title: Mandibular single-implant overdentures: a review with surgical and prosthodontic perspectives of a novel approach.
abstract: OBJECTIVE
  To review the literature on mandibular single-implant overdentures (opposing complete maxillary dentures), and present surgical and prosthodontic perspectives of a novel approach for this treatment option.
  
  
  METHODS
  An electronic search through the databases of Pubmed, Embase and Medline using the linked key words 'mandibular single implant overdentures' was performed. The search was limited to English language articles published up to August 2008. Hand searches through articles retrieved from the electronic search, peer-reviewed journals and recent conference proceedings were also conducted.
  
  
  RESULTS
  A limited number of reports were identified on mandibular single-implant overdentures (opposing maxillary complete dentures). They comprised of case-series reports, short-term prospective trials and current randomized-controlled clinical trials. Different loading protocols with different implant systems have been used, but always with regular diameter implants. Specific anatomical and vascular dangers of the mandibular midline symphysis are identified including a novel surgical approach using a currently available short, wide diameter tapered implant. In addition, the prosthodontic rationale for using a larger attachment system (incorporating a platform switch) for mandibular single-implant overdentures is described.
  
  
  CONCLUSIONS
  The review reveals that there is a lack of published randomized clinical trials using mandibular single-implant overdentures, opposing maxillary complete dentures. Without the evidence from randomized clinical trials, routine use of this novel approach cannot be recommended, compared with using regular diameter implants and matching attachment systems.
authors.affiliation: Oral Implantology Research Group, Sir John Walsh Research Institute, School of Dentistry, Dunedin, New Zealand.
authors.forename: Nabeel
authors.initials: N
authors.lastname: Alsabeeha
authors.forename: Alan G T
authors.initials: AG
authors.lastname: Payne
authors.forename: Rohana K
authors.initials: RK
authors.lastname: De Silva
authors.forename: Michael V
authors.initials: MV
authors.lastname: Swain
mesh_terms: D019250:Dental Implants, Single-Tooth; D017267:Dental Prosthesis Design / Q000295:instrumentation / Q000379:methods*; D019094:Dental Prosthesis, Implant-Supported / Q000295:instrumentation / Q000379:methods*; D003781:Denture Retention / Q000295:instrumentation / Q000379:methods; D003826:Denture, Complete, Lower; D003828:Denture, Overlay; D006801:Humans; D007575:Jaw, Edentulous / Q000534:rehabilitation; D008334:Mandible / Q000601:surgery; D013516:Oral Surgical Procedures, Preprosthetic / Q000379:methods*; D011476:Prosthodontics / Q000295:instrumentation / Q000379:methods