Is a two-step impression mandatory for complete denture fabrication on the severely resorbed mandible? A randomized trial on mastication, patient satisfaction and adjustments.
OBJECTIVES
To compare one- vs two-step impression procedures for the provision of conventional complete dentures (CCDs) for edentulous individuals with severe mandibular resorption, in terms of (1) masticatory performance and ability; (2) satisfaction with mandibular CCDs; and (3) post-delivery adjustments.


METHODS
Fifty-two patients requiring maxillary + mandibular CCDs were randomly divided into two parallel arms according to the impression method of the mandibular ridge: (SI) single impression with stock trays (irreversible hydrocolloid); (TI) two-step impression in custom trays, with border molding (impression compound) followed by the impression itself (polyether). Mastication performance was evaluated by a colorimetric test, whereas patients answered questions on masticatory ability and satisfaction with mandibular CCDs (100-mm visual analogue scale). The number of post-delivery sessions for adjustments were also quantified. Outcomes were assessed at 3 and 6 months after delivery.


RESULTS
The masticatory performance was similar for both groups, regardless of time (3 months, P = 0.62; 6 months, P = 0.61). No significant difference was found for patient-reported (P > 0.05), i.e. masticatory ability (general ease of chewing and quality of grinding food; ability to chew specific foods), general satisfaction with the mandibular CCD (general satisfaction, comfort, aesthetics, ability to speak and to perform correct cleaning, retention and stability). Both methods resulted in a similar number of post-delivery adjustment sessions [SI: 3.8 (1.7); TI: 3.2 (1.4); P = 0.09].


CONCLUSIONS
Compared to a traditional approach, CCDs obtained from a single impression achieve similar masticatory performance/ability and patient satisfaction, even in patients with severely reabsorbed mandibular ridge. Both methods demand the same amount of post-delivery adjustment.


CLINICAL SIGNIFICANCE
A simplified impression technique which eliminates the secondary impression can provide CCDs of good clinical quality, which influences the OHRQoL, and satisfaction in the same extent they would by a two-step procedure, even for patients with severely reabsorbed mandibular ridges (ClinicalTrials.gov: NCT02339194).
['Albuquerque|Ivo S|IS|', 'Freitas-Pontes|Karina M|KM|', 'de Souza|Raphael F|RF|', 'Negreiros|Wagner A|WA|', 'Ramos|Marcelo B|MB|', 'Peixoto|Raniel F|RF|', 'Regis|Rômulo R|RR|']
D003781:Denture Retention D003824:Denture, Complete D006801:Humans D008334:Mandible D008409:Mastication D009066:Mouth, Edentulous D017060:Patient Satisfaction
complete denture mastication patient satisfaction dental impression technique edentulous jaw