Kavitha P Das1, Leila Jahangiri, Ralph V Katz. 1. Department of Prosthodontics, College of Dentistry, New York University, New York City, , NY 11220, USA. kav2010.k@gmail.com
Abstract
BACKGROUND: In 2002 and 2009, two consensus statements-one from a symposium in Canada and one from England-were issued that recommended that the first-choice standard of care for an edentulous mandible should be the two implant-retained mandibular overdenture (IRMOD). The authors conducted a survey to determine if, in 2011, U.S. academic prosthodontic experts' opinions were aligned with those in the two consensus statements. METHODS: The authors administered a Delphi method survey to an expert panel of 16 nationally representative academic prosthodontists to determine if there is consensus on the first-choice standard of care for an edentulous mandible between the IRMOD and a conventional mandibular complete denture (CD). Consensus agreement was defined as a 70 percent agreement level among the panelists. RESULTS: The panel attained consensus favoring the IRMOD for nine of the 10 parameters assessed-retention, stability, speech, masticatory efficiency, comfort while eating soft foods and hard foods, confidence in intimate situations, satisfaction and self-esteem. The exception was esthetics for which only a majority (51-69 percent) favored the IRMOD. CONCLUSIONS: The panelists reached consensus that they would recommend an IRMOD instead of a CD as the first-choice standard of care for patients who are healthy or have mild systemic disease, but not for patients with severe systemic disease. CLINICAL IMPLICATIONS: Surveyed academic prosthodontists recommend an IRMOD as the first choice standard of care when restoring an edentulous mandible of a healthy patient or a patient with mild systemic disease.
BACKGROUND: In 2002 and 2009, two consensus statements-one from a symposium in Canada and one from England-were issued that recommended that the first-choice standard of care for an edentulous mandible should be the two implant-retained mandibular overdenture (IRMOD). The authors conducted a survey to determine if, in 2011, U.S. academic prosthodontic experts' opinions were aligned with those in the two consensus statements. METHODS: The authors administered a Delphi method survey to an expert panel of 16 nationally representative academic prosthodontists to determine if there is consensus on the first-choice standard of care for an edentulous mandible between the IRMOD and a conventional mandibular complete denture (CD). Consensus agreement was defined as a 70 percent agreement level among the panelists. RESULTS: The panel attained consensus favoring the IRMOD for nine of the 10 parameters assessed-retention, stability, speech, masticatory efficiency, comfort while eating soft foods and hard foods, confidence in intimate situations, satisfaction and self-esteem. The exception was esthetics for which only a majority (51-69 percent) favored the IRMOD. CONCLUSIONS: The panelists reached consensus that they would recommend an IRMOD instead of a CD as the first-choice standard of care for patients who are healthy or have mild systemic disease, but not for patients with severe systemic disease. CLINICAL IMPLICATIONS: Surveyed academic prosthodontists recommend an IRMOD as the first choice standard of care when restoring an edentulous mandible of a healthy patient or a patient with mild systemic disease.
Authors: Livia Fernandes Probst; Tazio Vanni; Denise de Fátima Barros Cavalcante; Erica Tatiane da Silva; Yuri Wanderley Cavalcanti; Luis Augusto Passeri; Antonio Carlos Pereira Journal: Rev Saude Publica Date: 2019-08-19 Impact factor: 2.106