15 December 2022

---

Can the overdenture on roots still be a plausible alternative to the overdenture on implants?

Lara Figini

---

Edentulism is a state associated with reduced chewing performance and dietary alterations. This can include a decreased protein intake and a percentage increase in total calories due to increased intake of fatty foods rich in cholesterol with consequent worsening of quality of life. When teeth are extracted, the residual alveolar bone is resorbed leaving little residual support for adequate retention of full dentures.

The most important characteristics of prostheses are comfort, stability and the ability to offer chewing that is not only efficient but also easy. If the prostheses can be stabilized or retained by maintaining roots or inserting implants, there would be a significant benefit.

But which prosthetic rehabilitation offers better performance: overdenture on roots or overdenture on implants?

Materials and Methods

In a review published in the Journal of Prosthodontics in October 2022, the authors compared the results of prosthetic treatment for patients who wear complete maxillary dentures compared with a root-supported mandibular overdenture (RSO) or an implant-supported mandibular overdenture (ISO). 

The authors conducted a literature search using seven electronic databases: Medline via PubMed, Embase, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, Scopus, Web of Science and AgeLine. The search terms were developed by the primary investigators and the health sciences librarian, who then started with PubMed and adapted the original search strategy for the other databases.

Results

Seven relevant articles were included in the final review. No comparative studies were identified for clinically important outcomes such as abutment survival rates, restorative or maintenance issues, and longitudinal cost of care.

Regarding prosthetic complications, patient satisfaction and the ability to clean correctly, no differences were reported between the two different methods.

For oral tactile sensitivity in RSOs a significantly increased sensitivity was found, while in ISO rehabilitations a greater maximum bite force capacity was found, but the difference was not statistically significant, except for subjects with a cross bite or a lingualized occlusion

Conclusions

From the data of this review, the research team concluded that the literature does not give conclusive answers on this issue, except for maximum bite force, where ISO rehabilitations seem to perform better than RSO. 

ISOs had higher survival rates than RSOs, and required less maintenance, but were more expensive. Researchers said it was disappointing to find so few studies comparing these clinical treatment modalities, which suggests that either treatment may be clinically acceptable and depends upon a shared decision between patients and their dentists.

Ronald L Ettinger, Leonardo Marchini and Christopher A Childs. “Are Root-Supported Overdentures Still an Alternative to Implant-Supported Overdentures? A Scoping Review.” Journal of Prosthodontics. 2022 Oct;31(8):655-662. doi: 10.1111/jopr.13498. Epub 2022 Mar 5.