A 2-year Prospective Study of Single-implant Mandibular Overdentures: Patient-reported Outcomes and Prosthodontic Events

Objective: This prospective clinical trial aimed to assess clinical and patient-reported outcomes of the single-implant mandibular overdenture treatment (SIMO) after a 2-year follow-up period.

Materials And Methods: An external hexagon implant was inserted in the mandibular midline of 45 complete denture wearers. Participants had a mean age of 63.4 (SD = 8.3), and 75.6% were female. Based on the primary stability of the implant, immediate loading was performed in 38 patients (84.4%). O'ring/ball attachments were used for retention. Outcome assessment included the participants' satisfaction with the dentures and oral health-related quality of life (OHRQoL) impacts at the 3-, 6-, 12-, and 24-month follow-up visits after implant loading. Moreover, all prosthodontic events were recorded during this period.

Results: The post-loading implant survival rate was 95.3%. There was a significant increase in satisfaction with the mandibular overdenture (p < .001) and a decrease in the overall OHRQoL impacts (p < .001) in the 3-month follow-up. No significant changes were observed between the 3- and 24-month follow-ups. The incidence of prosthodontic events was relatively high, including the need for matrix replacement and repair of the overdenture fracture. Most prosthodontic complications were minor and properly managed in periodic recall visits.

Conclusions: Single-implant mandibular overdenture is a feasible alternative for subjects poorly adapted to the mandibular denture and resulted in significant improvement in patient satisfaction and quality of life measures. A careful selection of patients based on their demanding needs and expectations is essential to indicate this alternative. The incidence of maintenance events in the long term reinforces the need for periodical clinical monitoring.