The effect of single-implant mandibular overdenture on the pattern of denture uses and patient-reported outcomes: a 2-year prospective study

Abstract

Objectives To assess the effect of single-implant mandibular overdenture (SIMO) on the patterns of denture use after the transition to overdenture treatment and the changes in patient-reported outcomes (PROMs) throughout a 2-year follow-up. Materials and methods Complete denture was provided to edentulous patients and the pattern of denture use was assessed after an adaptive period of 3 months after denture delivery and post-insertion care. Then, patients were invited to SIMO treatment. For those who accepted implant treatment, a single morse taper implant was inserted in the mandibular midline and loaded after four months using an O’ring-ball attachment. The pattern of denture use, patient satisfaction, and oral healthrelated quality of life impacts (OHRQoL) were assessed at the pre-and up to 2-year post-treatment follow-up. Data analyses included regression analysis for longitudinal data using Generalized Estimating Equations (GEE). Results Conventional dentures were provided to 58 patients, and 25 underwent SIMO treatment. At baseline assessment, 13 patients (52%) presented poor adaptation and discontinuous use of the mandibular denture. At the 3-month follow-up after the delivery of SIMO, there was a significant reduction in the impacts on OHRQoL and a notable improvement in patient satisfaction, which remained unaltered throughout the 2-year assessments. Treatment benefits were more pronounced for patients poorly adapted to the mandibular denture (p<0.05). All patients showed continuous use of the mandibular denture after conversion to a SIMO. Conclusions SIMO significantly improves PROMs and positively changes the pattern of denture use in patients who are poorly adapted to the conventional mandibular denture. Immediate changes were sustained after two years of SIMO use. Clinical relevance The delayed loaded SIMO markedly improved patient satisfaction with the mandibular denture and reduced OHRQoL impacts. It also shifted patients with discontinuous use into continuous users after the transition to overdenture treatment. SIMO can be a minimally invasive and less costly alternative for patients struggling with uncomfortable conventional mandibular dentures.