Single-implant Mandibular Overdentures Research Articles

A 1-Year Parallel-Group Randomized Clinical Trial Comparing the Effectiveness of a Mandibular Complete Denture vs an Early Loaded Single-Implant Overdenture.

To assess the effectiveness of converting a conventional mandibular denture (CMD) into a single-implant mandibular overdenture (SIMO). Edentulous patients received a new CMD and were randomly assigned to the CMD or SIMO group. For SIMO patients, a midline early-loaded implant was inserted and incorporated into the CMD after 3 weeks. Patient satisfaction and oral health-related quality of life were assessed at baseline and up to 1 year. Regression models were constructed using Generalized Estimating Equation (GEE). After 12 months, 32 patients were assessed (CMD: n = 17; SIMO: n = 15). Significant improvement was observed for the SIMO group compared to baseline measures. SIMO may be considered an effective alternative for patients unsatisfied with their CMDs.

Single lateral implant for mandibular overdentures as a fallback solution or a viable treatment alternative: Four case reports.

This report of four clinical cases aims to illustrate the use of a lateral implant as a solution for implant overdentures in the mandible in different clinical situations. The first two cases describe the clinical situations of patients wearing two-implant mandibular overdentures until the failure of one of the implants, one due to implant loss and the other due to a fracture of an abutment screw, and how the conditions were managed. The third case illustrates the placement of a single implant to retain an overdenture, where a midline implant, as originally planned, was not feasible due to anatomic reasons. The final case describes the use of a lateral implant to support and retain a single-implant mandibular overdenture. The four cases demonstrate that a single lateral implant can be utilized as sole retention in cases of a failing contra-lateral implant and as an alternative to a single implant in the midline.

3D Printing/Additive Manufacturing of Single- Implant Overdentures. A Randomized controlled clinical trial.

Mandibular single-implant overdenture is a well-established treatment modality for the management of completely edentulous patients. The use of CAD/CAM printing technology to fabricate complete dentures and overdentures is burgeoning. The trial aimed to clinically evaluate 3D-printed single-implant overdentures and compare outcomes to those of overdentures manufactured using conventional techniques. A randomized clinical trial (RCT) was designed. Twenty-eight participants were randomly allocated into two equal groups. Participants in the control group received conventionally manufactured single-implant overdentures, while participants in the printed group received digital light processing (DLP) printed single-implant overdentures. An evaluation was conducted to assess the rates of implant survival and success, as well as overdenture survival and success, along with the measurement of maximum biting force (MBF) over a one-year follow-up period. Data was collected and subjected to statistical analysis. Statistical significance was determined using a two-sided p-value with a threshold of less than 0.05. The printed denture group had higher implant survival (100%) and success rates (92.8%) compared to the conventional denture group (85.7% survival, 85.7% success). Overdenture survival and success rates were 100% in the printed group and 78.6% in the conventional group. Both groups showed a significant increase in maximum biting force (MBF) at 3, 6, and 12 months of follow-up (P<0.001). The printed group demonstrated a statistically significant improvement in MBF compared to the conventional group (P<0.001). 3D-printed mandibular single-implant overdentures may represent an alternative to conventionally fabricated ones.

Speaking Space, Chewing Rotational Denture Movement, OHRQoL, and Patient Expectations for Single-Implant Mandibular Overdentures.

To compare the speaking space, perceived rotational movement during chewing, and oral health-related quality of life (OHRQoL) of elderly people rehabilitated with new conventional complete dentures (CDs) and single-implant mandibular overdentures (SIMOs) using a paired design. Patient expectations for SIMO use were also evaluated. The participants were 22 elderly users of unsatisfactory CDs. They received new sets of conventional CDs, and assessment was performed after 2 months of use. Speaking space was recorded with a kinesiograph while participants read a list of words. Participants were asked two questions about perceived posterior rotational denture movement during chewing. The Dental Impact on Daily Living (DIDL) questionnaire was used to examine OHRQoL, and a visual analog scale was used to quantify participants' SIMO expectations. Subsequently, the mandibular CDs were converted to SIMOs, and the assessment was repeated after 2 months of use. Speaking space and OHRQoL data were submitted to ANOVA and Student t test, and perceived mandibular movement and expectation data were examined using likelihood-ratio chi-square test. The speaking space and perceived rotational movement did not differ between CD and SIMO use. General performance and eating restriction DIDL scores increased after SIMO insertion. Participants' SIMO expectations regarding speaking, cleaning, esthetics, and general aspects were met. Relative to CD use, SIMO use did not change the speaking space or perceived rotational movement when chewing among elderly patients. It improved OHRQoL via enhancement of two DIDL dimensions and met most elderly patients' expectations.

Comparison of marginal bone loss in implant supported over dentures in early loading

Aim: The purpose of the present research was to evaluate the marginal bone loss in implant supported over-dentures in case of early loading on denture. Methodology: 36 edentulous participants (mean age 68 years, SD 9.2) were randomly assigned into three treatment groups (n¼12). A single implant was placed in the mandibular midline of participants to support an overdenture using a 6-week loading protocol. The control group received Southern regular implants and standard ball attachments. One group received Southern 8-mm-wide implants and large ball attachments. Another group received Neoss regular implants and Locator attachments. SPSS was used to determine between groups differences in marginal bone loss, implant stability, implant, and prosthodontic success (P&lt;0.05). Results: Implant success after 1 year was 75% for Southern regular implant (control) group; and 100% for the Southern wide and Neoss regular implant groups (P¼0.038). Prosthodontic success was comparable between the groups but the maintenance (41 events overall, mean 1.2) was greater for the Locator and the standard ball attachments. Conclusion: Mandibular single-implant overdentures are a successful treatment option for older edentulous adults with early loading protocol using implants of different diameters and with different attachment systems.

One-year prospective study on single short (7-mm) implant overdentures in patients with severely resorbed mandibles.

This prospective study aimed to assess the effectiveness of using a single short implant to retain a single-implant mandibular overdenture (SIMO) in participants with severely atrophic edentulous mandibles. The study sample included 18 edentulous participants with severely resorbed mandibular ridges and limited bone height in the symphyseal region sufficient for the insertion of a 7.0-mm-height implant. First, patients received new conventional dentures or had their dentures relined, followed by the insertion of a 3.75x7mm morse-taper implant, and the incorporation of a stud-type attachment and a nylon retentive insert after a 3-month healing period. Implant stability quotient (ISQ) was measured at baseline and after 3 and 12months. Patient-reported outcomes (satisfaction with the dentures and oral health-related quality of life) were assessed before implant placement and at the 3-, 6-, and 12-month follow-ups. Clinical-radiographic outcomes and the incidence of prosthodontic events were assessed throughout the follow-up period. The implant survival rate was 100%. ISQ increased from baseline (72.7±6.6) to the 3-month (82.0±3.3) and 1-year (85.4±2.9) follow-ups (p<.001). After 1year, satisfaction with the mandibular prosthesis increased significantly, and the overall OHIP-Edent score decreased by 79.2%. No effects were found for the maxillary denture (p=.420). Due to dissatisfaction with treatment, two participants (11.1%) required additional implants after the 1-year follow-up and were considered as prosthodontic failures. Single-implant mandibular overdenture retained by a short implant showed favorable outcomes after 1year. Further studies with larger samples and longer follow-up periods are needed to confirm the findings of this single-group prospective study. The present study was registered at the Brazilian Clinical Trials Registry (REBEC), identifier RBR-7p2xmg. The trial registry occurred during the study execution, and its final approval was delayed because of several formatting adequacies required by the platform REBEC.

Comparison of general satisfaction, oral health-related quality of life, and patient's self-assessment between mandibular single-implant overdentures and experimental removable complete dentures: A randomized crossover clinical trial

Objective Patient satisfaction with single-implant overdentures (1-IODs) is unclear. This randomized crossover trial aimed to compare the general satisfaction, oral health-related quality of life, and patients’ self-assessment between mandibular 1-IODs and experimental removable complete dentures (eRCDs).Methods New mandibular RCDs were fabricated for 22 patients with edentulous mandibles. After adapting to the RCDs, one implant was inserted in the mandibular midline. The participants were then randomly classified into groups 1 and 2. Group 1 received IODs for the first 2 months, while group 2 used eRCDs with a non-loaded implant in the midline. After 2 months, the treatment was switched. Four validated, patient-reported dental outcome measures were assessed: general satisfaction, Japanese version of the Oral Health Impact Profile for edentulous subjects (OHIP EDENT-J), General Oral Health Assessment Index (GOHAI), and Patient's Denture Assessment (PDA). The assessments were performed at the end of the IOD- and eRCD- use periods.Results General satisfaction was significantly higher during the IOD period (p = 0.002). Significant differences were observed in all domains of the OHIP, except orofacial pain (p = 0.084). Further, the total score (p<0.001) and the scores of the physical (p<0.001) and psychosocial functioning (p = 0.001) domains of the GOHAI differed significantly. The total PDA score (p = 0.001) and the scores of the function (p = 0.004), lower denture (p = 0.002), esthetics and speech (p = 0.026), and importance (p = 0.009) domains were significantly higher during the IOD period than during the eRCD period.Conclusion General satisfaction, oral health-related quality of life, and patient self-assessment scores were significantly higher for 1-IODs than for eRCDs.Clinical significance Within the limitations of this study, we found that mandibular single-implant overdentures may be an efficient alternative to mandibular experimental removable complete dentures due to higher general satisfaction, oral health-related quality of life, and patient self-assessment scores of dentures.

Immediately loaded single-implant mandibular overdentures compared to conventional complete dentures: A cost-effectiveness analysis

BackgroundIn recent years, the single-implant mandibular overdenture (SIMO) has been proposed as an alternative to more complex overdenture designs as a simplified implant intervention for edentulous patients. ObjectiveThe aim of this study was to run a cost-effectiveness analysis alongside a randomized clinical trial comparing the SIMO and the conventional complete denture (CCD) treatment. Imediately loaded external hexagon implant and ball attachment were used for the overdenture goup. Direct costs related to therapies were identified and valuated throughout a 1-year period after delivery, in Brazilian currency (R$) and converted into international dollars (I$) using purchase power parity exchange rates. Treatment effectiveness was measured using the OHIP-Edent and satisfaction scores for calculation of incremental cost-effectiveness ratios (ICER). ResultsOutcomes were assessed at the 1-year follow-up for 65 patients (CCD=34; SIMO=31). Overall OHIP-Edent and satisfaction scores improved significantly in the SIMO group, while remained unchanged in the CCD group. The mean overall costs were R$1,179.04 (I$590.99) for the CCD group and R$2,127.91 (I$1,068.20) for the SIMO group – 80.7% incremental cost for SIMO. The ICER calculation for SIMO treatment showed a mean cost of I$48.20 for 1-point reduction in OHIP-Edent scores, and I$12.56 for 1-point increase in satisfaction score. ConclusionsFindings support the effectiveness of this simplified and low-cost implant intervention for edentulous patients. SIMO also seems a cost-effective alternative to the CCD and the relatively low incremental cost may potentially increase the utilization of dental implants among older subjects, especially those with limited financial resources. Clinical significanceThe immediately loaded single-implant mandibular overdenture was superior to the conventional complete denture in terms of patient-reported outcome measures at a low incremental cost.

Implant Stability Changes for Nonsubmerged and Submerged Protocols for a Single Implant Mandibular Overdenture Using Ball Attachment.

Objectives To compare the changes in implant stability for the nonsubmerged (NS) and submerged (S) protocols for the single implant retained mandibular overdenture using ball attachment throughout a 24-month follow-up. Materials and Methods Eighty completely edentulous patients were seeking to improve retention of their lower complete denture by installing a single implant in the midline of the completely edentulous mandible. At the day of implant installation, patients were randomized into 2 groups using sealed envelopes: the nonsubmerged (NS) and submerged (S) group. After a 3-month healing period, all patients were randomized using sealed envelopes into ball attachment and CM-LOC attachment. The Periotest readings (PTV) was recorded using the Periotest M device and was recorded every 3 months for the first year and then annually in the second year. The scope of this clinical trial focused only on results of the ball attachment. The Mann–Whitney U test was used for comparison between study groups for independent samples. Two-sided p values less than 0.05 was considered statistically significant. Results There was no statistically significant difference in the mean change in PTV reading between the NS and S group at the different follow-up intervals. Initially, at the day of pickup (baseline) and 3-month follow-up, the mean PTV reading for the NS was greater than that of the S group (−4.471 ± 1.489, −4.391 ± 1.4727 (p=0.913)), while the S group has shown a greater improvement in PTV than the NS group after 6-month follow-up and continued throughout the 24-month follow-up (−5.730 ± 1.7804, −50855 ± 1.2581 (p=1)). Conclusion Both the nonsubmerged and the submerged healing protocol have shown reliable Periotest readings using ball attachment for a single implant retained overdenture. The submerged group has resulted in a greater improvement in Periotest readings after the 12- and 24-month follow-up period when compared to the nonsubmerged group although this improvement was not statistically significant.

Masticatory Ability for a Single Implant Mandibular Overdenture Retained by Two Different Attachments: A Randomized Controlled Trial.

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.

Speech and the swallowing threshold in single implant overdenture wearers: A paired control study.

Single implant mandibular overdentures (SIMOs) can improve mastication in edentulous elderly people. However, little attention has been paid to their effects on articulation disorders and the swallowing threshold relative to those of conventional complete dentures (CDs). To compare the effects of new conventional CD set and SIMOs on articulation disorders, mandibular movements during speech and swallowing threshold using a paired study design. Twenty-two edentulous Brazilian Portuguese-speaking elderly people (mean age 66.7±4.6years) were first evaluated whilst wearing their old conventional CDs. Articulation disorders were analysed by audio and video recordings, mandibular movements during speech were measured by kinesiography, and the swallowing threshold was assessed by masticatory cycle counting and medium particle size (X50 ) calculation. Participants then received new conventional CDs, and evaluations were repeated 2months later. Subsequently, single implants were installed in the midlines of subjects' mandibles, and the conventional CDs were converted to SIMOs. After 2months of SIMOs use, the evaluations were repeated. Data were submitted to the Cochran-Mantel-Haenszel and ANOVA. No difference in articulation disorders was found between new conventional CD and SIMO use. The frequency of anterior lisp during /s/ and /z/ phoneme pronunciation was reduced with new conventional CD use relative to old conventional CD use (p<.05). The X50 decreased progressively with new conventional CD and SIMO use (both p<.05). SIMOs do not alter speech relative to new well-fitted conventional CDs, but improved the swallowing threshold, in edentulous elderly people.

Single-implant mandibular overdentures: Clinical, radiographic, and patient-reported outcomes after a 5-year follow-up

Statement of problemPrevious studies on single-implant mandibular overdentures have reported favorable results for clinical and patient-reported outcomes. However, information from longer term clinical studies is lacking. PurposeThe purpose of this clinical study was to assess clinical, radiographic, and patient-reported outcomes of edentulous individuals rehabilitated with single-implant mandibular overdentures after a 5-year follow-up. Material and methodsA prospective clinical study was performed including completely edentulous individuals who received new conventional complete dentures and then an external hexagon implant in the mandibular midline region, followed by the incorporation of a retention system (O-ring/ball attachment; Neodent). Data collection occurred at baseline and 3, 6, 12, 24, and 60 months after implant loading. Assessed outcomes included implant stability, peri-implant soft tissue condition, peri-implant marginal bone level, satisfaction with the prostheses, and oral health–related quality of life (OHRQoL). Clinical maintenance events were also recorded. Descriptive statistics, incidence rates, Wilcoxon Signed Ranks test, and Generalized Estimating Equation regression were used for data analysis (α=.05). ResultsThirty of 34 eligible participants attended the 5-year follow-up visit, mean ±standard deviation age was 68.1 ±7.8 years, and 70% were women. The overall implant survival rate was 88.9%. After 5 years, the OHRQoL showed statistically significant improvement for all evaluation periods compared with baseline (P<.001). Regarding satisfaction with the mandibular denture, a significant increase was found between all evaluation periods compared with baseline in terms of comfort, stability, and ability to masticate (P<.001). Implant stability significantly increased (P=.003), and a mean bone loss of 1.46 mm was observed compared with baseline measures. The most frequent maintenance event was replacement of the O-ring matrix (n=80). Twenty-one midline fractures of the overdenture occurred in 14 study participants. No significant changes in peri-implant soft tissue conditions were observed. ConclusionsA single-implant mandibular overdenture effectively maintained the positive effect of the intervention on oral health–related quality of life and patient satisfaction, stable peri-implant condition, and acceptable rates of prosthetic events.

A prospective cohort on the incidence of fractures in single-implant mandibular overdentures

ObjectiveDenture fracture is one of the most common complications in prosthodontics and implant overdentures are reported to be at higher risk of fractures. Therefore, the aim of this study was to assess the incidence and factors associated with the occurrence of fractures in patients treated with a single implant mandibular overdenture (SIMO) opposed by a conventional maxillary complete denture. MethodsA cohort of 152 patients, 65.1% female and 34.9% male, mean age 65.4 ± 8.5 years, were prospectively followed-up for a minimum of 1 year and up to 6.7 years. Patients received a single midline mandibular implant with a retention system incorporated in the overdenture: Straumann ball abutment and gold elliptical matrix (n = 37), Neodent ball/nylon matrix (n = 83), or Neodent Equator/nylon matrix (n = 32). Fracture was defined as a complete separation of denture parts and classified as midline fracture (over the implant region), or elsewhere. No metal reinforcement was incorporated into the overdenture. Incidence rates, life table analysis, Kaplan–Meier, and Cox regression were used for data analysis. ResultsOverdenture fractures occurred in 49 patients (32.2% incidence), with repeated fractures in 16 patients. The majority of fractures were associated with function (42.6%) or due to the overdenture being dropped (36.8%). Overall incidence density was 0.14 fracture/patient/year. The risk of fracture was associated with the duration of the overdenture use (HR = 0.84; 95%CI = 0.71–0.99). ConclusionMidline denture fracture was a common complication in patients receiving SIMO treatment regardless of the implant / retention system. The use of metal reinforcement may be considered to reduce the risk of recurrent fractures. Clinical SignificanceThis clinical prospective study showed that single-implant mandibular overdentures are at high risk of midline fractures. Proper post-insertion monitoring and the identification and management of patient’s individual risk factors are essential for the successful treatment in the long-term.

Patient-reported outcome measures of edentulous patients restored with single-implant mandibular overdentures: A systematic review.

To review the literatures concerning the effect of the single-implant mandibular overdenture (SIMO) on patient-reported outcome measures (PROMs) and masticatory function in the fully edentulous patients. Electronic databases (PubMed, Cochrane Library, EMBASE and Web of Science) were searched, complemented with manual resources. Prospective studies published in English up to February 2020 reporting the effect of SIMO on PROMs and masticatory function in the edentulous patients were included. This review focused on oral health-related quality of life (OHRQoL), satisfaction and masticatory function outcomes. Of 1157 initially screened articles, 9 randomised controlled trials (RCTs) and 8 prospective studies involving 551 subjects fulfilled the inclusion criteria. Two RCTs were graded as high risk of bias or some concern, while others were low risk. All prospective studies had adequate representativeness and assessment, but only one study had a controlled cohort. In general, the edentulous patients restored with SIMOs had improved OHRQoL and general satisfaction compared to those with conventional complete dentures (CCDs), but the outcome of masticatory function was controversial. Compared with two-implant mandibular overdenture (TIMO), SIMO showed no significant differences regarding general satisfaction and satisfaction with speech, comfort, chewing ability, aesthetics and social life. Conflicting results were observed in OHRQoL and satisfaction with retention and stability. Better masticatory performance was observed in TIMO group than SIMO group. Within the limitation of this review, SIMO is featured with better OHRQoL and satisfaction than CCD. SIMO and TIMO rendered similar patient satisfaction, but TIMO had better masticatory performance.

Masticatory function improvement with the use of mandibular single-implant overdentures in edentulous subjects: a systematic literature review.

In this systematic review, several masticatory function parameters assessed during mandibular single-implant overdenture (SIO) use were compared to pre- SIO placement values in edentulous patients with aim of contributing to a consensus regarding denture treatment options. This study was registered a priori in the PROSPERO database (CRD42018106567). Two independent reviewers carried out electronic searches in eight databases, without language or time frame limitations, to collate clinical studies comparing masticatory function of edentulous patients before versus after SIO installation with the implant placed on the mandibular midline. Risk of bias was assessed with a before-and-after tool and evidence certainty level was evaluated with the Grading of Recommendations Assessment, Development and Evaluation program. Eleven studies were included in this review (1 prospective, 3 crossover trials, 4 randomized clinical trials, 2 paired clinical trials, and 1 pilot). Enrolled patients were mostly over 60 years old; all patients were using conventional complete dentures (CD) prior to SIO installation. Masticatory performance, masticatory efficiency, bite force, and muscle activity were improved after the SIO placement compared to during mandibular CD use. Mandibular movement and masticatory ability data were inconclusive. Most of the studies had low risk of bias, but all had very low certainly level ratings due to methodological heterogeneity. Placement of SIO improves masticatory function, as reflected mostly by masticatory performance and efficiency data, relative to CD use. Further studies comparing dental rehabilitation options, including SIOs, are needed to improve the quality of evidence in the literature.

Single Implant Mandibular Overdentures: A Clinical Study of Cobalt Chromium vs. PEEK Reinforced bases on Ridge Base Relation

Single Implant Mandibular Overdentures: A Clinical Study of Cobalt Chromium vs. PEEK Reinforced bases on Ridge Base Relation

Bite Force, Masseter Thickness, and Oral Health-Related Quality of Life of Elderly People with a Single-Implant Mandibular Overdenture.

To compare maximum bite force, masseter thickness, and oral health-related quality of life (OHRQoL) in elderly patients rehabilitated with conventional complete dentures (CDs) and single-implant overdentures (SIOs). A paired design was conducted, and 12 elderly patients were selected. Initially, a set of new CDs was manufactured and placed. After a 2-month adaptation period, the mandibular CD was transformed into an SIO by inserting one osseointegrated implant into the symphysis region. All variables were evaluated 2 months after both treatments (CD and SIO). Maximum bite force was evaluated using pressure sensors, while masseter thickness was obtained via ultrasound during muscle contraction and relaxation. The Oral Health Impact Profile for edentulous people (OHIP-Edent) was used to measure OHRQoL. Data were analyzed using Student t test and Wilcoxon test. Pearson coefficient of correlation between bite force and masseter thickness was calculated. Values for maximum bite force and masseter thickness during contraction increased significantly after SIO use (P < .001), indicating an improvement in muscle function. Considering OHRQoL, the general score and the domains functional limitation and physical pain were reduced (P < .05), indicating better perception of OHRQoL, with SIO use. Moreover, masseter thickness during contraction was moderately correlated with bite force (r = 0.480; P = .018). Using SIO increased the maximum bite force and masseter thickness of elderly patients, leading to an improved OHRQoL.

Oral Health-Related Quality of Life in Single Implant Mandibular Overdenture Retained by CM LOC versus Ball Attachment: A Randomized Controlled Trial

AIM:This randomised clinical study aimed to detect whether CMLOC attachment could improve Oral Health-Related Quality of Life (OHRQOL) when compared to ball attachment.METHODS:Eighty edentulous patients were recruited to receive a single symphyseal implant for mandibular overdenture, after three months, randomisation was done to divide them into two groups; Dalbo ball (control group) and Cendres and Metaux locator (CM-LOC) (intervention) attachments respectively, oral health impact profile for edentulous patients (OHIP-EDENT)questionnaire was recorded before implant placement, two weeks after pick up, at 3, 6, 9, and 12 months.RESULTS:Results revealed a lack of statistical significance between the two groups except for psychological discomfort at 2 weeks after pick-up (p-value = 0.029)CONCLUSION:Single implant overdenture is a simple, reliable treatment modality for treating edentulous mandible and both CM LOC and Ball attachments are good alternatives for such treatment modality.

Cost-Effectiveness of CM-LOC Attachment versus Ball Attachment Retaining Single Implant Mandibular Overdentures.

AIM:To investigate the cost-effectiveness of the novel CM-LOC attachment compared to the gold standard ball attachment in single implant mandibular overdenture.MATERIAL AND METHODS:Fifty-two completely edentulous patients (50 to 69 years old) seeking to improve the retention of their complete mandibular dentures by installing a single implant in the midline of the mandible were recruited for this study. The patients were equally divided into two groups. The first group received a ball attachment abutment over the implant and the second group received CM-LOC attachment abutment. The initial cost and aftercare (maintenance) cost were calculated for each attachment and compared to each other.RESULTS:The initial cost of the CM-LOC attachment was 2.2 times that of the traditional ball attachment. The after-care cost of the CM-LOC attachment was 2.39 times more than the ball attachment. The total cost of the CM-LOC attachment was 2.22 times that of the ball attachment.CONCLUSION:The ball attachment system showed better cost-effectiveness compared to the CM-LOC attachment from the beginning of the study and throughout all the treatment period during the first year.

Patient satisfaction with ball and Equator attachments for single-implant mandibular overdentures: A short-term randomised crossover clinical trial.

Retention and stabilisation of a single-implant mandibular overdenture (SIMO) are influenced by the biomechanical properties and clinical performance of the attachment system. To compare clinical and patient-reported outcomes following the use of two retention systems, a ball and a stud-type Equator attachment used for SIMO. Eighteen fully edentulous participants were treated with a SIMO opposing to a maxillary complete denture. They received two retentive attachments (ball and Equator) in alternate periods (sequences A-B and B-A) and outcomes were assessed after the 1week (initial) and 3months (final) periods. In the final assessment, patients were also asked about their preferred retention system. Compared with baseline, there was an improvement in patient satisfaction using both attachments, whilst no difference was observed between initial and final periods. Similarly, no significant differences were observed when comparing the ball and Equator at the initial (P=.330) and final (P=.08) periods. The multilevel mixed-model analysis revealed that the patients' satisfaction was predicted only by their satisfaction with dentures before implant placement. Although no significant difference was found between attachments regarding patient preference, this may be biased by the sequence of attachment use, which suggests that a learning effect might be present in this crossover study design. The use of a single midline implant to retain a mandibular overdenture significantly improves patient satisfaction irrespective of the attachment used, but patients' preference for the second treatment suggested a learning effect in this study.