Patient Satisfaction and Oral Health–Related Quality of Life 10 Years After Implant Placement

 

TAKE-HOME MESSAGE

  • This cross-sectional study examined the oral health–related quality of life after 10 years of implant restorations in 95 patients. Most patients were satisfied with the treatment and felt that the implant restorations had improved their quality of life. The inability to clean the implant prostheses and presence of peri-implantitis were the primary complaints.

  • The study suggested that implant restorations can improve oral health–related quality of life. Implant restorations should therefore be considered as part of improving and maintaining general health, especially in elderly populations.
–  Sompop Bencharit, DDS, MS, PhD, FACP

Implant outcomes research has traditionally focused on clinically assessed disease-oriented measures. However, in most cases these physical measures are not readily perceived by patients. Therefore, patient‑reported outcome measures (PROMs), which are true outcomes, have gained momentum in dental and medical research to better capture disease burden and treatment effect. Examples of dental PROMs include overall patient-reported satisfaction, phonetics, chewing comfort, stability, cleanability, and aesthetics. Wang et al recently reported on “[p]atient satisfaction and oral health-related quality of life 10 years after implant placement.”

This study is of great interest for 2 reasons. Firstly, long-term outcomes are valuable in dentistry because they can provide estimates of the longevity of the intervention. Secondly, by capturing PROMs after 10 years, the authors provide valuable data that can be highly translatable when communicating expectations to patients prior to treatment. Results showed that in a sample of 95 persons mostly restored with single implant-supported crowns or partial fixed dental prostheses, 87.4% of participants reported high satisfaction after 10 years, while 11.6% were “mostly satisfied.” PROMs for phonetics, aesthetics, and chewing comfort, all of which are important dimensions of oral health-related quality of life, were high. From a patient-reported viewpoint, “cleanability” was a possible concern for a number of individuals with only 66% of the sample population reporting no concerns. The Oral Health-Impact Profile (OHIP-49) long-version questionnaire was employed to assess oral health-related quality-of-life burden and identified that the most common limitations experienced by partially edentulous patients with implants have to do with “functional limitation” in the form of “food catching.” 

Collectively, these results show that implant treatment is a viable option to restore function, aesthetics, and overall well-being for dental patients after 10 years post-implant placement. This is a much more relevant outcome for the next patient in our dental chair rather than a X% risk for greater than 2 mm of marginal bone loss after 10 years.

BACKGROUND

Implant survival and implant success (freedom of biologic complications) are important factors in assessing the success of implant therapy. However, these factors are not the only determinants. Patients' satisfaction also plays a very important role in daily practice. Therefore, the aim of this study was to assess patients' satisfaction regarding function (phonetics, chewing comfort, stability, cleanability) and aesthetics in patients treated with XiVE and Frialite implants in a private periodontal practice ten years after implant placement. Furthermore, oral health-related quality of life (OHRQoL) was evaluated.

METHODS

Patient-reported outcome measures (PROMs) regarding overall satisfaction, phonetics, chewing comfort, stability, cleanability, and aesthetics were examined on a Visual Analog Scale (VAS) 10 years ± 6 months after implant placement in a cross-sectional survey. OHRQoL and psychological impact were assessed via the Oral Health Impact Profile (OHIP) and Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ). Potential influence of patient-related factors (age, gender, smoking, peri-implantitis, implant position, type of restoration) on VAS, OHRQoL and PIDAQ were investigated using regression analyses.

RESULTS

High satisfaction with implant-supported restorations was seen in all 95 patients ten years after implant placement. Mean VAS-score for general satisfaction with implant-supported restoration was 93.0% (SD ± 9.4, median: 96.3%, range 50.0-100%). Mean OHIP score was 11.3 (SD ± 10.8, median: 9.0, range 0-45), mean PIDAQ score 20.5 (SD ± 11.37, median: 17.0, range 0-52). A slight tendency that presence of a moderate/severe peri-implantitis lowers satisfaction could be detected (overall satisfaction: ordinal, p = 0.012, VAS, p = 0.026). Also, the factors age, implant position and type of restoration might have an impact on patient's satisfaction.

CONCLUSIONS

Patients restored with mostly fixed implant-supported restorations showed a very high patient satisfaction regarding function and aesthetics 10-year after implant placement. The presence of a moderate/severe peri-implantitis showed a slight tendency for influencing patient satisfaction. Due to the cross-sectional design results have to be interpreted with care.

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