Oral health-related quality of life and prosthetic rehabilitation in patients with mild cognitive impairment and early dementia: a systematic review.

Older adults with mild cognitive impairment (MCI) face increased challenges in maintaining oral health and prosthetic functionality. As fixed and implant-supported prostheses are increasingly considered in geriatric dentistry, questions remain regarding their impact on oral health-related quality of life (OHRQoL) compared to conventional removable dentures. This systematic review and meta-analysis aimed to assess the effects of prosthetic rehabilitation types on OHRQoL among older adults with MCI or early dementia. Searches were conducted across PubMed, Scopus, Web of Science, and Cochrane CENTRAL through March 2025. Studies were included if they evaluated OHRQoL or related patient-reported outcomes (PROMs) in individuals aged 60+ with MCI undergoing prosthetic treatment. A total of 18 studies involving 1,457 participants were analyzed. A meta-analysis using a random-effects model revealed a significant improvement in OHIP-14 scores among recipients of fixed or implant-retained prostheses compared to those with conventional dentures (WMD = -5.63; 95% CI: -6.38 to - 4.87; p < 0.001), with negligible heterogeneity (I2 = 0%). Subgroup analysis suggested enhanced outcomes with implant-retained overdentures. Studies consistently showed improved comfort, mastication, retention, and social confidence with fixed prostheses. Conversely, removable dentures were associated with increased discomfort and dissatisfaction, particularly in individuals with reduced dexterity or poor caregiver support. The risk of bias was low in nearly half of the included studies. These findings highlight the clinical benefits of fixed prosthetic options in enhancing the quality of life in cognitively impaired older adults. Interdisciplinary care, caregiver involvement, and long-term follow-up are crucial for optimizing outcomes. The evidence supports a more tailored prosthetic approach, prioritizing cognitive and functional capacities in conjunction with prosthetic design. Future research should evaluate long-term adaptation, maintenance burden, and cost-effectiveness to further inform decision-making in this vulnerable population.