Longitudinal Assessment of Denture Maintenance Needs

in an Overdenture Population
Ronald L. Ettinger, BDS, MDS, DDSc, DDSc(hc)1 & Fang Qian, PhD2
1
Department of Prosthodontics, University of Iowa College of Dentistry, Iowa City, IA
2
Department of Preventive and Community Dentistry, University of Iowa College of Dentistry, Iowa City, IA

Keywords Abstract
Longitudinal study; maintenance needs;
overdentures.
Purpose: To evaluate the longitudinal denture maintenance needs of a tooth-supported
overdenture population.
Correspondence
Materials and Methods: This prospective cohort study was composed of patients
Ronald Ettinger, Department of who had received tooth-supported overdentures from 1974 to 1994 in the Department
Prosthodontics, University of Iowa College of of Prosthodontics, University of Iowa. There were 272 persons with 662 abutments
Dentistry, Iowa City, IA 52242. who fulfilled the inclusion criteria. To simplify analysis and reduce the number of
E-mail: ronald-ettinger@uiowa.edu. confounding variables, only those participants wearing complete maxillary dentures
and opposing complete mandibular overdentures supported by teeth #22 and #27 were
The authors deny any conflicts of interest included in this analysis. The denture maintenance needs of these participants were
related to this study. identified and related to age, gender, length of time wearing overdentures, number of
medications, and denture-wearing habits. Descriptive statistics and bivariate analyses
Accepted August 8, 2017
were used for the statistical analysis (α = 0.05).
Results: Of the 91 participants (mean age = 59.5 ± 10.1 years; 63.7% male) who
doi: 10.1111/jopr.12735
fulfilled the inclusion criteria at baseline, 48.4% took 1 to 3 medications daily, and
84.6% wore their dentures day and night. The percentages of participants who needed
one or more of the following denture treatments were: 91.2% denture base adjust-
ments, 76.9% laboratory processed relines, 61.5% denture remakes, 33% laboratory
remount and occlusal adjustment, 22% repaired bases, and 19.8% needed denture
teeth replaced. Bivariate analyses indicated that participants who were 65 years and
older needed more denture adjustments than patients younger than 65 years (p =
0.0343). Participants who had worn overdentures for more than 5 years were more
likely to require denture remakes (p = 0.0304). Participants who wore their dentures
only during the day were less likely to require repairs (p = 0.0403). Participants who
did not take any medications were significantly less likely to require denture base
repairs (p = 0.0258). For the 35 participants who returned for recalls at all 4 time
points, males were more likely to need denture teeth repaired or replaced (p = 0.0335)
and those aged 50 to 64 were more likely to need 2 or more adjustments (p = 0.0311).
No overdenture abutments were lost by the participants in this study.
Conclusions: According to the results of this study, age, medication usage, denture-
wearing habits, and age of the overdentures were significant factors associated with
denture maintenance needs. Persons wearing overdentures need regular recalls, be-
cause they have continuing maintenance needs.

Overdentures have been discussed in the literature for over
150 years.1,2 However, it was not until Miller3 reintroduced
the concept of placing complete dentures over retained teeth
in 1958 that this treatment modality became an accepted, re-
alistic alternative to extraction of the remaining teeth. Since
the 1960s, an analysis of several longitudinal studies4-9 showed
benefits to overdentures, such as the retardation of progressive
residual ridge reduction,4,5 better stability of the dentures, as
well as better load transmission of the prostheses, especially of
mandibular overdentures, allowing improved masticatory abil-
ity and efficiency.6-12 There have also been reports of psycho-
logical benefits to patients because they do not feel they are
edentulous.7 This may be an important factor in maintaining
a more positive self-image. There is some evidence that these
persons may maintain some sensory feedback from the peri-
odontal receptors13-15 of the remaining roots, allowing them
more precise oral tactile discrimination than persons wearing
complete dentures.

Journal of Prosthodontics 00 (2017) 1–8 

C 2018 by the American College of Prosthodontists 1
Overdenture Maintenance Needs
Figure 1 Fractured mandibular denture base approximately 18 months
after insertion.
Figure 2 Laboratory preparation on a mandibular overdenture that
needed a repair of the hole over the overdenture abutment.
The disadvantages of using overdentures is a risk of tooth
loss due to susceptibility of overdenture abutments to caries
and periodontal disease due to plaque accumulation; this has
been reported in several longitudinal studies.6-8,16-18 The risk
decreases if the patient has frequent recall appointments for
maintenance, is meticulous with his/her daily hygiene and uses
daily a high concentration topical fluoride gel.6,16 Potential
problems are also associated with the “technical problems of
denture fabrication, denture fracture and increased maintenance
costs.”19 The reported problems20,21 are denture base fracture
(Fig 1), perforation of the denture over the abutment teeth
(Fig 2), loss/fracture of denture teeth, wear of the denture teeth
resulting in loss of occlusal vertical dimension (Fig 3), mobility
of the denture base due to resorption of the residual bone in the
posterior edentulous areas, which would require the overden-
ture be relined or refabricated, and also chronic discomfort with
or without ulceration. A review of mandibular overdentures did
not report on any denture-related problems associated with their
use.22 There is some prospective data on the clinical and tech-
nical aspects related to implant-supported overdentures.23-25 A
few studies20,21 have documented denture-related problems and
denture maintenance needs of persons wearing root-supported
2 Journal of Prosthodontics 00 (2017) 1–8 
Ettinger and Qian
Figure 3 These overdentures had been used for more than 4 years.
overdentures, but even fewer have reported longitudinal data.
The purpose of this paper was to review and report the longitu-
dinal denture maintenance needs of an overdenture population
wearing complete maxillary dentures and mandibular overden-
tures.
Materials and methods
The Iowa prospective cohort study was composed of pa-
tients who received overdenture therapy between 1974 and
1994 in the Department of Prosthodontics at the University
of Iowa. All patients scheduled for new overdentures in the
prosthodontic clinic were asked to participate in this study,
which was approved by the university’s ethics committee (IRB-
01 Biomedical- #9703212b). Written informed consent was ob-
tained from all participating subjects. All restorative care was
provided by predoctoral students, graduate students, or the first
author. The inclusion criteria for this study were that patients
were cognitively able to give informed consent, were ambula-
tory, able to return for recall appointments, physically healthy
enough to clean their own teeth independently and needed new
overdentures.
To be included in the study, participants must have remained
in the study for at least 2 years and returned for at least two
recalls in that time period. Of the 395 participants who were
initially enrolled in the study, 104 failed to return for recall
in the 2-year window, and for 19 the data were incomplete;
they were not included. Therefore, 272 persons with 662 abut-
ments fulfilled the initial inclusion criteria. An evaluation of
the distribution of all types of teeth prepared for use as over-
denture abutments found that these participants had 465 canine
teeth, 70.2% of the total number of teeth. To reduce the number
of confounding factors in a longitudinal study, this report fo-
cused only on participants who returned on recall and who were
wearing a complete maxillary denture and complete mandibu-
lar overdentures supported by teeth #22 and #27. None of the
teeth included in this analysis were restored with attachments.
This paper reported on the denture evaluations of participants
who returned for recalls at four time points, which were 6 to
18 months, 19 to 30 months, 31 to 42 months, and 43 to 53
months. A total of 35 participants fulfilled these criteria.
C 2018 by the American College of Prosthodontists
Ettinger and Qian
Abutment teeth preparation
All the teeth were scaled and cleaned, and the patients were
taught how best to clean the abutments before their reduction
to a level of 1.5 to 2.0 mm above the free gingival margin. If
necessary, the patients were referred to the Department of Pe-
riodontics for more extensive care to establish optimal gingival
health. No participants had probing depths deeper than 3 mm on
their overdenture abutment teeth. For most patients, endodontic
therapy was completed in one visit, and access openings were
restored with amalgam, composite resin, or a glass ionomer
(Ketac Silver; 3M ESPE, St. Paul, MN).
Standardized assessment
At overdenture delivery, a questionnaire was used to record
demographic data, medical and drug histories, as well as den-
ture histories and denture-wearing habits. The first author made
all baseline measurements and photographs. The photographs
were not standardized, and no measurements were made from
them. The heights above the gingival margins were measured
with a periodontal probe and recorded in millimeters at four lo-
cations on each tooth: mid-mesial, mid-distal, mid-facial, and
mid-lingual surfaces. The distance measured was from the gin-
gival margin to the most occlusal part of the tooth, which was
determined by the intersection of the periodontal probe with a
metal ruler placed horizontally over the tooth. The periodontal
probing depths were was also determined at the same four sites.
Attachment loss was measured both at baseline and at each re-
call appointment and was the sum of the probing depth plus the
height above the gingival margin. The health of the periodontal
tissues was measured by evaluating plaque levels. These were
measured as 0 = no bleeding on probing; 1 = bleeding after
probing; and 2 = spontaneous bleeding. Horizontal mobility
greater than 1 mm (stage 2 mobility as defined by Miller)26 was
also recorded. The periodontal findings from this study have
been published in a previous paper.27
At delivery, all maxillary dentures were stable and retentive.
The mandibular dentures were also stable. The dentures were
clinically remounted to establish that centric relation and cen-
tric occlusion coincided. All the participants were prescribed a
5000 ppm neutral sodium fluoride gel and were asked to place
one drop of gel into each depression in the dentures correspond-
ing to the abutment teeth after cleaning daily and not to eat or
drink anything for 30 minutes.
Participants were asked to return to the Department of
Prosthodontics at 6-month intervals. At these recall appoint-
ments a single examiner (RLE) evaluated the overdenture teeth
with respect to the condition of the restorations, the presence of
caries, and periodontal disease. Appropriate maintenance care
was performed on the dentures, the abutments, and the soft
tissues. An assessment of the dentures was made for stabil-
ity, retention, extensions, and occlusal stability using a modi-
fication of the assessment developed by Kapur.28 The denture
maintenance/treatment needs were characterized as dentures
requiring cleaning, repair or adjustment of the denture bases,
or adjustment of the occlusion. If more significant changes had
occurred, the overdentures were designated as requiring relines
or a refabrication.
Journal of Prosthodontics 00 (2017) 1–8 
C 2018 by the American College of Prosthodontists
Overdenture Maintenance Needs
Denture stability was determined by placing a finger on the
occlusal surface of the premolars on each side of the dentures
and rocking them from side to side. They were graded as ade-
quate stability (no treatment required, score of 0), or movement
and loss of stability (treatment required, score of 1). Appropri-
ate treatment for loss of stability was determined by the use of
pressure indicator paste to be either adjustment of the denture
base (1), relining of the dentures (2), or refabrication of the
dentures (3).
Maxillary denture retention was determined by trying to
break the peripheral and postpalatal seals with the thumb and
first finger in the premolar region and in the anterior midline. To
test retention of the mandibular overdentures, the dentures were
seated with the mouth open, and an attempt was made to lift
the dentures. The dentures were graded as adequate retention
(no treatment required, score of 0), or unacceptable movement
(treatment required, score of 1). Treatment for loss of reten-
tion was either to replace the postpalatal seal or to reline or
refabricate the dentures.
Denture extensions were evaluated to ensure that the den-
ture bases were not cracked or broken nor were they over or
underextended. The dentures bases were graded as adequate
(no treatment required, score of 0), or unacceptable (treat-
ment required, score of 1) Treatment for these problems was
either denture adjustments or reline or refabrication of the
dentures.
The occlusion was evaluated by examining the occlusal sur-
faces for wear. The dentures were stabilized, and the par-
ticipants were instructed to close their jaws into a posterior,
retruded, unstrained position, which was usually achieved by
having the participant curl the tongue up to the roof of their
mouth and close slowly. Visual examination was used to de-
termine if there was equal contact of the posterior teeth in
maximum intercuspation on both sides of the arch. If there
were unstable contacts, a centric relation record was made in
wax, and the dentures were remounted. The occlusion was
graded as adequate (no treatment required, score of 0), or
unacceptable (treatment required, score of 1). The treatment
was either occlusal adjustment by selective grinding, rebuild-
ing the occlusion in tooth-colored, autopolymerizing acrylic
resin, or removing and replacing the posterior teeth on both
arches, or refabrication of the dentures. Soft tissues supporting
the dentures were also evaluated for signs of inflammation or
ulceration.
For statistical evaluation the maintenance needs of the partic-
ipants were recorded as either: (1) cleaning of the dentures only;
(2) cleaning combined with repair of a denture base defect; (3)
cleaning and adjustment of the denture bases; (4) cleaning and
adjustment of the occlusion; (5) relining; (6) or refabrication
of the dentures. To simplify the analysis the participants were
divided by age into three groups, 28 to 49, 50 to 64, and 65+
years. The participants’ denture-wearing habits were divided
into two groups: those who wore their dentures day and night,
occasionally or not at all were compared to those who wore
them by day only. The lengths of time persons had been wear-
ing overdentures were divided into three groups: 1 to 5, 6 to 10,
and 11+ years. Those who did not take any medications daily
were compared to those who took one or more medications per
day.
3
Overdenture Maintenance Needs
Table 1 Distribution of participants and overdenture abutments
Baseline
Number of participants 272
Number of overdenture teeth 662
Number of canine teeth
#6 95
#11 93
#22 137
#27 140
Total no. of canine teeth 465 (70.2%)
Number of participants with only #22 & #27 91
Statistical analysis
A total of 35 participants fulfilled the recall criteria. For each
year of the study, five participants were selected for replicate
examinations to determine intra-examiner reliability. This was
measured by the test/retest method.29 Percent agreement was
calculated, and disagreement occurred in fewer than 10% of the
measurements. Descriptive statistics were calculated, and bi-
variate analyses were performed using chi-square test, Fisher’s
exact test, and the nonparametric Wilcoxon rank-sum test. A
significance level of 0.05 was set for all tests. Statistical analy-
sis was done with a statistical package (SAS System v9.3; SAS
Institute Inc., Cary, NC).
Results
The mean age of 91 participants in this study at baseline (time
of delivery of the dentures) was 59.5 (SD = 10.1) years; 63.7%
were men. The number of participants who returned on recall,
the number of overdenture teeth, and the number of canine teeth
in these participants at each recall period are shown in Table 1.
The characteristics of the participants are shown in Table 2. It
was found that 48.4% of the participants took 1 to 3 drugs daily.
The mean time for participants to be wearing overdentures was
9.3 (SD = 4.7) years, and 84.6% of the participants reported that
they wore their dentures during the day only. The percentage of
participants who needed one or more of the following denture
treatments over the length of the study was:
r 91.2% denture base adjustment;
r 76.9% reline;
r 61.5% denture refabrication;
r 33.0% denture remounts and occlusal adjustments;
r 22.0% denture base repairs due to fracture or holes over
the abutments;
r 19.8% tooth repairs or replacements.
Table 3 presents the denture maintenance needs by gender,
age group, and by a variety of other variables for the 91 partic-
ipants at baseline. When evaluating these 91 participants, older
participants were significantly more likely to require two or
more denture base adjustments when compared with those in
the younger age groups (80% vs. 69.8% vs. 50%, p = 0.0343).
The participants who had worn overdentures for more than
4 Journal of Prosthodontics 00 (2017) 1–8 
Ettinger and Qian
6-18 months 19-30 months 31-42 months 43-53 months
204 125 81 51
502 287 179 115
75 50 30 20
76 52 31 20
99 55 34 19
106 59 37 20
356 (70.9%) 216 (75.3%) 132 (73.7%) 79 (68.7%)
80 57 47 35
5 years were significantly more likely to require denture re-
makes than those who had worn them for fewer than 5 years
(74.3% vs. 66.7% vs. 34.8%, p = 0.0304). Participants who
did not take any medications daily were compared to those
who took one or more medications per day, and it was found
that they were significantly less likely to require a repair of
their denture bases (6.4% vs. 29.5% vs. 31.2%, p = 0.0258).
Participants who wore their dentures only during the day were
significantly less likely to require denture base repair than those
who wore them continuously (18.2% vs. 42.9%, p = 0.0403).
Table 4 presents the denture maintenance needs by gender,
age group, and a variety of other variables for the 35 participants
who returned for all four timepoints. Men were significantly
more likely to need their teeth repaired or replaced (p = 0.0335).
Persons aged 50 to 64 years old participants were significantly
more likely to require two or more denture base adjustments
when compared with those in the younger age groups (88.9%
vs. 84.6% vs. 25.0%, p = 0.0311), and also more likely to need
an occlusal adjustment (61.1% vs. 23.1% vs. 0.0%).
Discussion
As in the previously reported study27 based on this population,
the participants were continuously recruited from 1974 to 1994.
The participants entered the study and returned for evaluation
at different points in time; some returned more frequently than
others. The protocol asked all participants to return for recalls
at least once every 6 months; however, as they returned at
varying time periods throughout the length of the study, the
time periods were divided into four separate windows. This
analysis required the participants to be in the study for at least
45 months and to return for recalls in each of the four time
periods, have only teeth numbers #22 and #27 as overdenture
abutments, and to be wearing complete maxillary dentures and
mandibular overdentures. Thirty-five participants fulfilled the
criteria. If a person returned more than once in a designated
time period, then only the appointment nearest the end of that
time period was included in the final analysis for this report.
Canines have a unique position in the arch, they have long
roots, generally single canals, and mandibular canines seem to
survive longest of all teeth,30 so they are frequently chosen as
overdenture abutments. To reduce confounding factors in this
study and because canines made up at least 70% of the teeth in
C 2018 by the American College of Prosthodontists
Ettinger and Qian Overdenture Maintenance Needs

Table 2 Descriptive statistics of the variables included in the analysis Table 2 Continued
(N = 91)
Valid
Valid Variable Frequency percent
Variable Frequency percent
Number of remakes 1.3 1.3
Gender Number of repairs of the 0.5 1.6
Female 33 36.3 denture base
Male 58 63.7 Number of repairs or 0.3 0.6
Number of daily medications replacements of teeth
0 31 34.1 Number of remounts and 0.4 0.7
1 19 20.9 occlusal adjustments
2 17 18.7
3 8 8.8
4 10 11.0
5+ 6 6.5 this population, this report focused only on those participants
Denture-wearing habits who were wearing complete maxillary dentures and mandibu-
Day 77 84.6 lar overdentures supported by abutments #22 and #27. Davis
Day and night 7 7.7 et al8 also chose to evaluate only canines in their study. In this
Occasional 4 4.4 study, one examiner (RLE) conducted the evaluations to give
Not wearing 3 3.3 consistency to the results. Also replicate examinations by the
Number of adjustments of the denture base test-retest method29 were used to reevaluate five participants
0 8 8.8 each year who returned on recall. These participants needed
1 20 22.0 to come back for follow-up treatment 24 or 48 hours after the
2 22 24.2 examination appointment. This measure was used to determine
3 12 13.2 intra-examiner reliability and was recorded with less than 10%
4 7 7.7 error. The denture quality evaluation was developed to assess
5+ 22 24.1
complete dentures and was a modification of one developed by
Number of relines
Kapur.28 It has been used by the author for several other pub-
0 21 23.1
lished studies.11,20,21 Few longitudinal studies have assessed
1 25 27.5
denture problems of persons wearing root-supported overden-
2 25 27.5
3 8 8.8
tures. Previous papers on the general population in this study
4+ 12 13.1
evaluated patient satisfaction11 and denture treatment needs.21
Number of refabrications It can be hypothesized that because of wear and tear and
0 35 38.5 adaptation, denture maintenance needs in this population would
1 21 23.1 increase over time. It was therefore surprising to find that age
2 20 22.0 of the dentures was not a significant factor with regard to main-
3 7 7.7 tenance needs for the 35 participants who returned for all four
4+ 8 8.7 time periods and was only a significant factor for remakes in the
Number of repairs of the denture base baseline population of this study. An explanation may be that
0 71 78.0 dropouts over time could confound the data because persons
1 10 11.0 who needed care may not have returned to the clinic, or they
2+ 10 11.0 may have had their overdenture abutments extracted elsewhere
Number of repairs or replacements of teeth and so did not return or were excluded from the study. Men
0 73 80.2 needed more teeth replaced or repaired and that may be due
1 12 13.2 to their stronger masticatory muscles, causing more stress and
2+ 6 6.6 wear on the dentures. The reason age group 50 to 64 required
Number of remounts and occlusal adjustments more adjustments may be that they were more robust than the
0 61 67.0
older age group and perhaps the younger patients tended to
1 24 26.4
complain less because they had less bone resorption.31
2 5 5.5
3 1 1.1
Mean Standard Limitations
deviation This study has several limitations: first, it included participants
Age (years) 59.5 10.1 who had only two teeth, # 22 and #27, at baseline, and were
Age for dentures (years) 9.3 4.7 wearing complete maxillary dentures and complete overden-
Number of daily 1.8 2.1 tures supported by those two teeth. The relatively small sample
medications
size was also a limitation, as it could reduce statistical power
Number of adjustments of 3.1 2.5
substantially. Because of the small numbers, and to simplify the
the denture base
analysis, some variables such as medical history, oral hygiene
Number of relines 1.8 1.6
habits, or patient satisfaction information were not included in
(Continued)

Journal of Prosthodontics 00 (2017) 1–8 

C 2018 by the American College of Prosthodontists 5
6
Table 3 Denture maintenance needs by gender, age group, and the variables of interest (N = 91)

# Denture base # Repaired or # Occlusal

adjustments (%) # Relines (%) # Remakes (%) # Repaired bases (%) replaced teeth (%) adjustments (%)
Overdenture Maintenance Needs

0-1 2+ 0 1+ 0 1+ 0 1+ 0 1+ 0 1+

Gender
Female 39.4 60.6 30.3 69.7 45.5 54.5 78.8 21.2 87.9 12.1 69.7 30.3
Male 25.9 74.1 19.0 81.0 34.5 65.5 77.6 22.4 75.9 24.1 65.5 34.5
p-Value 0.1787 0.2172 0.3010 0.8941 0.2731 0.6834
Age groups
28-49 years 50.0 50.0 16.7 83.3 44.4 55.6 72.2 27.8 83.3 16.7 83.3 16.7
50-64 years 30.2 69.8 25.6 74.4 37.2 62.8 81.4 18.6 81.4 18.6 58.1 41.9
65+ years 20.0 80.0 23.3 76.7 36.7 63.3 76.7 23.3 76.7 23.3 70.0 30.0
p-Value 0.0343∗∗ 0.7642 0.6279 0.8222 0.5512 0.5256
Denture wearing
Day 29.9 70.1 23.4 76.6 40.3 59.7 81.8 18.2 80.5 19.5 63.6 36.4
Others 35.7 64.3 21.4 78.6 28.6 71.4 57.1 42.9 78.6 21.4 85.7 14.3
p-Value 0.6630 1.000 0.5539 0.0403∗∗ 1.000 0.1315
Number of drugs taken daily
0 35.5 64.5 19.4 80.6 45.2 54.8 93.6 6.4 80.7 19.3 74.2 25.8
1-3 27.3 72.7 25.0 75.0 34.1 65.9 70.5 29.5 84.1 15.9 63.6 36.4
3+ 31.3 68.7 25.0 75.0 37.5 62.5 68.8 31.2 68.8 31.2 62.5 37.5
p-Value 0.6548 0.8455 0.4944 0.0258∗∗ 0.4618 0.3505

Journal of Prosthodontics 00 (2017) 1–8 

Length of time wearing overdentures
1-5 years 39.1 60.9 39.1 60.9 65.2 34.8 91.3 8.7 91.3 8.7 73.9 26.1
6-10 years 27.3 72.7 21.2 78.8 33.3 66.7 72.7 27.3 78.8 21.2 72.7 27.3
11+ years 28.6 71.4 14.3 85.7 25.7 74.3 74.3 25.7 74.3 25.7 57.1 42.9
p-Value 0.3709 0.1700 0.0304∗∗ 0.2018 0.2846 0.9325
**
Statistically significant (p < 0.05) using Fisher’s exact test.
Ettinger and Qian

C 2018 by the American College of Prosthodontists

 Ettinger and Qian

Table 4 Denture maintenance needs by gender, age group, and the variables of interest (N = 35)

# Denture base # Repaired # Repaired or # Occlusal

adjustments (%) # Relines (%) # Remakes (%) bases (%) replaced teeth (%) adjustments (%)

Journal of Prosthodontics 00 (2017) 1–8 

0-1 2+ 0 1+ 0 1+ 0 1+ 0 1+ 0 1+

Gender
Female 33.3 66.7 25.0 75.0 33.3 66.7 83.3 16.7 91.6 8.3 66.7 33.3
Male 13.0 87.0 4.4 95.6 26.1 73.9 69.6 30.4 56.5 43.5 56.5 43.5
p-Value 0.1999 0.1061 0.7062 0.4496 0.0335∗∗ 0.7210
Age groups
28-49 years 75.0 25.0 0.0 100.0 75.0 25.0 75.0 25.0 100.0 0.0 100.0 0.0
50-64 years 11.1 88.9 16.7 83.3 22.2 77.8 77.8 22.2 66.7 33.3 38.9 61.1
65+ years 15.4 84.6 7.7 92.3 23.1 76.9 69.2 30.8 61.5 38.5 76.9 23.1
p-Value 0.0311∗∗ 0.7721 0.1366 0.8612 0.5153 0.0267∗∗
Denture-wearing habits
Day 21.4 78.6 14.3 85.7 25.0 75.0 75.0 25.0 67.9 32.1 53.6 46.4

C 2018 by the American College of Prosthodontists

Others 14.3 85.7 0.0 100.0 42.9 57.1 71.4 28.6 71.4 28.6 85.7 14.3
p-Value 0.9999 0.5620 0.3811 1.0000 1.0000 0.2027
Number of daily medications
0 36.4 63.6 18.2 81.8 27.3 72.7 90.9 9.1 72.7 27.3 63.6 36.4
1-3 5.9 94.1 5.9 94.1 29.4 70.6 64.7 35.3 76.5 23.5 58.8 41.2
3+ 28.6 71.4 14.3 85.7 28.6 71.4 71.4 28.6 42.9 57.1 57.1 42.9
p-Value 0.1009 0.5143 1.0000 0.3482 0.3063 1.0000
Length of time wearing overentures
1-5 years 40.0 60.0 20.0 80.0 40.0 60.0 100.0 0.0 80.0 20.0 60.0 40.0
6-10 years 6.3 93.7 6.3 93.7 25.0 75.0 62.5 37.5 75.0 25.0 75.0 25.0
11+ years 28.6 71.4 14.3 85.7 28.6 71.4 78.6 21.4 57.1 42.9 42.9 57.1
p-Value 0.1352 0.4813 0.8809 0.2844 0.5372 0.2338

**Statistically significant (p < 0.05) using Fisher’s exact test.

7
Overdenture Maintenance Needs
Overdenture Maintenance Needs
the assessment of their possible associations with dental main-
tenance needs. Radiographs of the abutment teeth were made
only when necessary for clinical diagnosis, as stipulated by the
IRB so they were not available for statistical analysis.
Conclusions
A longitudinal study was conducted for a population of patients
seen in a dental school environment who were using mandibu-
lar overdentures and complete maxillary dentures. From the
evaluations, the following observations were made:
1. The three most common denture treatment needs in this
study were adjustment of the denture bases, denture re-
lines, or denture remakes.
2. Older participants were less likely to need two or more
denture base adjustments.
3. Those who were not taking any medications were less
likely to need their dentures repaired.
4. Participants who had worn overdentures for more than
5 years were more likely to need remakes and participants
who wore their dentures continuously were more likely
to need denture base repairs.
5. Being male was statistically associated with needing
teeth replaced, while being aged 50 to 64 was statistically
associated with needing more denture base adjustments
or occlusal adjustments.
It is important for dental educators and practitioners to ap-
preciate that patients wearing overdentures need regular recalls,
because they have continuing maintenance needs that require
evaluation and denture services.
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