Abstract
Objective The aim of this randomized clinical trial was to compare the masticatory ability subjectively between ball and Cendres+Métaux Locator (CM-LOC) attachment for a single implant retained mandibular overdenture throughout a 24-month follow-up period. Materials and Methods Eighty completely edentulous patients were recruited. All patients received new complete dentures, and masticatory ability was recorded using a questionnaire (baseline record). All patients received a single implant in the midline of the completely edentulous mandible. After 3-month healing period, patients were randomized using sealed envelopes into two groups: ball or CM-LOC attachment. The same masticatory ability questionnaire was used to record masticatory ability for both groups after 2 weeks of pickup and 3-, 6-, 9-, 12-, and 24-month follow-up. Comparison between the study groups was done using Mann–Whitney U test for independent samples. Two-sided P values less than 0.05 were considered statistically significant. Results The mean masticatory scores improved for both attachments, with no statistically significant difference between them throughout the 24-month follow-up. The CM-LOC attachment group showed a greater improvement change in masticatory ability after 6- and 12-month follow-up (−12.47 ± 12.006, −11.46 ± 14.625; P=0.826), while the ball attachment group showed a slight improvement after the 24-month follow-up (−11.72 ± 12.368, −10.88 ± 11.963; P=0.778). Conclusion Single implant retained mandibular overdenture improved masticatory ability subjectively with no significant difference between both attachments used although the ball attachment showed better masticatory ability scores after 24-month follow-up.
Highlights
Introduction e McGill consensus2002 and York consensus 2009 concluded that two implants installed in the mandible were considered the standard of care for completely edentulous patients [1,2,3]
When having a closer look at the changes in the mean masticatory ability scores for patients with their complete dentures and at 6, 12, and 24-month follow-up after installation of a single implant in the midline of a completely edentulous mandible, we found that there was no statistically significant difference between the two groups of patients, but there was an improvement in mean masticatory ability scores for patients with ball and Cendres+Metaux Locator (CM-LOC) attachment after implant installation, as negative values denote more improvement
Alveolar ridge resorption that follows tooth extraction will result in reducing the area supporting the prosthesis which is more encountered in the mandible [33]. is consequence of edentulism will greatly affect the retention and stability of complete dentures constructed for edentulous patients [34]
Summary
Edentulism is considered one of the most common diseases that affect the oral health of the elderly population. Patients with ACP Class I were not included in this study because, according to McGarry [28], the posterior bone height of the mandible range could be greater than 21 mm, so those patients will most probably be satisfied with their conventional mandibular complete dentures and will not need implant installation to improve their retention. At could explain why, at the 24-month follow-up period, the masticatory ability was slightly greater for patients with ball attachment than the CM-LOC attachment group Another important factor that has to be considered is the incidence of fracture of the lower implant retained overdenture, which is a widespread incidence due to insufficient space to accommodate the height of the attachment [49]. Most fractures occurred in the CMLOC group of patients after 12-month follow-up and that was mainly because the CM-LOC attachment had a greater height than the ball attachment, so probably that had negatively affected he masticatory ability in the 24-month follow-up period for the CM-LOC attachment
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