Patient-Reported Outcome Measures of Edentulous Patients Restored with Implant-Supported Removable and Fixed Prostheses
Amsterdam 2018
Patient-Reported Outcome Measures Associated with Implant Dentistry
Consensus Statement
Treatment Outcomes and Continuing Care
Preamble

The aim of this review was to summarize the scientific evidence on implant supported removable and fixed prostheses for edentulous populations and to compare Patient-Reported Outcome Measures such as satisfaction, impact of prosthesis on oral health-related quality of life or any other PROMs reported within this field. In all, 13 studies met the inclusion criteria. Most studies reported different measures of patients’ satisfaction and oral health-related quality of life PROMs. However, due to lack of standardization and high heterogeneity, no meta-analysis or collective quantitative analysis of the results was possible. On the basis of the existing evidence on all studied parameters, neither prosthetic design — fixed or removable — was rated by patients as consistently superior, with the exception of the ability to practice oral hygiene, which is perceived by patients to be superior with removable implant supported prostheses.

Consensus Statements
  • PROMs are not commonly used in clinical implant research. There are currently no guidelines on what PROMs are most appropriate for implant dentistry. This statement was based on 13 investigations, including one RCT, seven prospective and five retrospective studies.
     
  • The timing of PROMs assessment in the literature is inconsistent and often limited to one time point.
    This statement was based on 13 investigations, including one RCT, seven prospective and five retrospective studies.
     
  • Reporting of patients’ characteristics and sampling techniques in PROMs research is inadequate, which could limit the ability to draw conclusions in implant dentistry.
    This statement was based on 13 investigations, including one RCT, seven prospective and five retrospective studies.
     
  • There are no differences in PROMs between Implant-supported Overdentures (IOD) and Implant-supported Fixed Complete Dentures (IFCD), except for perceived maintenance of oral hygiene, which is rated higher with IODs.
    This statement was based on 13 investigations, including one RCT, seven prospective and five retrospective studies. The oral hygiene superiority of IOD is based on five investigations, including one RCT, three prospective and one retrospective studies.
Clinical Recommendations
  • Should PROMs supplement clinical implant patient care? Patient perceptions of psychosocial state, functional limitation, pain and discomfort, and expectations should be assessed before implant treatment. Clinicians are advised to use PROMs when assessing clinical outcomes.
    Based on Consensus Statement 1.
     
  • Should the assessment of PROMs be conducted prospectively? Before implant treatment , a baseline assessment of patient perception of oral health-related quality of life and satisfaction should be recorded. After treatment completion, the assessment of PROMs should be conducted prospectively at appropriate intervals, case dependent.
    Based on Consensus Statement 2.
     
  • Based on PROMs, should clinicians rehabilitate fully edentulous patients with Implantsupported Overdentures (IOD) or Implant-supported Fixed Complete Dentures (IFCD)? The decision of whether to rehabilitate a patient with fixed or removable implant prostheses cannot be based solely on PROMs. Such decisions should be guided by the specific anatomy, clinical parameters, as well as the patient’s needs and wishes. In cases in which either treatment is feasible, proper assessment of patients’ expectations and desires before treatment is critical prior to deciding between fixed or removable prosthesis.
    Based on Consensus Statement 4.
     
  • Do patients perceive differences in their ability to maintain oral hygiene with IFCDs and IODs? Patients report that it is easier for them to maintain oral hygiene with an implant overdenture (IOD) than with an implant fixed conventional denture (IFCD); therefore, the IOD may be preferable for certain patients.
    Based on Consensus Statement 4.
Review Paper
Classification Tags
Case Type
Consensus Statement
Edentulous Mandible
Edentulous Maxilla
FDP
Full-Arch FDP
Full-Arch RDP
Outcomes
Prosthesis Design
Prosthodontics
RDP
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Publication date: November 16, 2018 | Review date: November 09, 2018 | Next review date: November 09, 2021