introduction aim of study hypothesis statistical analysis materials and methods results Conclusion

1. MASTICATORYEFFIFICIENCYINCOMPLETE
DENTUREANDSINGLEIMPLANTRETAINED
MANDIBULAROVERDENTUREWEARERS
WITHDIFFERENTOCCLUSIONSCHEMES:A
RANDOMIZEDCLINICALTRIAL
CibeleO. M. Rocha,DDS, MSc,aDiogoLonghini,DDS, MSc,PhD,bRodrigo
P. Pereira,DDS,MSc,PhD,c Amanda L. O. Lima,DDS,MSc,d Fernanda
S. S. Bonafé,DDS,MSc,PhD,eandJoãoN.ArioliFilho,DDS,MSc,PhDf

2. INTRODUCTION
 Edentulism --- loss of facial muscle support and
decreased masticatory function
 Overdentures- alternative option

3. To evaluate the masticatory efficiency (ME) in completely
edentulous participants rehabilitated with bimaxillary
conventional complete dentures or single implant
mandibular overdentures with bilateral balanced
occlusion (BBO) and lingualized occlusion (LO).
AIM
OF
STUDY

4. HYPOTHESIS
 Masticatory efficiency would be similar for
complete dentures and overdentures and for
bilateral balanced occlusion and lingualized
occlusion.

5. MATERIALS
& METHODS
Study design:
2 stages randomized
crossover clinical trial
Sample size:
30 edentulous
participants

7. STATISTICAL
ANALYSIS
Gpower software was used.
ANOVA (3way to compare ME according to type of
prosthesis & 2way to compare no. of cycles)
Followed by shapiro wilk and levene tests (to verify
distribution of normality) and sidak test (for
multiple comparison).

8. MATERIALS&METHODS
INCLUSION CRITERIA
• Angle class I relationship
• Minimal or moderate alveolar bone
resorption
• Normal neuromuscular control.
EXCLUSION CRITERIA
• Neuromuscular dysfunction
• Psychological problems
• Xerostomia
• Oral lesions

9. RESULTS

10. RESULTS

11. RESULTS (P <0.05)

12. RESULTS

13. RESULTS

14. DISCUSSION
The null hypothesis was accepted for the occlusal
scheme and rejected for the type of prosthesis.
Improved mastication has been reported for LO in
some studies.
Deniz and oskan reported that LO increased the ME
and patient satisfaction, besides reducing the
mastication time.

15. DISCUSSION
Kawai et al did not find any difference between occlusal
schemes initially, but after 6 months, participants with
severe mandibular resorption and BBO showed lower
satisfaction.
However, these studies were conducted for conventional
complete dentures, and the results cannot be assumed for
overdentures.

16. DISCUSSION
STRENGTHS
• True randomization eliminates biasness from study.
• Allows within patient comparison of two or more
interventions.

17. DISCUSSION
LIMITATIONS
• 2-crossover design instead of a single crossover design.
• The installation order of prostheses was not
randomized.
• Single implant overdenture were included.
• Inability to masticate the artificial test food, resulting in
null ME

18.  A mandibular single implant improved the
masticatory efficiency of patients with complete
dentures, but the occlusal scheme did not influence
this factor.
CONCLUSION

19. REFRENCES
Maeda Y, Horisaka M, Yagi K. Biomechanical rationale for a single implant retained mandibular overdenture: an in vitro study. Clin Oral Implants Res
2008;19:271-5.
Walton JN, Glick N, Macentee MI. A randomized clinical trial comparing patient satisfaction and prosthetic outcomes with mandibular overdentures
retained by one or two implants. Int J Prosthodontic 2009;22:331-9.
ronstrom M, Davis B, Loney R, Gerrow J, Hollender L. A prospective randomized study on the immediate loading of mandibular overdentures supported
by one or two implants: a 12-month follow-up report. Int J Oral Maxillofac Implants 2010;25:181-8. 21. Bryant SR, Walton JN, MacEntee MI. A 5-year
randomized trial to compare 1 or 2 implants for implantoverdentures. J Dent Res 2015;94:36-43.
Manly RS, Bradley LC. Masticatory performance and efficiency. J Prosthetic Dent 1950;29:448-62.
Deniz DA, Kulak Ozkan Y. The influence of occlusion on masticatory performance and satisfaction in complete denture wearers. J Oral Rehabil
2013;40:91-8.
Kawai Y, Ikeguchi N, Suzuki A, Kuwashima A, Sakamoto R, Matsumaru Y, et al. A double blind randomized clinical trial comparing lingualized and fully
bilateral balanced posterior occlusion for conventional complete dentures. Prosthodontic Res 2017;61:113-22.
Basso MFM, Nogueira SS, Arioli Filho JN. Comparison of the occlusal vertical dimension after processing complete dentures made with lingualized
balanced occlusion and conventional balanced occlusion. J Prosthetic Dent 2006;96:200-4.
Becker CM, Swoope CC, Guckes AD. Lingualized occlusion for removable prosthodontics. J Prosthet Dent 1977;38:601-8.
Sutton AF, Mc Cord JF. A randomized clinical trial comparing anatomic, lingualized and zero-degree posterior occlusal forms for complete dentures.J
Prosthet Dent 2007;97:292-8.
Kimoto S, Atsuko G, Yamakawa A, Ajiro H, Kanno K, Shinomiya M, et al. Prospective clinical trial comparing lingualized occlusion to bilateral balanced
occlusion in complete dentures: a pilot study. Int J Prosthodont 2006;19: 103-9.
Khamis MM, Zaki HS. A procedure for constructing dentures with interchangeable teeth. J Prosthet Dent 1997;78:609-13.
Olthoff LW, van der Bilt A, Bosman F, Kleizen HH. Distribution of particle sizes in food comminuted by human mastication. Arch Oral Biol 1984;29: 899-
903.
Cordioli G, Majzoub Z, Castagna S. Mandibular overdentures anchored to single implants: a fifive-year prospective study. J Prosthet Dent 1997;78:159-
65.
Alsabeeha N, Swain MV, Payne AGT. Clinical performance and material properties of single-implant overdenture attachment systems. Int J Prosthodont
2011;24:247-54.
iddelow G, Henry P. A prospective study of immediately loaded single implant-retained mandibular overdentures: preliminary one-year results. J
Prosthet Dent 2007;97:S126-37.
McKenna G, Lillywhite G. Accelerated rehabilitation of an edentulous patient with an implant retained dental prosthesis: a case report. Gerodontology
2007;24:181-4.

20. REFRENCES
Maeda Y, Horisaka M, Yagi K. Biomechanical rationale for a single implant retained mandibular overdenture: an in vitro study. Clin Oral Implants Res
2008;19:271-5.
Walton JN, Glick N, Macentee MI. A randomized clinical trial comparing patient satisfaction and prosthetic outcomes with mandibular overdentures
retained by one or two implants. Int J Prosthodont 2009;22:331-9.
ronstrom M, Davis B, Loney R, Gerrow J, Hollender L. A prospective randomized study on the immediate loading of mandibular overdentures supported
by one or two implants: a 12-month follow-up report. Int J Oral Maxillofac Implants 2010;25:181-8. 21. Bryant SR, Walton JN, MacEntee MI. A 5-year
randomized trial to compare 1 or 2 implants for implantoverdentures. J Dent Res 2015;94:36-43.
Manly RS, Bradley LC. Masticatory performance and efficiency. J Prosthet Dent 1950;29:448-62.
Deniz DA, Kulak Ozkan Y. The influence of occlusion on masticatory performance and satisfaction in complete denture wearers. J Oral Rehabil
2013;40:91-8.
Kawai Y, Ikeguchi N, Suzuki A, Kuwashima A, Sakamoto R, Matsumaru Y, et al. A double blind randomized clinical trial comparing lingualized and fully
bilateral balanced posterior occlusion for conventional complete dentures. Prosthodont Res 2017;61:113-22.
Basso MFM, Nogueira SS, Arioli Filho JN. Comparison of the occlusal vertical dimension after processing complete dentures made with lingualized
balanced occlusion and conventional balanced occlusion. J Prosthet Dent 2006;96:200-4.
Becker CM, Swoope CC, Guckes AD. Lingualized occlusion for removable prosthodontics. J Prosthet Dent 1977;38:601-8.
Sutton AF, Mc Cord JF. A randomized clinical trial comparing anatomic, lingualized and zero-degree posterior occlusal forms for complete dentures.J
Prosthet Dent 2007;97:292-8.
Kimoto S, Atsuko G, Yamakawa A, Ajiro H, Kanno K, Shinomiya M, et al. Prospective clinical trial comparing lingualized occlusion to bilateral balanced
occlusion in complete dentures: a pilot study. Int J Prosthodont 2006;19: 103-9.
Khamis MM, Zaki HS. A procedure for constructing dentures with interchangeable teeth. J Prosthet Dent 1997;78:609-13.
Olthoff LW, van der Bilt A, Bosman F, Kleizen HH. Distribution of particle sizes in food comminuted by human mastication. Arch Oral Biol 1984;29: 899-
903.
Cordioli G, Majzoub Z, Castagna S. Mandibular overdentures anchored to single implants: a fifive-year prospective study. J Prosthet Dent 1997;78:159-
65.
Alsabeeha N, Swain MV, Payne AGT. Clinical performance and material properties of single-implant overdenture attachment systems. Int J Prosthodont
2011;24:247-54.
iddelow G, Henry P. A prospective study of immediately loaded single implant-retained mandibular overdentures: preliminary one-year results. J
Prosthet Dent 2007;97:S126-37.
McKenna G, Lillywhite G. Accelerated rehabilitation of an edentulous patient with an implant retained dental prosthesis: a case report. Gerodontology
2007;24:181-4.

21. THANK YOU

22. QUESTION
 Q.What is difference between randomized clinical trial
and randomized crossover clinical trial?
 Q.Why overdenture is considered better option than
complete denture?