Author ORCID Identifier

Date Available


Year of Publication


Degree Name

Doctor of Philosophy (PhD)

Document Type

Doctoral Dissertation




Clinical and Translational Science

First Advisor

Dr. Jamie L. Studts

Second Advisor

Dr. Hannah Knudsen


Patient satisfaction and quality of life are integral parts of assessing the quality of oral health care. Current aging population trends suggest a growing need to understand the effects of edentulism on oral health and quality of life. As the proportion of aged Americans expands, there will be an increased need to understand treatment options and patient communication strategies. In addition, as new treatment options and innovative technologies emerge, it will be essential to understand patients' concerns and identify best practices associated with denture treatments' individual fit and function. Advanced denture treatments can now be fabricated using CAD/CAM digital denture techniques. However, for many Americans still using conventional complete dentures (CD) or Implant Retained-Overdentures (IOD), it remains essential to consider improving their oral health outcomes and quality of life metrics. Dental schools often feel pressured to adopt and teach the most advanced practices. However, they must continue to focus on the needs of edentulous patients and develop communication training and treatment options for an expanding population of CD and IOD patients. New technological innovations will not displace the need for dental school clinics to prepare student clinicians to identify patient concerns and carefully communicate treatment options.

Due to inexperienced student dentists who provide dental care to patients in dental school settings, patient grievances are generally considered a problem. Patients become unhappy and dissatisfied due to several factors such as less caregiving efficiency, discontinuity of care due to the school's curriculum and summer break, and various institutional policies, i.e., competencies. Patient feedback and satisfaction have proven to be valuable resources for monitoring and improving patient safety. Effective management of patient concerns can assist individual patients and provide insight for dental schools and professional prosthodontic practices that aspire to deliver the highest quality of care possible. Until the new CAD/CAM methods are made more available in public practice and reduced in cost, many edentulous patients will choose between CD and IOD based on the recommendations of their dental provider. In some instances, a CD may be required because of anatomic, functional, or economic reasons. However, implant-retained overdentures are increasingly understood as a preferential alternative treatment option for those with remaining natural teeth and financial ability. While these are the two leading treatment options for edentulism, there is a lack of comparative studies in the literature comparing CD and IOD outcomes. Therefore, there is a need for studies that examine patient satisfaction and quality of life outcomes, particularly as they are associated with student dentists and considered in association with demographic factors. This study assesses patient satisfaction and quality of life among CD wearers and those with IODs. The data collected enable the examination of many essential factors related to oral health and quality of life. Together, these variable considerations allow a deeper understanding of the interpersonal skills and fabrication techniques that should be emphasized in a clinical dental school environment.

The research question that guided the comparative analysis was, "Is patient satisfaction and quality of life affected by the type of prostheses and provider?" A validated questionnaire was mailed to 520 individuals randomly selected from records of patients who had received treatment for edentulous mandible at a student prosthodontic clinic at the University of Kentucky College of Dentistry from 2014 to 2016 with at least one year of follow-up time. A validated questionnaire for edentulous patients based on the Oral Health Impact Profile (OHIP-19) was used. In addition, information on patients' oral health-related quality of life, including questions related to the edentulous patients' satisfaction with their dentures, was collected.

The response rate was 33% (N = 171). Survey results were analyzed using two-sample t-tests and chi-square tests to evaluate differences between and within groups. The study's findings confirm previous findings which suggest that IODs may have a greater impact on oral health-related quality of life. Data show that 76% of the IOD group reported improvement in experience when using the implants to retain the mandibular denture. However, there were no statistically significant differences in the OHIP scores between overall CD and IOD patient groups. Males with IOD had lower physical pain, limitations, and disability scores than males with CD. However, females with IOD reported more significant concerns associated with a social disability and handicap domains. Comparing users who had experiences with both treatment options, this study discerned important characteristics that contribute to increased patient satisfaction with IOD and identified significance in outcomes by gender. These findings serve to guide prosthodontic practitioners' patient care practices and identify a continuing need to discuss CD and IOD treatment protocols within dental school curricula.

Digital Object Identifier (DOI)

Funding Information

This study was supported by the College of Dentistry fund in 2018.