Willingness to accept or refuse mandibular implant overdenture treatment: a prospective study on edentulous enrolled in a clinical trial.

Leles, Cláudio Rodrigues; Nascimento, Lays Noleto; Silva, Jésio Rodrigues; de Paula, Marcella Silva; Curado, Thalita Fernandes Fleury; McKenna, Gerald; Schimmel, Martin (2023). Willingness to accept or refuse mandibular implant overdenture treatment: a prospective study on edentulous enrolled in a clinical trial. Journal of oral rehabilitation, 50(5), pp. 392-399. Wiley 10.1111/joor.13429

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OBJECTIVE

The aim was to evaluate edentulous patient's willingness to accept or refuse the offer and provision of implant-retained treatment.

METHODS

As part of a clinical trial, edentulous subjects were offered a mandibular overdenture retained by four mini-implants opposing a conventional maxillary denture. Treatment was offered without any financial costs for the patients. Patients' level of interest in receiving treatment was assessed using a 5-point Likert scale and they were asked to respond to a list of reasons that led to their decision to accept or refuse implants. Those who refused implants received conventional prosthodontic interventions as required, and those who accepted implant treatment underwent surgical planning and implant placement.

RESULTS

Of 175 eligible subjects, 147 accepted the offer of treatment and were invited to take part in the study (69.4% women, mean age 67.4±10.0 years). Overall, 111 patients (75.5%) expressed a positive intention to undergo implant treatment at the initial contact. Implant treatment was performed for 56.3% (9/16) of those who answered "probably yes" about their level of interest in implant treatment on the Likert scale, and 69.6% (64/92) of "certainly yes" (p<0.001). Older subjects were less likely to receive implants (OR=0.93; p=0.036), whilst those with a positive intention toward implants (OR=3.15; p=0.001), those previously treated by the dental team (OR=7.89; p<0.001), and who actively demanded implants (OR=18.1; p<0.001) were more likely to accept treatment. Improved chewing was the most common reason for accepting implants, whilst fear of surgery was the most reported reason for refusal.

CONCLUSION

Refusal of implants was high amongst edentate patients even when financial costs were removed. Patients' initial attitude towards acceptance is a key factor in the demand for and uptake of implant therapy.

Interest & Impact

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