy (P <0.05). The present study may conclude from clinical findings that mandibular SIO promote greater satisfaction of the elderly in the face of retention, improvement in masticatory function and increase in the speed of opening and closing of the masticatory cycles, besides reduction of sodium intake, being an alternative for edentulous elderly individuals with reduced residual height of the mandibular ridges. Also, the technique of strengthening the SIO can be considered as a simplified and efficient procedure, since it saves chairside management time for the clinician and constitute a strengthen instrument for the rehabilitation.