Objectives
The
aim of this multi-center pilot study was to assess the viability and
feasibility of a novel treatment concept – the canine-positioned single
implant mandibular overdenture (c-SIMO), with the single implant placed
on the patient's preferred chewing side instead of the midline.
Materials and methods
Participants
received a single implant in the canine region of their preferred
chewing side, based on an Asymmetry Index observed during mastication.
The pre-existing mandibular denture was transformed into a c-SIMO on a
spherical attachment. The primary outcome was oral health-related
quality of life (OHRQoL), measured with GOHAI and OHIP-EDENT. Secondary
outcomes included denture satisfaction index (DSI), chewing efficiency
(CE), maximum bite force (MBF), implant survival and success, and
prosthetic maintenance. Data analysis included descriptive statistics
and bivariate comparison tests.
Results
Fifteen
participants received the c-SIMO treatment (mean age: 69.9 ± 7.0).
Implant success and survival rates were 100% at 1 year. Patient-reported
outcome measures improved significantly compared to pre-treatment
values (OHIP-EDENT: p = 0.001; DSI: p = 0.001; GOHAI: p = 0.002). Masticatory outcomes also improved significantly (CE: p = 0.001; overall MBF: p = 0.005). Post-implant, MBF was significantly higher in the ipsilateral side compared to the contralateral side at 2 weeks (p = 0.019) and 3 months (p = 0.015), but no longer at T3 (p = 0.730). Common prosthodontic events included denture base adjustments (n = 17) and matrix activation (n = 9).
Conclusions
This
pilot study concludes that c-SIMO is a promising treatment option, and a
potential alternative to the single midline implant overdenture.
Clinical relevance
The
novel treatment concept of a canine-positioned single implant
mandibular overdenture could be a viable treatment alternative to the
midline positioning.
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