Quality of life and satisfaction of users of total tissue-supported and implant-supported prostheses in the municipality of Macapá, Brazil

Despite the high number of total edentulism cases in Brazil, no studies have yet examined the characteristics of people with edentulism in Amapá. Therefore, the objective of this study was to evaluate and compared the satisfaction and quality of life of edentulous users of total tissue-supported and total implant-supported prostheses in Macapá, Amapá, Brazil. Two hundred ninety-nine users of total tissue-supported prostheses and 48 users of total implant-supported prostheses were surveyed using two questionnaires: The Oral Health Impact Profile-14Br and a visual analog scale of satisfaction. The means and standard deviations were used to characterize the quantitative variables and absolute and relative frequencies were used to characterize the qualitative variables as well as certain quantitative variables. When evaluating users’ satisfaction according to the type of prosthesis, we found that users of implant-supported prostheses were 100% satisfied with both upper and lower prostheses. By contrast, among users of tissue-supported prostheses, 90% reported being satisfied with the upper prosthesis, while 56% demonstrated some dissatisfaction with the lower removable prosthesis. All users of implant-supported prostheses reported good quality of life; by contrast, only 5% of users of tissue-supported prostheses reported good quality of life, while 73% reported a reasonable quality of life and 22% a poor quality of life. To our knowledge, this is the first study on this topic in Amapá. The study results are clinically relevant for accurately determining the quality of life of these prosthesis users.


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The number of people with edentulism is growing in Brazil

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We applied the following inclusion criteria: users with complete edentulism who 88 had up to 10 years of use of either total tissue-supported or total implant-supported 89 prostheses and who lived in Macapá. We excluded the following patients: patients who 90 had used their prostheses for more than 10 years; patients with partial edentulism; 91 patients with complete edentulism only in a single arcade; users of removable partial 92 tissue-supported prosthesis; users of removable or partial dentures on implants; users 93 with complete edentulism who use total tissue-supported prosthesis in one arcade but 94 total implant-supported prosthesis in another; patients who do not live in the urban 95 area of Macapá; and patients with some form of mental or physical disability.

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To calculate the ideal sample size for each group, we applied the following 97 formula:

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We determined the margin of error to be 5% and the confidence level to be 104 95%. Accordingly, the necessary sample sizes for the total tissue-supported and 105 implant-supported prosthesis users were 299 and 48, respectively.

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The first questionnaire assessed satisfaction with the prostheses using a visual 113 analog scale (VAS). The questionnaire assessed four aspects-satisfaction with 114 retention, mastication, esthetics, and overall satisfaction-that applied to each of the 115 prostheses that patients used. The VAS for each question ranged from 0 to 10 points 116 (for a potential total score of 40 points). We divided the total score by four to arrive at 117 the final score for satisfaction with the prosthesis. We further categorized the results 118 as follows: 0-2.5 points corresponded to "very dissatisfied," 2.75-5.0 to "dissatisfied," 119 5.25-7.5 to "satisfied," and 7.75-10 to "very satisfied." 136 Second, this value was multiplied by a specific weight assigned to each question, as 137 shown in Table 1.
138 158 The nonparametric Mann-Whitney U-Test was adopted because it is useful not 159 only for analyzing non-normal data but also for analyzing categorical data. We

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Of the 347 participants, 299 used total tissue-supported prostheses and 48 169 used total implant-supported prostheses. As for the period of use of implant-supported 170 prostheses, the most prevalent answer was one to three years, at 48% (n = 23) for the 171 upper prosthesis and 44% (n = 21) for the lower prosthesis. By contrast, among users 8 172 of tissue-supported prostheses, four to six years of use was the most prevalent, at 173 62% (n =185) for the upper prosthesis and 47% (n = 140) for the lower (Table 2).

Implant-supported prosthesis Tissue-supported prosthesis Classification
194  204 The mean quality of life score of patients who used implant-supported 205 prostheses was 3.24 (±01.32), which was significantly lower (p < 0.0001) than that of 206 patients who used tissue-supported prostheses, who had a mean score of 15.63 207 (±3.23). Thus, individuals who used the implant-supported prostheses had a better 208 quality of life than did those who used tissue-supported prostheses (Table 7).
209 Tissue-supported prosthesis 15.63 3.23 We found strong correlations of quality of life with age and period of use for 213 tissue-supported prosthesis users. Specifically, the longer the use of the prosthesis 214 and the greater their age, the worse was their quality of life. These relationships did 215 not exist among users of implant-supported prostheses (Table 8). No other correlation 216 showed statistical significance (p > 0.05).