Objective This parallel three‐group randomised clinical trial compared the 1‐year changes in dental patient‐reported outcomes and chewing function associated with three treatment strategies for the edentulous mandible: single‐implant (G‐I; n = 11) or two‐implant overdentures (G‐II; n = 13), and fixed 4‐implant complete denture (G‐III; n = 13). Methods Complete denture (CD) treatment was provided to all participants and after an adaptation period, they were randomly assigned to one of the three study groups. Implants (Neodent TI Cortical, Brazil) were inserted using single‐stage surgery and conventional loading. The mandibular dentures were incorporated into implants using specific retention systems and procedures according to the treatment group: O’ring/ball attachments for G‐I and GII, and mini‐conical abutments for G‐III. Patients were assessed at baseline (CD stage) and up to 1‐year after implant‐retained prosthodontic treatment. Treatment outcomes included oral health‐related quality of life (OHIP‐Edent), satisfaction with the dentures and chewing function using a mixing ability test. Data analyses included pairwise comparison tests, estimates of effect sizes and regression analysis using Generalized Estimating Equations. Results Results showed improvement in patient‐reported outcomes (lower OHIP‐Edent scores and higher satisfaction) and chewing function, compared to baseline. No significant between‐group differences were found, although effect sizes were lower for G‐III. Conclusions All treatments improved the assessed outcomes after transition from the baseline condition. Findings suggest that simplified implant treatments for edentulous patients result in favourable outcomes and may be considered as suitable alternatives to more complex interventions.

Background There are scarce data regarding the combined assessment of the costs and effects of implant treatments for edentulous patients when multiple options are available. Aim This randomised clinical trial aimed to assess the cost‐effectiveness of three different concepts for treatment: mandibular overdenture retained by a single (Group I; n = 11) or two implants (Group II; n = 13) and fixed hybrid prosthesis on four implants (Group III; n = 13). Methods Treatment effectiveness was measured as the 1‐year before‐after changes in patient satisfaction with the mandibular prosthesis. Costs were prospectively quantified from the perspective of the health provider, including all direct cost items attributed to the delivery of treatments and up to the 1‐year follow‐up, using a “bottom‐up” costing estimation method. Results Patient satisfaction after treatment improved significantly for the three groups. The overall costs were R$ 2370.66, R$ 3185.21 and R$ 5739.52 for Groups I, II and III, respectively (P < .001). Analysis of incremental cost‐effectiveness ratios suggested that the overdentures retained by one or two implants were more cost‐effective than the fixed implant treatment, considering the mean cost and effectiveness values and the ±20% one‐way sensitivity analysis. Conclusion This study suggests that the incremental costs for the fixed hybrid prosthesis, compared to the overdenture treatments, is not proportional to the respective gain in effectiveness. Therefore, although all treatment options had satisfactory outcomes, the use of implants to retain a mandibular overdenture, irrespective of the use of one or two implants, is more cost‐effective than the fixed implant treatment for the edentulous mandible.

Objective This prospective study assessed the number and reasons for post‐treatment visits due to prosthodontic complications in patients treated with three types of implant treatment for the edentulous mandible. Methods Study groups comprised patients treated with single‐implant overdenture (G‐I; n = 11), 2‐implant overdenture (G‐II; n = 13), and 4‐implant fixed prosthesis (G‐III; n = 13). Programmed recall visits occurred at the 6‐, 12‐ and 36‐month follow‐ups. The management of prosthodontic complications occurred continuously in unscheduled appointments. Data analysis included calculation of incidence rates, chi‐square and Kruskal‐Wallis tests, and Poisson regression with robust error variance to model the occurrence of visits due to prosthodontic complications. Results There were 89 unscheduled appointments during the entire follow‐up period, ranging from 0 to 7 (mean = 2.41; SD = 2.2) per patient. No between‐group differences were found regarding the frequency of unscheduled visits. However, the duration of the appointments (scheduled and unscheduled) was significantly higher for G‐III (p < .001). The length of follow‐up was the only predictor of the number of post‐insertion visits (p = .004). The frequency of prosthodontic events was higher for G‐I and G‐II compared to G‐III (p < .001). Nearly half of the events in G‐I and G‐II were matrix replacements, and artificial teeth fracture was more frequent in G‐III. Conclusions All patients were at risk of post‐delivery prosthodontic complications and required regular recall visits to achieve satisfactory function and to prevent further problems. Overdentures required higher rates of maintenance visits, particularly for replacement of the retentive inserts, while fixed implant prostheses required longer clinical times for management of complications when compared to overdentures.

RESUMO:Utilizando-se o método histórico dedutivo, o presente artigo traz a ideia de que os investimentos a serem realizados para a promoção da defesa nacional caracterizam-se como políticas públicas que devem ser implementadas pelo governo. Sob essa perspectiva é que teve início no ano de 2000 um Plano de Fortalecimento de Controle do Espaço Aéreo Brasileiro, dentro do qual havia o projeto denominado de F-X, que consistia na aquisição de caças para a Força Aérea Brasileira (FAB). Referido projeto, após idas e vindas, acabou sendo relançado com a titulação de F-X2, em que se destacava que para a aquisição de caças supersônicos, a empresa vencedora do procedimento licitatório deve fazer a transferência irrestrita de tecnologia. Além disso, é feita uma análise sobre as empresas transnacionais e como ocorre a sua atuação para além das fronteiras do Estado de origem, evidenciando-se a sua relação com o projeto F-X2. Portanto, há que se ressaltar a utilização do método dedutivo para a realização do presente estudo.Palavras-chave: Políticas públicas. Projeto F-X. Projeto F-X2. Transferência de tecnologia. Empresa transnacional.