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. 2024 Sep 21;16(9):e69845.
doi: 10.7759/cureus.69845. eCollection 2024 Sep.

Comparison of Clinical and Radiographic Outcomes Between Single Symphyseal and Parasymphyseal Implants Versus Two Implant-Assisted Complete Mandibular Overdentures

Ahmed E Al-Gazzar  1 , Ahmed El-Okl  1 , Mohamed Aboshama  1 , Ahmed F Elhagali  1 , Emad Boriqaa  1
Affiliations

Comparison of Clinical and Radiographic Outcomes Between Single Symphyseal and Parasymphyseal Implants Versus Two Implant-Assisted Complete Mandibular Overdentures

Ahmed E Al-Gazzar et al. Cureus. .

Abstract

Purpose: This study aimed to compare the efficacy of single implants in the symphyseal and parasymphyseal regions with that of two implants in complete mandibular overdentures.

Patients and methods: Fifteen completely edentulous male patients (50-65 years) were chosen and randomly grouped into three equal groups (five patients in each) according to the position and number of the received implants to assist mandibular complete overdentures: group I: single median implant; group II: single parasymphyseal implant; and group III: two implants were inserted in the canine area bilaterally. After three months of osseointegration, the lower denture was transformed into an implant-assisted complete mandibular overdenture. Clinical observations were documented on the day of loading, and three, six, and nine months later for each implant. Follow-up cone beam computed tomography scans were performed to assess marginal bone loss on the day of loading, and six and twelve months later. The masticatory efficiency evaluation was conducted one and three months after loading.

Results: The obtained results demonstrated insignificant differences between the three groups concerning marginal bone loss, plaque index, pocket depth, and bleeding index. Regarding the masticatory efficiency, the results revealed a significantly higher masticatory efficiency in group III than in groups I and II.

Conclusion: Using two implants to retain mandibular overdentures is the first choice due to their higher masticatory efficiency than a single implant. However, a single implant may be a viable treatment alternative, especially in cases where there are any limitations that restrict the use of additional implants.

Keywords: bleeding index; implant overdentures; masticatory efficiency; plaque index; pocket depth; single implant.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. The Research Ethics Committee, Faculty of Dental Medicine, Al-Azhar University, Asyut issued approval AUAREC20210006-5. The Research Ethics Committee, Faculty of Dental Medicine, Al-Azhar University, Asyut, met on June 8, 2021, and reviewed the presented documents for the research and approved the research. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Flow diagram of the study
Figure 2
Figure 2. A mucosa-supported surgical guide
Figure 3
Figure 3. The metal housing is in its place above the ball abutment. (A) One median implant. (B) One parasymphyseal implant. (C) Two implants in the intraforaminal distance
Figure 4
Figure 4. (A) Axial CBCT image displaying the panoramic reconstructed curve. (B) Reconstructed cross-sectional image displaying measurements of the buccal and lingual bone levels surrounding the implant. (C) Axial CBCT image displaying the alignment of the coronal section to pass through the implant. (D) Coronal image displaying measurements of the distal and mesial bone levels surrounding the implant
CBCT: cone beam computed tomography
Figure 5
Figure 5. Intergroup comparison of (A) plaque index, (B) bleeding index, (C) pocket depth, and (D) marginal bone loss
The results are presented as mean value for each group
Figure 6
Figure 6. Intergroup comparison of the masticatory efficiency between the groups for three different types of food (carrot, banana, and apple) regarding the chewing stroke count before the first swallow (A), the chewing stroke count until the oral cavity empties food (B), the count of swallows until the oral cavity empties food (C), the time estimated in seconds until the first swallow (D), and the time estimated in seconds until the oral cavity is empty of food (E)
The results are presented as mean value for each group
See this image and copyright information in PMC

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