Impact of Implant-Supported Prosthetics on Geriatric Care in Mumbai Dental Hospital

Thesis Abstract

This study investigates how implant-supported prosthetics influence the quality of geriatric oral healthcare within Mumbai Dental Hospital, addressing rising edentulism, partial tooth loss, and the associated deterioration in masticatory efficiency, nutrition, and overall wellbeing among older adults. The aim is to evaluate clinical outcomes, satisfaction, functional independence, and provider-driven workflows to inform evidence-based geriatric dentistry practices. Specific objectives include (i) assessing changes in masticatory performance and nutritional status pre- and post-implant-supported prostheses, (ii) evaluating patient-reported outcomes on comfort, aesthetics, and functional satisfaction, (iii) analyzing the impact on oral-health-related quality of life using the Geriatric Oral Health Assessment Index (GOHAI), (iv) examining treatment-related costs, time to rehabilitation, and maintenance requirements, and (v) identifying organisational and clinical factors that facilitate or hinder successful geriatric rehabilitation within the hospital setting. The theoretical framework integrates the International Classification of Functioning, Disability and Health (ICF) to conceptualise how implant-supported prosthetics affect bodily functions, activities, and participation, and Social Cognitive Theory to understand patient adherence, self-efficacy, and perceived behavioral control in continued oral care. A mixed-methods design is employed, combining a prospective cohort (n=180 elderly patients receiving implant-supported prostheses over 24 months) with a qualitative component of semi-structured interviews (n=30) of patients, caregivers, and clinicians to capture experiential dimensions. The study employs a multimodal data collection approach quantitative clinical measures (crestal bone height via panoramic radiography, implant survival, bite force measurements, and food hardness testing), standardized questionnaires (GOHAI, Oral Health Impact Profile for Elderly, and a cost-analysis instrument), and qualitative data gathered through audio-recorded interviews transcribed and coded thematically. Validity and reliability are ensured through instrument calibration, pilot testing, triangulation, and member checking. Quantitative data will be analysed using paired t-tests and repeated-measures ANOVA to detect changes over time, regression analyses to identify predictors of functional outcomes, and survival analysis for implant longevity. The qualitative dataset will be examined using thematic analysis guided by Braun and Clarke’s framework, with coding corroborated by independent researchers to enhance credibility. Expected findings include statistically significant improvements in masticatory performance and GOHAI scores from baseline to 24 months post-implant placement, better nutritional markers (e.g., serum albumin and BMI stability) associated with improved chewing ability, and high patient satisfaction with aesthetics and function. It is anticipated that lower prosthetic maintenance burdens and shorter rehabilitation durations will correlate with streamlined clinical workflows and multidisciplinary coordination. The study is expected to reveal heterogeneity in outcomes tied to comorbidity burden, cognitive status, and access to follow-up care, highlighting the moderating role of social support and caregiver involvement. The contribution to knowledge lies in providing context-specific evidence from a large urban tertiary hospital in India that links implant-supported dental rehabilitation to functional independence, nutritional status, and health-related quality of life among geriatric patients, while offering a comprehensive evaluation of costs and organizational factors relevant to service delivery in similar low-to-middle-income city settings. The study will also extend the application of the ICF framework in geriatric dental rehabilitation by empirically mapping functional improvements to participation outcomes. The main conclusion is expected to be that implant-supported prosthetics substantially enhance functional, nutritional, and psychosocial outcomes for elderly patients when delivered within an integrated hospital-based geriatric care pathway, complemented by caregiver education and robust maintenance protocols. Recommendations include adopting standardized geriatric assessment protocols prior to implant therapy, developing multidisciplinary care teams with defined referral and follow-up pathways, implementing patient-centered cost planning and insurance navigation, and prioritising durable, low-maintenance prosthetic solutions to optimize long-term outcomes and resource utilisation in Mumbai Dental Hospital and comparable urban dental services.