Influence of guidance concept in complete dentures on oral health related quality of life - Canine guidance vs. bilateral balanced occlusion

PURPOSE: To compare the impact of canine guided vs. bilateral balanced occlusion on oral health related quality of life (OHRQoL) as a patient-reported outcome measure.

METHODS: In this randomized single-blind crossover trial, 19 patients have been provided with new complete dentures in the maxilla and mandible. OHRQoL was assessed using the 49-item Oral Health Impact Profile (OHIP-49) before the start of the prosthodontic treatment (B), 3 months after insertion of the new dentures (T1), and 3 months after rework into the alternative concept (T2). Multilevel mixed-effect linear regression models were computed to determine the effect provided by the new set of dentures and the specific impact of the occlusal concept on OHRQoL using summary scores of the OHIP-49 and of a 19-items subset specific for edentulous patients (OHIP-EDENT).

RESULTS: At baseline, participants' OHRQoL was substantially impaired indicated by an average OHIP-49 score of 42.1 points and an OHIP-EDENT score of 21.1 points. The effect of provision of a new set of complete dentures was a statistically significant decrease of 8.3 points (OHIP-49) and 4.0 points (OHIP-EDENT), respectively, representing a clinically relevant improvement in OHRQoL. When wearing dentures with bilateral balanced occlusion, participants showed on average 1.6 points higher OHIP-49 scores and 0.9 points higher OHIP-EDENT scores compared to canine guided dentures. This effect of the occlusal concept was neither statistically nor clinically significant.

CONCLUSIONS: Both investigated occlusal concepts for complete dentures were comparable in their effect on patients' perceptions with none being considerably superior in terms of OHRQoL.