Patient Satisfaction and Dissatisfaction with

Background: Different attachment systems for mandibular two-implant overdentures could influence levels of patient satisfaction. Positive consensus of the majority of patients being satisfied does not preclude the possibility of dissatisfaction for some. Purpose: To evaluate patient satisfaction before and after 5 years of wearing mandibular two-implant overdentures using different attachment systems. Materials andMethods: A total of 106 edentulous participants enrolled in a clinical trial completed a preliminary self-report inventory of their original complete denture complaints. New complete maxillary dentures and mandibular two-implant overdentures were provided to each participant using one of six different attachment systems. Patient satisfaction was determined at pretreatment; at baseline with mandibular two-implant overdenture insertion; and then annually for 5 years, using visual analogue and Likert-type scales. Results: Patient satisfaction with mandibular two-implant overdentures at baseline was significantly improved in all domains compared to pretreatment (old dentures) and sustained up to the 5-year recall. The level of satisfaction with Straumann gold alloy matrices at 5 years was significantly lower than that with other attachment systems. Highly significant differences were found with some social and psychological aspects by the fifth year compared to baseline. Diagnostic and prognostic indicators from a pretreatment inventory identified 12 participants (13.5%) who were dissatisfied. These indicators revealed a maladaptive predisposition to mandibular two-implant overdentures. Conclusions: A mandibular two-implant overdenture (opposing a conventional complete maxillary denture) will improve patient satisfaction, regardless of the attachment system. Careful evaluation of pretreatment complaints with conventional dentures can possibly identify patient dissatisfaction with mandibular two-implant overdentures. KEY WORDS: attachment systems, mandibular implant overdentures, patient satisfactio