Functional Outcomes of Prosthetic Rehabilitation in Older Adults With Tooth Loss: A Systematic Review and...

To assess the effect of prosthodontic treatment and management on oral function and oral-health-related patient reported outcome measures (PROMs) in older adults with tooth loss.

A systematic search of four databases identified clinical studies (≥ 10 participants) reporting functional or PROM outcomes in partially or fully edentulous adults ≥ 65 years rehabilitated with dental prostheses for ≥ 6 months. Pooled standardized mean differences in pre-post changes were estimated by prosthesis type and follow-up using random-effects models (REML), with heterogeneity assessed by Cochran's Q and I² (p < 0.05).

From an initial 7654 studies, 24 were included in this review, covering 1711 individuals. Fourteen studies assessed masticatory performance (MP), masticatory ability (MA), and maximum bite force (MBF). Complete dentures (CDs) showed modest functional improvement, while implant overdentures (IODs) consistently produced higher MP and MBF with significant long-term improvements. Eighteen studies evaluated OHRQoL using OHIP variants, OIDP, and modified GOHAI-11. IODs and fixed full-arch prostheses showed the greatest improvements, while CDs and removable partial dentures were associated with smaller but positive changes. Subjective MA improved over 6-12 months post insertion in regardless groups, with high heterogeneity. OHRQoL showed short-term benefits of implant-supported prostheses, particularly for OHIP-20, while OHIP-14 results were inconsistent over time, indicating more reliable functional and patient-reported outcomes with dental implants.

Tooth loss leads to functional and psycho-social limitations, and although restorative measures can alleviate these shortcomings, they require ongoing maintenance, highlighting the complexity of care in this vulnerable older population.

PROSPERO International prospective register of systematic reviews (CRD420251077683).