Abstract
OBJECTIVES: Controversy remains regarding the impact of palatal coverage or palatless designs for maxillary implant overdentures. This within subject study aimed to compare the swallowing threshold and efficiency of maxillary implant assisted overdentures with and without palatal coverage. MATERIALS AND METHODS: The study included 14 healthy completely edentulous subjects with ages ranged from 50 to 70 years. For each participants, four dental implants were inserted in the canines and premolars areas of the maxillary arch, and two implants in the canines region of the mandibular arch. Two designs of maxillary implant-assisted overdentures (with and without palatal covreage designs) and one design of mandibular implant overdenture were constructed for each patient. The overdentures were retained to the implants by using locator attachments. Swallowing threshold and efficiency were evaluated using Test of Mastication and Swallowing Solids (TOMASS). Swallowing evaluation was conducted 3 months after each maxillary implant overdenture design insertion, while the participants were eating solid food. Independent samples t-test was used to compare the differences between the two overdenture designs. RESULTS: There was statistically significant reduction in swallowing threshold, number of swallows, number of masticatory cycles, and total ingestion time for the maxillary implant overdenture without palatal coverage (p < 0.05). However, there was non-significant difference in the number of bites between the two maxillary implant overdenture designs (p > 0.05). CONCLUSION: Within the limitation of this study, it could be concluded that maxillary implant overdenture without palatal coverage improves chewing and swallowing efficiency for solid food. CLINICAL RELEVANCE: Palatal coverage with maxillary implant overdenture negatively affected bolus formation during oral food processing. Increased chewing cycles and time of mastication lead to increase the viscosity of the bolus, which might cause aspiration during swallowing. Maxillary implant overdenture without palatal coverage may be a viable treatment option as it improve the oral food processing for safe swallowing. In addition, TOMASS test is easy to be incorporated as part of the clinical evaluation of swallowing efficiency for solid foods processing.