A nationwide evaluative study on implant-retained overdentures

Objectives: In the Netherlands, dental implants have been included in the National Dental Insurance Scheme (NDIS) since 1989. Nowadays, out-of-pocket expenditure is low, making implant treatment financially feasible for a large group of edentulous, potential implant candidates. Treatment can be performed by both oral surgeons and general dentists. Results of implant treatment in the literature are usually obtained in academic and specialized centers. In contrast to this, the present study evaluates the quantitative and qualitative aspects of rehabilitation with oral implants in combination with an overdenture when applied on a nationwide scale. Methods: For this purpose all patients (n=5410) treated between January 1989 and July 1992 were extensively documented pre-operatively, implant patients (n=429) were clinically investigated by two independent observers and the effect of treatment on denture complaints was assessed by means of a questionnaire (n=460). Results: Only a small proportion of the potential pool of implant candidates is actually being treated, to a constant number of approximately 2000 patients a year. The selected patients have major denture problems and have received relatively high levels of prosthetic care during the last decade. Clinical results are comparable to those reported in the literature, implant survival after 3 years for the lower jaw being 96.3% and for the upper jaw 70.4%. Oral hygiene was frequently considered suboptimal and seen in conjunction with marginal inflammation of the peri-implant mucosa. Subjective results were excellent, patients were quite satisfied with the improvements in the comfort and esthetics of their lower denture. Conclusions: Implant-overdenture treatment, within the guidelines and regulations set by the Dutch NDIS, is a safe and effective treatment alternative, in particular for the rehabilitation of the lower jaw. (C) 1997 Elsevier Science Ltd.