Purpose: The purpose of this study was to compare elderly patients’ satisfaction and oral health–related quality of life with mandibular two-implant overdentures and conventional dentures. Materials and Methods: Sixty edentulous subjects aged 65 to 75 years were randomly assigned to two groups treated with maxillary conventional dentures and either a mandibular conventional denture (n = 30) or an overdenture supported by two implants with ball retainers (n = 30). Subjects rated their general satisfaction, as well as other features of their dentures (comfort, stability, ability to chew, speech, esthetics, and cleaning ability), prior to treatment and 2 months postdelivery. Changes in ratings on the original Oral Health Impact Profile (OHIP) and its short form (OHIP-EDENT) were also used as indicators of oral health–related quality of life. Results: The primary outcome of this study, ratings of general satisfaction 2 months postdelivery, was significantly better in the group treated with mandibular two-implant overdentures ( P= .001). In addition, the implant group gave significantly higher ratings on comfort, stability, and ability to chew. Furthermore, using OHIPEDENT, subjects who received mandibular two-implant overdentures had significantly fewer oral health–related quality of life problems than did the conventional group. Conclusion: These short-term results suggest that mandibular two-implant overdentures combined with maxillary conventional dentures provide better function and oral health– related quality of life than conventional dentures. Int J Prosthodont 2003;16:390–396.