Mandibular single-implant overdenture as an alternative for full-arch rehabilitations: a literature review
Oral rehabilitation with mandibular single-implant overdentures (SIO) has been characterized as a solution to improve retention and stability of conventional complete dentures (CD). Among the benefits of this therapy, it can be mentioned minimally invasive surgery, simple prosthetic technique, better retention, and significantly reduced costs. However, the application of this protocol in daily clinic is still not widespread. Aim: Thus, this study aimed to perform a literature review to address the clinical characteristics of this rehabilitation, when compared to two-implant mandibular overdentures and CD. Methods: For this, searches were conducted in the PubMed, Scopus and Scielo databases, considering articles published in English language, without date limitation. Results: It was found 243 manuscripts, of which 20 were compatible with the aim of this study after title/ abstract reading. The selected papers focused on masticatory muscles function, satisfaction levels and self-reported quality of life, as well as surgical and prosthetic outcomes, such as need of maintenance and repair, costs, and implant failure rates. All evaluated manuscripts showed similar masticatory function and patients’ satisfaction with SIO and two-implant overdenture, while results for SIO were greater when compared to rehabilitations with CD. In addition, SIO costs were half of the TIO, and SIO have proven to do not damage the implant, being implant loss close to zero. However, the prosthesis fracture adjacent to the implant was a recurrent clinical outcome, which requires further studies to solve this impairment. Conclusion: Thus, it can be concluded that SIO represents an alternative treatment for frail elders or low-income patients, by increasing masticatory function and improving quality of life.
2. Furuta M, Komiya-Nonaka M, Akifusa S, Shimazaki Y, Adachi M, Kinoshita T, et al. Interrelationship
of oral health status, swallowing function, nutritional status, and cognitive ability with activities of
daily living in Japanese elderly people receiving home care services due to physical disabilities.
Community Dent Oral Epidemiol. 2013 Apr;41(2):173-81. doi: 10.1111/cdoe.12000.
3. Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in older adults:
evidence for a phenotype. J Gerontol. 2001;56(3):146-56.
4. Fitzpatrick B. Standard of care for the edentulous mandible: A systematic review. J Prosthet Dent.
5. Muller F, Duvernay E, Loup A, Vazquez L, Herrmann FR, Schimmel M. Implant-supported mandibular.
Interventions for edentate elders – what is the evidence? J Gerodontol. 2014;31(1):44-51.
6. Laird WRE, McLaughlin EA. Management of the elderly edentulous patient. Int J Prosthodont. 1989
7. Feine JS, Carlsson GE, Awad MA, Chehade A, Duncan WJ, Gizani S, et al. The McGill consensus
statement on overdentures. Mandibular two‑implant overdentures as first choice standard of care for
edentulous patients. Int J Oral Maxillofac Implants. 2002 Jul-Aug;17(4):601-2.
8. Klemetti E. Is there a certain number of implants needed to retain an overdenture? J Oral Rehabil.
2008 Jan;35 Suppl 1:80-4. doi: 10.1111/j.1365-2842.2007.01825.x.
9. Boven GC, Raghoebar GM, Vissink A, Meijer HJ. Improving masticatory performance, bite force,
nutritional state and patient satisfaction with implant overdentures: a systematic review of the
literature. J Oral Rehabil. 2015 Mar;42(3):220-33. doi: 10.1111/joor.12241.
10. Cordioli G, Majzoub Z, Castagna S. Mandibular overdentures anchored to single implants: a five-year
prospective study. J Prosthet Dent. 1997Aug;78(2):159-65.
11. Passia N, Wolfart S, Kern M. Six-year clinical outcome of single implant-retained mandibular
overdentures--a pilot study. Clin Oral Implants Res. 2015 Oct;26(10):1191-4. doi: 10.1111/clr.12427.
12. Walton JN, Glick N, Macentee MI. A randomized clinical trial comparing patient satisfaction
and prosthetic outcomes with mandibular overdentures retained by one or two implants. Int J
Prosthodont. 2009 Jul-Aug;22(4):331-9.
13. Bryant SR, Walton JN, MacEntee MI. A 5-year randomized trial to compare 1 or 2 implants for implant
overdentures. J Dent Res. 2015 Jan;94(1):36-43. doi: 10.1177/0022034514554224.
14. Harder S, Wolfart S, Egert C, Kern M. Three-year clinical outcome of single implant-retained
mandibular overdentures--results of preliminary prospective study. J Dent. 2011 Oct;39(10):656-61.
15. Amaral CF, Pinheiro MA, de Moraes M, Rodrigues Garcia RCM. Psychometric analysis and
masticatory efficiency of elderly people with single-implant overdentures. Int J Oral Maxillofac
Implants. 2018 Nov/Dec;33(6):1383-1389. doi: 10.11607/jomi.6557.
16. Cheng T, Ma L, Liu XL, Sun GF, He XJ, Huo JY, et al. Use of a single implant to retain mandibular
overdenture: a preliminary clinical trial of 13 cases. J Dent Sci 2012 Sep;7(3):261-6.
17. Grover M, Vaidyanathan AK, Veeravalli PT. OHRQoL, masticatory performance and crestal bone loss
with single-implant, magnet-retained mandibular overdentures with conventional and shortened
dental arch. Clin Oral Implants Res. 2014 May;25(5):580-6. doi: 10.1111/clr.12111.
18. Bhat S, Chowdhary R, Mahoorkar S. Comparison of masticatory efficiency, patient satisfaction for
single, two, and three implants supported overdenture in the same patient: A pilot study. J Indian
Prosthodont Soc. 2016 Apr-Jun;16(2):182-6. doi: 10.4103/0972-4052.176522.
19. Alqutaibi AY, Kaddah AF, Farouk M. Randomized study on the effect of single-implant versus
two-implant retained overdentures on implant loss and muscle activity: a 12-month follow-up report.
Int J Oral Maxillofac Surg. 2017 Jun;46(6):789-797. doi: 10.1016/j.ijom.2017.02.001.
20. Policastro VB, Paleari AG, Leite ARP, Mendoza-Marin DO, Cassiano AFB, Shaddox LM, et al.
A randomized clinical trial of oral health-related quality of life, peri-implant and kinesiograph
parameters in wearers of one-or two-implant mandibular overdentures. J Prosthodont. 2018 Apr 20.
21. Cruz-Jentoft AJ, Kiesswetter E, Drey M, Sieber CC. Nutrition, frailty, and sarcopenia. Aging Clin Exp
Res. 2017 Feb;29(1):43-48. doi: 10.1007/s40520-016-0709-0.
22. Geckili O, Cilingir A, Erdogan O, Kesoglu AC, Bilmenoglu C, Ozdiler A, et al. The influence of
momentary retention forces on patient satisfaction and quality of life of two-implant-retained
mandibular overdenture wearers. Int J Oral Maxillofac Implants. 2015 Mar-Apr;30(2):397-402.
23. Krennmair G, Ulm C. The symphyseal single-tooth implant for anchorage of a mandibular
complete denture in geriatric patients: a clinical report. Int J Oral Maxillofac Implants.
24. Liddelow GJ, Henry PJ. A prospective study of immediately loaded single implantretained
mandibular overdentures: preliminary one-year results. J Prosthet Dent.
2007 Jun;97(6 Suppl):S126-37. doi: 10.1016/S0022-3913(07)60016-X.
25. Tavakolizadeh S, Vafaee F, Khoshhal M, Ebrahimzadeh Z. Comparison of marginal bone loss and
patient satisfaction in single and double-implant assisted mandibular overdenture by immediate
loading. J Adv Prosthodont. 2015 Jun;7(3):191-8. doi: 10.4047/jap.2015.7.3.191.
26. Nogueira TE, Aguiar FMO, de Barcelos BA, Leles CR. A 2-year prospective study of single-implant
mandibular overdentures: Patient-reported outcomes and prosthodontic events. Clin Oral Implants
Res. 2018 Jun;29(6):541-550. doi: 10.1111/clr.13151.
27. Nogueira TE, Oliveira Aguiar FM, Esfandiari S, Leles CR. Effectiveness of immediately
loaded single-implant mandibular overdentures versus mandibular complete
dentures: a 1-year follow-up of a randomized clinical trial. J Dent. 2018 Oct;77:43-50.
28. Kronstrom M, Davis B, Loney R, Gerrow J, Hollender L. A prospective randomized study on the
immediate loading of mandibular overdentures supported by one or two implants; a 3-year follow-up
report. Clin Implant Dent Relat Res. 2014 Jun;16(3):323-9. doi: 10.1111/cid.12006.
29. Vahidi F, Pinto-Sinai G. Complications associated with implant retained removable prostheses. Dent
Clin North Am. 2015 Jan;59(1):215-26. doi: 10.1016/j.cden.2014.08.001.
30. Gonda T, Maeda Y, Walton JN, MacEntee MI. Fracture incidence in mandibular
overdentures retained by one or two implants: J Prosthet Dent. 2010 Mar;103(3):178-81.
31. Passia N, Abou-Ayash S, Reissmann DR, Fritzer E, Kappel S, Konstantinidis I, et al. Single mandibular
implant study (SMIS) - masticatory performance - results from a randomized clinical trial using two
different loading protocols. J Dent. 2017 Oct;65:64-69. doi: 10.1016/j.jdent.2017.07.005.
32. AlSourori AA, Mostafa MH, Kaddah AF, Fayyed AE, Swedan MS, Al-Adl AZ. Impact of single implant
versus two-implant mandibular retained over-denture on retention and success rate in totally
edentulous patients. A randomized controlled clinical trial. J Osseointegr 2018;10(3):79-86.
33. Bilhan H, Geckili O, Mumcu E, Cilingir A, Bozdag E. The influence of implant number and attachment
type on maximum bite force of mandibular overdentures: a retrospective study. Gerodontology. 2012
Jun;29(2):e116-20. doi: 10.1111/j.1741-2358.2010.00421.x.
34. Sivaramakrishnan G, Sridharan K. Comparison of implant-supported mandibular overdentures
and conventional dentures on quality of life: a systematic review and meta-analysis of randomized
controlled studies. Aust Dent J. 2016 Dec;61(4):482-488. doi: 10.1111/adj.12416.
35. Merz MA, Terheyden H, Huber CG, Seixas AA, Schoetzau A, Schneeberger AR. Facilitators and
barriers influencing the readiness to receive dental implants in a geriatric institutionalised population
- A randomized non-invasive interventional study. Gerodontology. 2017;34(3):306-312.
36. Müller F, Salem K, Barbezat C, Herrmann FR, Schimmel M. Knowledge and attitude of elderly persons
towards dental implants. Gerodontology. 2012;29(2):e914-23.
37. Liu J, Pan S, Dong J, Mo Z, Fan Y, Feng H. Influence of implant number on the biomechanical
behaviour of mandibular implant-retained/supported overdentures: a three-dimensional finite
element analysis. J Dent. 2013;41(3):241-9. doi: 10.1016/j.jdent.2012.11.008.
38. Amaral CF, Gomes RS, Rodrigues Garcia RCM, Del Bel Cury AA. Stress distribution of
single-implant-retained overdenture reinforced with a framework: A finite element analysis study.
J Prosthet Dent. 2018b;119(5):791-6. doi: 10.1016/j.prosdent.2017.07.016.
39. Maeda Y, Horisaka M, Yagi K. Biomechanical rationale for a single implant-retained mandibular
overdenture: an in vitro study. Clin Oral Implants Res. 2008;19(3):271-5.
40. Nascimento JFM, Aguiar-Júnior FA, Nogueira TE, Rodrigues RCS, Leles CR. Photoelastic stress
distribution produced by different retention systems for a single-implant mandibular overdenture.
J Prosthodont. 2015;24(7):538-42. doi: 10.1111/jopr.12269.
41. Ahmed Elawady DM, Kaddah AF, Talaat Khalifa M. Single vs 2 implants on peri-implant marginal
bone level and implant failures in mandibular implant overdentures: a systematic review with
meta-analysis. J Evid Based Dent Pract. 2017;17(3):216-25. doi: 10.1016/j.jebdp.2017.02.002.
42. Rached RN, de Souza EM, Dyer SR, Ferracane JL. Dynamic and static strength of an implantsupported
overdenture model reinforced with metal and nonmetal strengtheners. J Prosthet Dent.
2011;106(5):297-304. doi: 10.1016/S0022-3913(11)60134-0.
43. Grageda E, Rieck B. Metal-reinforced single implant mandibular overdenture retained by an
attachment: a clinical report. J Prosthet Dent. 2014;111(1):16-9. doi: 10.1016/j.prosdent.2013.07.009.
44. Amaral CFD, Pinheiro MA, Rodrigues Garcia RCM. Reinforcement of single implant-retained
mandibular overdenture with a cobalt-chromium framework before implant surgery. J Prosthodont.
2017 Dec 14. doi: 10.1111/jopr.12732.
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