Aim:To evaluate effect of bilateral balanced & monoplane occlusion of implant retained mandibular overdenture on biting force and masticatory efficiency. Subjects and Methods: Six completely edentulous patients were selected for this study; all patients were received conventional upper and lower dentures that include bilateral balanced articulation for three months. Then each patient will receive two root form implant in the interforaminal region. The dentures processed to retrofit onto the implant. After adjustment and adaptation period occlusal biting force was recorded bilaterally at the canine and first molar area; although masticatory efficiency were evaluated by assessing chewing time and number of chewing strokes with different type of foods. Results: Significant increase in the maximum biting force and masticatory efficiency with mandibular overdentures. Conclusion: biting force and masticatory efficiency were improved with implant retained mandibular overdentures; in addition to prefer the bilateral balanced occlusion in case of biting force as it provides maximum biting force and better masticatory efficiency.

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Ten completely edentulous patients were selected. Each Patient had received conventional maxillary and mandibular complete denture with balanced lingualized occlusion. After adaptation period each patient had stage one surgery for placing two implant fixtures, in the cuspid area anterior to the mental foramina. The two endosseous root form (3.7 diameter and 13 mm length) fixtures were left submerged for a period of three months for osseointegration. The implant fixtures were uncovered, healing abutments were used and after two weeks the steps for modification of the patient existing denture were started and the metal housing was secured to the fitting surface of the mandibular denture by a chemical curing acrylic resin. Then the patients recall after 3, 6, 9, 12 months for evaluation. The clinical evaluation includes recording of probing depth (mm), bleeding index scores, gingival recession (mm) and the radiographic evaluation includes bone resorption on the mesial and distal side of the implant. The results showing that a significant increase (p≤0.05) in all the clinical parameters and amount of bone resorption from the base line till 12 months. The result concluded that: Balanced lingualized occlusion recommended for implant complete overdenture as enhancing stability and retention of the denture which essential for maintenance of implants. Clinical evaluation of implant ball retained overdentures with balanced lingualized occlusion not differs from base line scores also, the bone loss was within the accepted values so the ball attachments is recommended for retention of complete overdenture option. Codex : 36/1807 azhardentj@azhar.edu.eg http://adjg.journals.ekb.eg KEYWORDS Overdenture, implant, ball attachment, lingualized balanced occlusion.• Extracted from thesis.