OBJECTIVES:Males and females differ in their responses to many health conditions and treatments. The aim of this randomized clinical trial was to determine whether there are differences in the way that male and female edentulous elders rate their satisfaction with new mandibular implant overdentures (IODs) and conventional dentures (CDs), at 6 and 12 months following delivery.METHODS:Edentulous elders (n=256) were randomly assigned to receive maxillary conventional dentures and either mandibular overdentures supported by two implants with ball attachments or conventional dentures. Participants rated their general satisfaction, as well as other features of their dentures (comfort, stability, ability to chew, aesthetics, etc.) prior to treatment and 6 and 12 months after delivery.RESULTS:Ratings of satisfaction with IODs were significantly higher than with CDs. Six months after delivery, females in the CD group rated their general satisfaction and satisfaction with ability to chew and aesthetics significantly lower than did the males. The sex differences in the CD group remained at 12 months after delivery. However, males and females in the IOD group rated their general satisfaction and all six subcategories equally.CONCLUSIONS:Elderly females are less satisfied with conventional dentures than elderly males with regards to aesthetics and ability to chew, but equally satisfied with implant overdentures. At 6 and 12 months after delivery, elderly edentulous males and females wearing mandibular implant overdentures were significantly more satisfied than those wearing conventional dentures.

Although there may not be a direct association between oral hygiene and implant failure, oral hygiene must be maintained around implants in the edentulous mouth. Bacterial plaque on dentures can act as a reservoir for pathogens that cause respiratory disease. Unfortunately, many edentulous patients have poor oral hygiene. In this article, we describe the development of a brochure to educate patients wearing mandibular overdentures supported by 2 implants as a supplement to the dentist"s verbal instructions. Dental literature and several specialists were consulted during preparation of the brochure, which contains photographs accompanying oral hygiene instructions. It was sent to 25 participants who were subsequently called and questioned regarding its content and their oral hygiene habits. The 24 respondents found the brochure useful; most reported that they would keep the brochure for future reference and that they learned something new about how to maintain their implants properly. No one found the brochure too long or unclear. Most participants read the brochure entirely, rather than skimming it. The brochure is available to all clinicians who wish to incorporate this tool into their implant overdenture therapeutic approach.

OBJECTIVES:This study was carried out to determine whether inexperienced dentists can provide two-implant overdentures that are as satisfactory and of the same cost as those provided by experienced prosthodontists.METHODS:Edentulous elders were enrolled in a randomized controlled clinical trial to compare the effects of mandibular conventional and two-implant overdentures on nutrition. They were randomly assigned to groups that were treated by either an experienced prosthodontist or by a newly-graduated dentist with minimal training in implant treatment. Data for this study were obtained during the treatment of the first 140 subjects enrolled. The change in patient ratings of satisfaction after treatment, laboratory costs and the number of unscheduled visits up to 6 months following prosthesis delivery were compared.RESULTS:Satisfaction was significantly higher with implant overdentures than with conventional dentures, but there were no differences in scores for either prosthesis between the groups treated by experienced specialists or new dentists. Furthermore, six of the seven inexperienced dentists reported that they found the mandibular two-implant overdenture easier to provide than the conventional denture.CONCLUSIONS:The results of this study suggest that general dentists can provide successful mandibular two-implant overdentures with minimal training.

Trauma to oral soft tissues in comatose patients may be more widespread than reported, as no extensive study of this problem has been conducted. Various appliances for the prevention of self-inflicted injuries to oral tissues particularly in children and the physically and mentally challenged have been documented, but there is little information on their use in adult comatose patients. Because comatose patients lack cerebral control of the masticatory cycle, they can easily injure themselves. Although it is not uncommon for patients with a decreased level of consciousness and in need of intensive care to be restrained to prevent injury due to involuntary movement of the limbs, head and neck restraint is often difficult and may be dangerous to the patient. This case report presents a simple solution to the problem of self-inflicted trauma to oral tissues.