Single mandibular implant study – denture satisfaction in the elderly

Abstract

To investigate whether there are differences in patients' denture satisfaction when an implant placed in the midline of the edentulous mandible is loaded either immediately or three months later, after second-stage surgery. One hundred and fifty-eight edentulous patients received a single implant in the midline of the mandible. After randomisation, it was loaded either immediately after implant placement (N = 81, group A) or three months later, after a submerged healing phase and a second-stage surgery (N = 77, group B). Patients' denture satisfaction aspects were assessed, using visual analogue scales (VAS), before treatment, one month after implant placement during the submerged healing phase (only group B) and one and four months after implant loading. The statistical analysis was performed using the Wilcoxon signed-rank and rank-sum tests. One month after loading, a significant improvement in comfort, function and stability of the mandibular denture could be observed in both groups (P ≤ 0·05). A slight but not significant improvement was found between one and four months after loading. Patients with second-stage surgery and delayed loading rated the stability and fit of the mandibular denture as significantly better than patients who had immediate loading. A single implant in the edentulous mandible significantly increased patients' denture satisfaction. After four months, stability and fit of the mandibular denture were considered better when a delayed loading protocol had been followed. A single mandibular implant in the edentulous mandible significantly increases patients' denture satisfaction, regardless of the loading protocol.

Implant Placement under Existing Removable Dental Prostheses and the Effect on Follow‐Up and Prosthetic Maintenance

“…For implant‐retained overdentures in the edentulous jaw, the current literature shows that one to two implants in the mandible and four implants in the maxilla are considered sufficient to provide patients with improved comfort . These numbers of implants are in accordance with a review and meta‐analysis evaluating the survival rate of implants in the edentulous jaw .…”

“…28 For implant-retained overdentures in the edentulous jaw, the current literature shows that one to two implants in the mandible and four implants in the maxilla are considered sufficient to provide patients with improved comfort. [34][35][36][37] These numbers of implants are in accordance with a review and meta-analysis evaluating the survival rate of implants in the edentulous jaw. 38 However, in the present study, implants were planned and placed in strategic positions to support existing tooth-supported telescopic crowns and to reduce the load on the teeth during function.…”

Single Implant Retained Overdenture Treatment Protocol: A Systematic Review and Meta‐Analysis

“…Immediate loading was carried out in five studies, while at six weeks postoperatively, early loading was carried out in three studies . All the other studies undertook a conventional (delayed) loading protocol, that ranged between 2 and 4 months .…”

“…Two implant failures were reported in the bone healing phase of the conventionally loaded implants . Passia et al reported 9 failed immediately loaded implants, and one failed conventionally loaded implant . Liddelow et al observed a 100% survival rate in immediately loaded oxidized implants while all the immediately loaded machined implants had failed…”

“…This treatment modality provided clinicians with a successful, cost‐effective and functional alternative for the management of patients presenting with mandibular ridge resorption that rendered conventional complete dentures cumbersome. Several studies have reported the success and clinical viability of single implant‐retained overdentures (SIROD) . But, these publications presented differences in workflow and were associated with a plethora of complications.…”