Fatores associados ao desempenho funcional e clínico de usuários de overdentures mandibulares durante 3 anos de função

Abstract

Through the success of osseointegrated implants and concomitant to the need of circumvent patient complaints, such as lack of retention and stability, especially of the mandibular conventional complete denture (CCD), the option for mandibular overdentures (MO) has been widely disseminated as a minimum protocol to rehabilitate total edentulous individuals, due to its excellent costbenefit ratio. In addition, with the option of using narrow diameter implants (NDI), rehabilitation difficulties observed in elderly patients, with moderate and severe levels of mandibular atrophy, has been overcome making treatment with MO predictable and with high success rates. NDI has shown a success and survival rate of around 98%, and maintaining the stability of peri implant bone tissue, showing excellent predictability and success over the years. Still, implant-retained MO promote improvements in the levels of satisfaction with their treatment, quality of life, besides restoring the masticatory function efficiently. Considering all clinical and functional variables related to rehabilitation, which can interfere in maintenance, longevity and quality of life, annual monitoring of MO users is extremely important. This regular monitoring allows the understanding of the influence of individuals' intrinsic factors such as mandibular atrophy, facial pattern, anteroposterior discrepancy and bite force, in addition to occlusal loading, in rehabilitation with MO over time. In view of the above, a cohort of total edentulous patients was assessed annually over 3 years of MO use, in order to investigate possible changes in masticatory function, oral health-related quality of life and satisfaction with their oral condition and monitor variables and bone, which are predictive of the success of implant-supported prosthetic rehabilitation. As a result, this thesis presents, through 6 articles, a compilation of information that determines the predictability and positive impact of MO use retained by narrow diameter implants in the lives 13 of individuals. After 3 years, high success and survival rates and minimal biological and prosthetic complications have been reported, regardless of occlusal loading. In addition, despite reaching the balance of occlusal strength occurring in the first months of function, variations in chewing performance, oral health-related quality of life and clinical and bone variables are still observed during the 3-year follow-up. In addition, intrinsic variables such as facial morphology and gender of individuals continue to influence the clinical and functional behavior of OM.