Effect of implant rehabilitation on oral health-related quality of life with three different implant strategies

Abstract

Design Non-randomised controlled trial.

Case selection Patients requiring dental implants were recruited from a private dental surgery in Spain. According to the clinical diagnosis and patient preference, patients were assigned to one of the following three treatment protocols: the conventional treatment (CGCL), in which implants were inserted after flap elevation without guiding templates; the guided surgery/conventional loading group (GSCL); and the guided surgery/immediate loading group (GSIL).

Data analysis An oral examination and a questionnaire-based interview were carried out at baseline and three months after the delivery of the definitive prosthetic rehabilitation. Two complementary indicators, Oral Impacts on Daily Performances (OIDP) and Oral Satisfaction Scale (OSS) were used to assess the changes in oral health-related quality of life (OHQoL). Paired t-tests were used to compare the within-subject change scores. ANOVA tests were used to compare quantitative variables between groups. Chi-square tests were used to compare the distribution of data between groups. Effect size was used to assess the relative responsiveness of different health indicators and to compare the amount of change resulting from different treatment protocols. A forward stepwise logistic regression analysis was performed to predict the risk of having impact after treatment.

Results A total of 104 patients were recruited: CGCL (n = 40), GSCL (n = 35) and GSIL (n = 29). At baseline, the OHQoL was significantly greater among those assigned to CGCL (2.4 ± 1.3) than those assigned to GSCL (3.3 ± 1.3), which were both greater than those patients assigned to GSIL (4.6 ± 2.0). After implant therapy, the oral wellbeing was significantly better than at baseline, and patient satisfaction was greater when the implants were loaded immediately (8.7 ± 1.1) than if the prosthetic rehabilitation was delayed (8.3 ± 1.1). In the GSIL group, the effect size of the OIDP exceeded the threshold value of 0.8 for all of the OIDP domains and for the total OIDP score and patient satisfaction.

Conclusions A global improvement in the OHQoL scores and patient satisfaction was observed after implant therapy, but the change was marked greater in the GSIL group.