Single dental implant retained mandibular complete dentures - influence of the loading protocol

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In Germany, 30.5% in the age group of 65 to 74 years are edentulous in the maxilla and/or mandible. Edentulous people often complain about great functional deficits especially with the mandibular complete denture resulting in a reduce quality of life and a reduced masticatory function. Both can be greatly improved when dental implants are inserted to retain mandibular complete dentures. Using a single median implant has been shown to result in comparable outcomes as using two implants especially regarding patients’ satisfaction and quality of life, but to reduce costs and treatment time when implants are loaded three months after a second surgery. However, loading the implant immediately after implant placement would make a second surgery dispensable and would improve denture retention and provide all benefits for the patient immediately. Long-term data on the survival rate of directly loaded single mandibular implants in the edentulous mandible are still missing. It is the aim of the present prospective multicenter randomized clinical trial, which is requested for a prolongation, to show, that implant success is not compromised by immediate loading when one median implant in the edentulous mandible is used to retain a complete denture. In addition the trial aims to show that quality of life, patients’ denture satisfaction and chewing function will result in comparable clinical long-term outcomes. Edentulous patients between 60 and 89 years without contraindication for implant placement and an existing complete denture were included in the study (n=158). Patients received one median implant in the mandible, which retains the existing complete denture with a ball attachment. The implant was either loaded directly after implant placement (experimental group) or after three months of submerged healing at second stage surgery (control group).