The Effects of Mandibular Two-implant Overdentures on Nutrition in Elderly Edentulous Individuals

The Effects of Mandibular Two-implant Overdentures on Nutrition in Elderly Edentulous Individuals
2003
J.A. Morais1, G. Heydecke2, J. Pawliuk2, J.P. Lund2,3, and J.S. Feine2,4,*
Journal of Dental Research
1 Nutrition and Food Science Centre, Royal Victoria Hospital, Faculty of Medicine, McGill University;
2 Faculty of Dentistry, McGill University;
3 Centre de Recherche en Sciences Neurologiques, Universit?© de Montr?©al; and
4 Associate Member, Dept. of Epidemiology and Biostatistics, Faculty of Medicine, McGill University, 3640 University Street, Montreal, Quebec H3A 2B2, Canada;
*corresponding author, jocelyne.feine@mcgill.ca
ABSTRACT
It is unclear whether mandibular implant overdentures improve the nutritional state of edentulous patients better than conventional dentures. In a randomized clinical trial, we tested for post-treatment differences in nutritional status between patients with mandibular two-implant retained overdentures and those with conventional complete dentures. Edentulous subjects (ages 65ЗѓП75 yrs) received two-implant mandibular overdentures (IOD, n = 30) or conventional dentures (CD, n = 30). Measures of nutritional state were gathered before and 6 mos after treatment. Significant improvements in anthropometric parameters were detected in the IOD but not in the CD group, for percent body fat (p = 0.011) and skin-fold thickness at the biceps, subscapularis, and abdomen (p < 0.05), with significant decreases in waist circumference (p < 0.0001) and waist-hip ratio (p = 0.001). Significant increases were seen in concentrations of serum albumin (p = 0.015), hemoglobin (p = 0.01), and B12 (p = 0.01). No significant between-group differences were found. These results suggest that low-cost IOD treatment may improve the nutritional state of edentulous people.
KEY WORDS: nutrition Зѓў elderly Зѓў mandible Зѓў edentulous Зѓў dental prosthesis Зѓў dental implants
INTRODUCTION
Millions of people throughout the world have lost all of their teeth, and prevalence increases with age. In the United States, prevalence of edentulism in seniors (aged 65 yrs and over) ranges from 13.9% in Hawaii and 16.2% in California to 44.0% in Kentucky and 47.9% in West Virginia (US Department of Health and Human Services, 2000). In Europe, the prevalence of edentulism ranges from 12.8% in Italy to at least 60% in Denmark, the Netherlands (65.4%), and Iceland (69.6%; Bourgeois et al., 1998).
The elderly edentulous avoid many types of foods, particularly raw vegetables and other hard and tough foods, because they cannot chew these with conventional dentures (Hartsook, 1974; Wayler and Chauncey, 1983; Chauncey et al., 1984). As a result, such individuals consume significantly less protein and other key nutrientsЗѓУincluding fiber, calcium, non-heme iron, and some vitaminsЗѓУthan do individuals with teeth (Sheiham et al., 2001). This may explain why elderly institutionalized Japanese with no teeth have poorer general health and higher mortality rates than those with teeth (Shimazaki et al., 2001).
Several studies have shown that the ability of edentulous patients to chew most foods improves significantly when the mandibular denture is fully or partly supported by endosseous implants (Feine et al., 1994; Geertman et al., 1999). We have recently shown that a simple overdenture with ball attachments on 2 implants in the anterior mandible provides significantly greater satisfaction, masticatory function, and oral-health-related quality of life (OHRQoL) than new conventional dentures (Awad et al., 2000). In a second randomized clinical trial (RCT) (seniors aged 65ЗѓП75 yrs), the group with overdentures (IOD Group) had a greater ability to chew tough meat and raw fruits and vegetables than the conventional denture group (CD Group; Awad et al., in press). In this paper, we report the results of anthropometric and nutritional analyses that were carried out during the trial. We tested the hypothesis that there is no difference in nutritional status between patients with mandibular two-implant retained overdentures and those with conventional dentures at 6 mos post-treatment.
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