Implant-supported Mandibular Overdentures in Very Old Adults

Randomized, parallel-group, open-label controlled trial in very old institutionalized edentulous adults (age ≥75) requiring assistance with activities of daily living. 51 edentulous patients were screened; 45 were randomized to implant overdentures (n=23) or conventional relines (n=22). After randomization, withdrawals occurred (7 from intervention, 4 from control). Final analyzed: intervention n=16; control n=18. Baseline groups were balanced by sex (intervention: 9F/7M; control: 14F/4M). The intervention converted the lower denture to implant overdentures using two short interforaminal implants; follow-up at 3 and 12 months; intention-to-treat with last observation carried forward; not blinded.

Implant overdentures significantly improved denture satisfaction (DS-VAS) and denture stability and maximum bite force after 3 and 12 months compared with conventional relines. Masseter thickness on the preferred chewing side increased with IODs; chewing efficiency did not differ between groups. Oral-health-related quality of life improved in both groups (OHIP-EDENT). BMI declined modestly in both groups. Authors conclude that converting existing dentures to implant overdentures is a feasible and beneficial option for very old, dependent edentulous patients, though the study was small and underpowered for some outcomes.

Small sample size and premature termination due to funding; dropout and missing data; open-label design; limited generalizability to non-institutionalized or healthier elderly populations; some secondary outcomes may be underpowered.