Estudo clínico randomizado sobre o impacto do padrão oclusal no prognóstico de próteses totais convencionais de pacientes com rebordos severamente reabsorvidos

Abstract

Bilateral Balanced Occlusion (BBO) and Canine Guidance (CG) are occlusal schemes that have been used successfully in complete dentures of patients with normal mandibular bone height. However, there is still a lack of clinical evidence related to occlusal schemes for conventional complete dentures wearers with severely resorbed mandibular bone. Thus, this study aimed to evaluate the effect of CG in comparison to BBO on denture satisfaction, oral health-related quality of life (OHRQoL) and masticatory performance of conventional complete dentures wearers with severely resorbed mandibular bone by means of a crossover trial. Twelve edentulous patients with severely reabsorved ridges were treated with new maxillary and mandibular complete dentures and, after adaptation period, they were randomly divided into two groups who received a sequence of occlusal schemes: BBO for 30 days followed by 30 days of CG or 30 days of CG followed by BBO for 30 days. Patient satisfaction with their dentures, OHRQoL and masticatory performance were assessed immediately 30 days after the use of each occlusal scheme. The results of satisfaction and OHRQoL were evaluated by the Wilcoxon test and data regarding masticatory performance through paired t test. The IBM SPSS Statistics program (version 19.0) was used, with a significance level of 5%. The occlusal scheme used in complete dentures had no influence on general patient satisfaction (14.91 ± 2.10 for BBO and 14.00 ± 2.17 for CG; p = 0.06) overall OHRQoL (3.58 ± 3.57 for BBO and 4.91 ± 4.87 for CG; p= 0.09) or masticatory performance (%) of patients (28.70 ± 5.4 for BBO versus 34.40 ± 7.4 for CG; p = 0.182) of patients with severely resorbed mandibular bone. Thus, this study results showed that both BBO and CG can be considered as eligible occlusal schemes for oral rehabilitation with conventional complete dentures even in patients with severely resorbed alveolar ridges. Considering that both occlusal schemes provide similar satisfaction, quality of life and masticatory performance, CG might be considered as a scheme of choice by the clinician due to its greater simplicity and shorter execution time. (This trial was registered in ensaiosclinicos.gov.br, identification code UTN: U1111-1184-6412).