A Comparative Computerized Occlusal Analysis of Conventional Complete Denture and Single Implant Retained Mandibular Overdenture

A Comparative Computerized Occlusal Analysis of Conventional Complete Denture and Single Implant Retained Mandibular Overdenture | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article A Comparative Computerized Occlusal Analysis of Conventional Complete Denture and Single Implant Retained Mandibular Overdenture Dr. Anushi Goel, Dr. Veena Jain, Dr. Dheeraj kumar kohli, Dr. Aditi Nanda This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6415885/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Objectives: This study aimed to compare the occlusal characteristics of conventional complete dentures (CCD) and single implant-retained mandibular overdentures (SIMO) using computerized occlusal analysis over a six-month period. Materials and Methods: A randomized controlled study included 22 edentulous patients divided into SIMO (n=11) and CCD (n=11) groups. Randomization used computer-generated tables.Dentures were fabricated following standardized protocols, with post-insertion occlusal adjustments. Digital occlusal analysis (T-Scan) was performed at three time points: 48 hours (T1), 3 months (T2), and 6 months (T3) post-insertion. The primary outcomes measured were the number of occlusal tooth contacts, percent biting occlusal force, percent bilateral force difference (left vs. right), and percent force distribution on left and right sides. Independent t-tests compared groups at each time point (p<0.05). For longitudinal analysis, repeated measures ANOVA assessed changes from T1 to T3 within groups. Results: No significant differences were observed between groups in terms of number of occlusal contacts (P>0.05), percent biting occlusal force (P>0.05), percent bilateral force difference (P>0.05), and percent force distribution (P>0.05) at all time points. Conclusions: The findings suggest that CCD and SIMO provide comparable occlusal performance over six months when properly adjusted. Clinicians may consider patient-specific factors such as cost, comfort, and anatomical conditions rather than occlusal outcomes alone when selecting between these treatment options. Dentistry Complete denture Implant overdenture Occlusal analysis T-Scan Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Introduction The rehabilitation of completely edentulous individuals is increasingly necessary due to factors such as longer life expectancy, greater awareness of dental treatment, and the high prevalence of edentulism ( 1 ). Despite a strong interest in rehabilitation, economic constraints often lead to the widespread use of conventional complete dentures ( 2 ). The McGill consensus recommends using two implants to support mandibular overdentures ( 3 ); however, this approach is often not feasible. Recently, there has been growing interest in single implant-supported overdentures, which offer economic advantages, a simplified procedure, and favorable patient outcomes ( 4 , 5 ). Critical to the success of any prosthesis, whether complete dentures or implant-supported overdentures, is the proper occlusal scheme (6). Bilateral balanced occlusion is commonly suggested ( 7 ), but challenges such as micromovements of the prosthesis and changes in diet or habits can affect occlusion over time ( 8 ). Premature occlusal contacts, if not addressed, can lead to instability, mucosal lesions, and long-term complications like ridge resorption and prosthesis failure ( 9 , 10 ). Traditional methods for occlusal analysis, such as articulating paper, lack accuracy and objectivity ( 11 , 12 ). The introduction of computerized occlusal analysis systems provides a more reliable means to evaluate occlusal forces and contact distribution, offering both qualitative and quantitative insights into occlusal function ( 13 , 14 ). This study aims to compare changes in occlusal force and contact distribution between conventional complete dentures and single implant-retained mandibular overdentures using computerized occlusal analysis at various time intervals after insertion. Materials and Methods This randomized controlled trial compared the occlusal performance of single implant-retained mandibular overdentures (SIMO) and conventional complete dentures (CCD) in completely edentulous patients, adhering to CONSORT guidelines for transparent reporting. The study was conducted at the Division of Prosthodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, after obtaining ethical approval (IECPG-654/25.11.2020) and CTRI registration (CTRI/2021/04/033054). As a pilot investigation, formal sample size calculation was not performed, and all eligible patients during the recruitment period (August 2020-December 2021) were enrolled. The study prioritized methodological rigor through standardized operative procedures, blinded outcome assessment where feasible, and strict ethical protocol adherence. Twenty-two participants were randomly allocated into two groups (SIMO: n = 11; CCD: n = 11) using computer-generated block randomization with concealed allocation via sequentially numbered opaque envelopes. Inclusion criteria included patients aged 50–74 years, completely edentulous for 6–12 months, with adequate mandibular bone (≥ 10 mm height, ≥ 4.5 mm width), Class I jaw relationship, and no prior denture experience. Exclusion criteria included systemic/metabolic disorders, temporomandibular joint dysfunction, head/neck radiation history, substance abuse, or poor implant stability (< 30 Ncm). In the SIMO group, implants were placed using CBCT-guided surgical templates via an open-flap technique under local anesthesia (Fig. 1,2), achieving 30–35 Ncm insertion torque, and retained with ball attachments (Fig. 3,4). The CCD group received conventionally fabricated dentures. Both groups followed identical prosthetic protocols for denture fabrication, except for implant placement in SIMO. Occlusal analysis was performed using a computerized system (Fig. 5) at 48 hours (T1), 3 months (T2), and 6 months (T3) post-insertion, assessing number of occlusal tooth contacts, percent biting occlusal force, percent bilateral force difference (left vs. right), and percent force distribution on left and right sides. Adjustments were made using articulating paper as needed. Data were analyzed using Stata 14.0, with intergroup comparisons via independent t-tests and intragroup changes assessed using repeated measures ANOVA (p < 0.05). All procedures were performed by a single operator to ensure standardization, and all enrolled participants completed the 6-month follow-up without attrition. Results This study compared occlusal stability between single-implant overdentures (SIMOs) and conventional dentures (CCDs) across three timepoints (T1:48h, T2:3mo, T3:6mo). Intragroup analysis (Table 1) via repeated measures ANOVA revealed no significant temporal changes in either group for occlusal contacts (SIMO P = 0.73; CCD P = 0.54), force distribution (SIMO left P = 0.14/right P = 0.59; CCD left/right P = 0.27), bilateral force difference (SIMO P = 0.45; CCD P = 0.32), or biting force (SIMO P = 0.98; CCD P = 0.95), confirming treatment stability over time. Intergroup comparisons (Table 2) using unpaired t-tests demonstrated no significant differences between SIMOs and CCDs at any time point for occlusal contacts (T1 P = 0.66; T2 P = 0.63; T3 P = 0.97), force distribution (left side T1-T3 P = 0.37–0.90; right side P = 0.37–0.90), bilateral force difference (T1 P = 0.23; T2 P = 0.47; T3 P = 0.87), or biting force (T1 P = 0.70; T2 P = 0.60; T3 P = 0.48), with all 95% CIs crossing zero and effect sizes indicating trivial-to-small differences (Graph 1). These findings suggest equivalent occlusal performance between SIMOs and CCDs during the 6-month observation period. Discussion The study results supported the null hypotheses, demonstrating no statistically significant differences in occlusal parameters between conventional complete dentures (CCDs) and single implant-retained mandibular overdentures (SIMOs) over the six-month observation period ( 1 ). At 48 hours post-insertion, occlusal contacts averaged 16.80 ± 3.85 for CCDs and 17.36 ± 1.68 for SIMOs (P > 0.05), with comparable stability maintained at 3 and 6 months ( 2 ). This consistency likely reflects the effectiveness of bilateral balanced occlusion achieved through laboratory remounting procedures, a finding consistent with previous reports suggesting such stability typically persists for at least one year before requiring rebalancing ( 3 ). The mucosal resiliency observed in our study participants further contributed to this stability by accommodating minor occlusal discrepancies, supporting earlier observations by Heartwell and Rahn regarding tissue adaptation ( 4 ). Masticatory efficiency, quantified through percentage mean biting force, showed remarkable similarity between groups at all evaluation points ( 5 ). Initial values of 99.16 ± 1.00% for CCDs and 99.02 ± 0.68% for SIMOs (P > 0.05) with minimal subsequent fluctuations suggest both prosthetic approaches facilitate comparable functional adaptation ( 6 ). These findings align with Borie et al.'s documentation of force pattern stabilization within the first month of denture use ( 7 ). Force distribution analysis revealed consistent bilateral balance in both treatment modalities ( 8 ). The < 10% discrepancy threshold for adequate occlusion, as proposed by Floriani et al., was consistently maintained throughout the study period ( 9 ). Notably, the single implant in SIMOs did not compromise occlusal harmony, indicating that proper attachment selection and occlusal adjustment can effectively balance the different support mechanisms (mucosal versus ridge support) of these prostheses ( 10 ). While these results demonstrate equivalent short-term occlusal performance, several limitations warrant consideration ( 11 ). The six-month follow-up period precludes assessment of long-term outcomes, and the modest sample size may limit generalizability. Furthermore, the T-Scan system's inability to measure absolute forces or dynamic occlusal patterns suggests areas for methodological refinement in future investigations ( 12 ). Nevertheless, our findings corroborate existing evidence that both CCDs and SIMOs can provide satisfactory functional outcomes when meticulously fabricated and adjusted ( 13 ). Conclusions Within the limitations of this study, there were no significant differences between single implant-supported mandibular overdentures (SIMOs) and conventional complete dentures (CCDs) in terms of occlusal parameters, including occlusal contacts, biting force, force distribution, and bilateral force difference, over six months. Both treatments demonstrated comparable outcomes when bilateral balanced occlusion was implemented.This suggests that the choice between SIMOs and CCDs can be guided by other clinical or patient-specific criteria, as both provide similar occlusal functionality and stability in centric occlusion. Declarations Informed consent was obtained from all individual participants included in the study. Furthermore, consent for publication of their data and any associated images was also secured. Data Availability Statement The data supporting the findings of this study are available from the corresponding author upon reasonable request. Author Contributions Conceptualization: Goel A*, Jain V; Methodology: Koli DK, Jain V, Nanda A; Formal Analysis: Koli DK, Jain V, Nanda A; Investigation: Jain V, Nanda A; Resources: AlIMS New Delhi; Writing – Original Draft: Goel A*, Jain V, Nanda A; Writing – Review & Editing: Goel A*, Koli DK; Supervision: Koli DK, Jain V, Nanda A. Acknowledgements: None Conflict of Interest Statement: The authors declare no conflict of interest. References Gupta A, Felton DA, Jemt T, Koka S. Rehabilitation of edentulism and mortality: a systematic review. J Prosthodont. 2019;28(6):526-35. Hantash RO, AL-Omiri MK, Yunis MA, Dar-Odeh N, Lynch E. Relationship between impacts of complete denture treatment on daily living, satisfaction and personality profiles. J Contemp Dent Pract. 2011;12(3):200-7. Basso MFM, Giampaolo ET, Vergani CE, Pavarina AC, Machado AL, Jorge JH. Occlusal pressure analysis of complete dentures after microwave disinfection: a clinical study. J Prosthodont. 2017;26(7):606-10. Walton JN, Glick N, Macentee MI. A randomized clinical trial comparing patient satisfaction and prosthetic outcomes with mandibular overdentures retained by one or two implants. Int J Prosthodont. 2009;22(4):331-9. Alqutaibi AY, Esposito M, Algabri R, Alfahad A, Kaddah A, Farouk M, et al. Single vs two implant-retained overdentures for edentulous mandibles: a systematic review. Eur J Oral Implantol. 2017;10(3):243-61. Nogueira TE, Dias DR, Leles CR. Mandibular complete denture versus single-implant overdenture: a systematic review of patient-reported outcomes. J Oral Rehabil. 2017;44(12):1004-16. Aarts JM, Payne AG, Thomson WM. Patients' evaluation of two occlusal schemes for implant overdentures. Clin Implant Dent Relat Res. 2008;10(3):140-56. Kürklüarpacay D, Bayindir F, Dinçkalyanikoğlu N. Evaluation of premature contacts using the T-Scan III. Open J Stomatol. 2019;9:136-45. González Sequeros O, Garrido García VC, García Cartagena A. A study of occlusal contact variability within individuals in a position of maximum intercuspation using the T-scan system. J Oral Rehabil. 1997;24(4):287-90. Zayed MA, Shakal EA, Abutaleb FA. The effect of computer guided occlusal adjustment on radiographic outcome and masticatory efficiency of implant-supported overdentures. J Oral Health Dent. 2018;2:106-10. Kabbua P, Aunmeungtong W, Khongkhunthian P. Computerised occlusal analysis of mini-dental implant-retained mandibular overdentures: a 1-year prospective clinical study. J Oral Rehabil. 2020;47(7):757-65. Assunção WG, Barão VA, Delben JA, Gomes EA, Tabata LF. A comparison of patient satisfaction between treatment with conventional complete dentures and overdentures in the elderly: a literature review. Gerodontology. 2010;27(2):154-62. Ismail HA, Mahrous AI, Banasr FH, Soliman TA, Baraka Y. Two years retrospective evaluations of overdenture retained by symphyseal single implant using two types of attachments. J Int Oral Health. 2015;7(1):4-8. Rocha COM, Longhini D, Pereira RP, Lima ALO, Bonafé FSS, Arioli Filho JN. Masticatory efficiency in complete denture and single implant-retained mandibular overdenture wearers with different occlusion schemes: a randomized clinical trial. J Prosthet Dent. 2021;126(3):345-50. Km S, Koli DK, Jain V, Pruthi G, Nanda A. Comparison of ridge resorption and patient satisfaction in single implant-retained mandibular overdentures with conventional complete dentures: a randomized pilot study. J Oral Biol Craniofac Res. 2021;11(1):71-7. Bryant SR, Walton JN, MacEntee MI. A 5-year randomized trial to compare 1 or 2 implants for implant overdentures. J Dent Res. 2015;94(1):36-43. Alsabeeha N, Atieh M, Swain MV, Payne AG. Attachment systems for mandibular single-implant overdentures: an in vitro retention force investigation on different designs. Int J Prosthodont. 2010;23(2):160-6. El-Sheikh A, Shihabuddin OF, Ghoraba SMF. A prospective study of early loaded single implant-retained mandibular overdentures: preliminary one-year results. Int J Dent. 2012;2012:236409. Fouda K, Fahmy A, Aziz K, Aal MA, Naguib A, Nabi NA. Implant stability changes for a single implant mandibular overdenture. Eur J Dent. 2021;15(3):515-20. Kashyap S, Mittal S, Sharma N, Sukhija U, Kamra M, Gupta N. Evaluation of patient satisfaction and masticatory performance in mandible single implant-assisted overdenture. Tzu Chi Med J. 2021;33(4):406-11. Singh S, Mishra SK, Chowdhary R. Patient satisfaction and crestal bone changes with one-piece and two-piece single implant-retained mandibular overdenture: a randomized controlled clinical study. J Prosthodont Res. 2022;66(1):115-23. Afrashtehfar KI, Qadeer S. Computerized occlusal analysis as an alternative occlusal indicator. Cranio. 2016;34(1):52-7. Bozhkova TP. The T-SCAN System in evaluating occlusal contacts. Folia Med (Plovdiv). 2016;58(2):122-30. Chaturvedi S, Addas MK, Alqahtani NM, Al Ahmari NM, Alfarsi MA. Computerized occlusal forces analysis in complete dentures fabricated by additive and subtractive techniques. Technol Health Care. 2021;29(5):781-95. Ibraheem EM, ElGabry HS. Effect of mandibular complete dentures relining on occlusal force distribution using T-scan system. Bull Natl Res Cent. 2021;45:93. Floriani F, Sabatini GP, Oliveira Dos Santos TT, Philippi AG, Gonzaga LH, Mezzomo LA. Digital and analog analysis of occlusion in conventional and implant-retained complete dentures: preliminary results of a prospective clinical trial. Int J Prosthodont. 2022;35(1):27-36. Khuder T, Yunus N, Sulaiman E, Ibrahim N, Khalid T, Masood M. Association between occlusal force distribution in implant overdenture prostheses and residual ridge resorption. J Oral Rehabil. 2017;44(5):398-404. Resnik R. Misch's contemporary implant dentistry. 4th ed. St. Louis: Elsevier; 2020. Liddelow GJ, Henry PJ. A prospective study of immediately loaded single implant-retained mandibular overdentures: preliminary one-year results. J Prosthet Dent. 2007;98(1):62-4. Cheng T, Sun G, Huo J, He X, Wang Y, Ren YF. Patient satisfaction and masticatory efficiency of single implant-retained mandibular overdentures using the stud and magnetic attachments. J Dent. 2012;40(11):1018-23. Cordioli G, Majzoub Z, Castagna S. Mandibular overdentures anchored to single implants: a five-year prospective study. J Prosthet Dent. 1997;78(2):159-65. Naguib AA, El Khourazaty NS, El Monaem AA. Cost-effectiveness of CM-LOC attachment versus ball attachment retaining single implant mandibular overdentures. Maced J Med Sci. 2019;7(21):3655-8. Goiato MC, Garcia AR, Dos Santos DM, Zuim PR. Analysis of masticatory cycle efficiency in complete denture wearers. J Prosthodont. 2010;19(1):10-3. Pesun IJ. Occlusal consideration for mandibular implant overdentures. In: Feine J, Carlsson G, editors. Mandibular implant prostheses. Berlin: Springer; 2018. p. 249-60. Fontijn-Tekamp FA, Slagter AP, van't Hof MA, Geertman ME, Kalk W. Bite forces with mandibular implant-retained overdentures. J Dent Res. 1998;77(10):1832-9. Compagnoni MA, de Souza RF. Kinesiographic study of complete denture movement related to mucosa displacement in edentulous patients. Pesqui Odontol Bras. 2003;17(4):356-61. Maeda Y, Okada M, Makishi A, Nokubi T, Okuno Y, Aoki T. Using mandibular kinesiograph for measuring complete denture movements: a preliminary report. J Osaka Univ Dent Sch. 1984;24:123-9. Atashrazm P, Ansari LH, Khorsand M. An evaluation of occlusal contacts of remounted complete denture before final occlusal adjustment. Shiraz Univ Dent J. 2009;9(2):1-5. Mpungose SK, Geerts GA. Analyzing complete denture occlusal contacts: accuracy and reliability. Int J Prosthodont. 2016;29(1):50-2. Ruttitivapanich N, Tansalarak R, Palasuk J, Pumklin J. Correlation of bite force interpretation in maximal intercuspal position among patient, clinician, and T-Scan III System. Eur J Dent. 2019;13(3):330-4. Borie E, Orsi IA, Fuentes R, Beltrán V, Navarro P, Pareja F. Maximum bite force in elderly indigenous and non-indigenous denture wearers. Acta Odontol Latinoam. 2014;27(3):115-9. Tables Tables 1 and 2 are available in the Supplementary Files section Graph Graph 1 is available in the Supplementary Files section. Additional Declarations The authors declare no competing interests. Supplementary Files Graph1.pdf Graph 1 Table1PDF.pdf Table 1 TABLE2.pdf Table 2 consortchartupdated.pdf consort chart Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6415885","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":440897644,"identity":"b1f8de81-f863-411b-9ea1-d37399da92fa","order_by":0,"name":"Dr. Anushi Goel","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABB0lEQVRIiWNgGAWjYLCCByBCgrHxwYcKIIOZuYGwlgSIlmbDGWdAWhiJ1sLAJs3bBmIR0CLv3mP4IaHmTuL82c0NkjPn1UbztwO1/KjYhlOL4ZkzxhIJx54lbrhzsMHg47bjuTMOMzYw9py5jVvLjBwDiQS2w4kbJBIbEmduO5bbANTCzNiGV4vxj4R/hxPnz0hsOMw751jufEJa5CVyzCQS2w4nNtxIbGzmbajJ3UBIiwHPsTKLxL7DxhtuJDYzzjh2IHcjUMtBfH6Rb2/efOPDt8Oy82ekP//xoaYud975wwcf/KjAY8sBDgNk/mEweQCnepAtDewPkPl1+BSPglEwCkbBCAUAwTxo9gi66m0AAAAASUVORK5CYII=","orcid":"","institution":"AIIMS New Delhi","correspondingAuthor":true,"prefix":"Dr.","firstName":"Anushi","middleName":"","lastName":"Goel","suffix":""},{"id":440897645,"identity":"3a60a1f1-b6b9-471b-9888-0cfe29b5f57b","order_by":1,"name":"Dr. Veena Jain","email":"","orcid":"","institution":"AIIMS New Delhi","correspondingAuthor":false,"prefix":"Dr.","firstName":"Veena","middleName":"","lastName":"Jain","suffix":""},{"id":440897646,"identity":"daf5a04d-aa19-4b35-8f7f-d9a7529f0f31","order_by":2,"name":"Dr. Dheeraj kumar kohli","email":"","orcid":"","institution":"AIIMS New Delhi","correspondingAuthor":false,"prefix":"Dr.","firstName":"Dheeraj","middleName":"kumar","lastName":"kohli","suffix":""},{"id":440897647,"identity":"b556cbb6-e47a-4c07-9f0c-2b1d2ff3ea13","order_by":3,"name":"Dr. Aditi Nanda","email":"","orcid":"","institution":"AIIMS New Delhi","correspondingAuthor":false,"prefix":"Dr.","firstName":"Aditi","middleName":"","lastName":"Nanda","suffix":""}],"badges":[],"createdAt":"2025-04-10 03:13:34","currentVersionCode":1,"declarations":{"humanSubjects":true,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":true,"humanSubjectConsent":true,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-6415885/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6415885/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":81176842,"identity":"3d6dbea5-fe69-46fb-b32e-7e734f641058","added_by":"auto","created_at":"2025-04-23 06:30:04","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":84725,"visible":true,"origin":"","legend":"\u003cp\u003eCBCT evaluation prior implant impacement with template in mouth\u003c/p\u003e","description":"","filename":"fig1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-6415885/v1/531556d4226e6fd055498118.jpg"},{"id":81176010,"identity":"90ce8a0a-7c9c-4921-9600-c4b2f97892d8","added_by":"auto","created_at":"2025-04-23 06:22:04","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":19130,"visible":true,"origin":"","legend":"\u003cp\u003eImplant placement\u003c/p\u003e","description":"","filename":"fig2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-6415885/v1/03db4d2fc50e7df993b607cd.jpg"},{"id":81176023,"identity":"3ff57f5c-cc70-4675-a437-506decb2c733","added_by":"auto","created_at":"2025-04-23 06:22:04","extension":"jpg","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":1082643,"visible":true,"origin":"","legend":"\u003cp\u003eball attachment in mouth\u003c/p\u003e","description":"","filename":"figs3.jpg","url":"https://assets-eu.researchsquare.com/files/rs-6415885/v1/17b6d1007707490a323173f7.jpg"},{"id":81176022,"identity":"d3423d3d-4186-4545-b4a5-644bc69eb5a1","added_by":"auto","created_at":"2025-04-23 06:22:04","extension":"jpg","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":901410,"visible":true,"origin":"","legend":"\u003cp\u003epick up impresssion with female attachment in denture\u003c/p\u003e","description":"","filename":"fig4.jpg","url":"https://assets-eu.researchsquare.com/files/rs-6415885/v1/e3c47cc03f9f0a66f68ffd56.jpg"},{"id":81176019,"identity":"3861ec3e-168e-4e43-aedd-9556a555f5a3","added_by":"auto","created_at":"2025-04-23 06:22:04","extension":"jpg","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":45586,"visible":true,"origin":"","legend":"\u003cp\u003eocclusal analysis using T- scan\u003c/p\u003e","description":"","filename":"fig5.jpg","url":"https://assets-eu.researchsquare.com/files/rs-6415885/v1/4416f066dfbb5310d3ffe7ec.jpg"},{"id":81177139,"identity":"67f22094-9d90-478b-bfe1-8fb4d18d9671","added_by":"auto","created_at":"2025-04-23 06:38:05","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2696889,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6415885/v1/fd48f290-88d9-4e8e-9cb0-bac73aecaa19.pdf"},{"id":81176014,"identity":"f9184702-eaa5-42af-8418-558c85a84f2e","added_by":"auto","created_at":"2025-04-23 06:22:04","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":32013,"visible":true,"origin":"","legend":"\u003cp\u003eGraph 1\u003c/p\u003e","description":"","filename":"Graph1.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6415885/v1/3c2166bfe93db64fd6d1027f.pdf"},{"id":81176012,"identity":"95c5729a-a863-470c-a54f-9e96e9ab00a0","added_by":"auto","created_at":"2025-04-23 06:22:04","extension":"pdf","order_by":2,"title":"","display":"","copyAsset":false,"role":"supplement","size":2526,"visible":true,"origin":"","legend":"\u003cp\u003eTable 1\u003c/p\u003e","description":"","filename":"Table1PDF.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6415885/v1/287f7aa192477a3a767bc769.pdf"},{"id":81176015,"identity":"049a2cec-35c0-4097-8b05-79a3e92d430d","added_by":"auto","created_at":"2025-04-23 06:22:04","extension":"pdf","order_by":3,"title":"","display":"","copyAsset":false,"role":"supplement","size":2691,"visible":true,"origin":"","legend":"\u003cp\u003eTable 2\u003c/p\u003e","description":"","filename":"TABLE2.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6415885/v1/85bcd3c38b65d48a52cd0f59.pdf"},{"id":81176018,"identity":"19fcd238-9f20-4059-a1a1-68e8cef78fd2","added_by":"auto","created_at":"2025-04-23 06:22:04","extension":"pdf","order_by":4,"title":"","display":"","copyAsset":false,"role":"supplement","size":1331,"visible":true,"origin":"","legend":"\u003cp\u003econsort chart\u003c/p\u003e","description":"","filename":"consortchartupdated.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6415885/v1/a8ea29193337d957ee3cbea1.pdf"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003e\u003cstrong\u003eA Comparative Computerized Occlusal Analysis of Conventional Complete Denture and Single Implant Retained Mandibular Overdenture\u003c/strong\u003e\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003eThe rehabilitation of completely edentulous individuals is increasingly necessary due to factors such as longer life expectancy, greater awareness of dental treatment, and the high prevalence of edentulism (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). Despite a strong interest in rehabilitation, economic constraints often lead to the widespread use of conventional complete dentures (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). The McGill consensus recommends using two implants to support mandibular overdentures (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e); however, this approach is often not feasible. Recently, there has been growing interest in single implant-supported overdentures, which offer economic advantages, a simplified procedure, and favorable patient outcomes (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eCritical to the success of any prosthesis, whether complete dentures or implant-supported overdentures, is the proper occlusal scheme (6). Bilateral balanced occlusion is commonly suggested (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e), but challenges such as micromovements of the prosthesis and changes in diet or habits can affect occlusion over time (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). Premature occlusal contacts, if not addressed, can lead to instability, mucosal lesions, and long-term complications like ridge resorption and prosthesis failure (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eTraditional methods for occlusal analysis, such as articulating paper, lack accuracy and objectivity (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). The introduction of computerized occlusal analysis systems provides a more reliable means to evaluate occlusal forces and contact distribution, offering both qualitative and quantitative insights into occlusal function (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). This study aims to compare changes in occlusal force and contact distribution between conventional complete dentures and single implant-retained mandibular overdentures using computerized occlusal analysis at various time intervals after insertion.\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cp\u003e This randomized controlled trial compared the occlusal performance of single implant-retained mandibular overdentures (SIMO) and conventional complete dentures (CCD) in completely edentulous patients, adhering to CONSORT guidelines for transparent reporting. The study was conducted at the Division of Prosthodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, after obtaining ethical approval (IECPG-654/25.11.2020) and CTRI registration (CTRI/2021/04/033054). As a pilot investigation, formal sample size calculation was not performed, and all eligible patients during the recruitment period (August 2020-December 2021) were enrolled. The study prioritized methodological rigor through standardized operative procedures, blinded outcome assessment where feasible, and strict ethical protocol adherence.\u003c/p\u003e \u003cp\u003eTwenty-two participants were randomly allocated into two groups (SIMO: n\u0026thinsp;=\u0026thinsp;11; CCD: n\u0026thinsp;=\u0026thinsp;11) using computer-generated block randomization with concealed allocation via sequentially numbered opaque envelopes. Inclusion criteria included patients aged 50\u0026ndash;74 years, completely edentulous for 6\u0026ndash;12 months, with adequate mandibular bone (\u0026ge;\u0026thinsp;10 mm height, \u0026ge;\u0026thinsp;4.5 mm width), Class I jaw relationship, and no prior denture experience. Exclusion criteria included systemic/metabolic disorders, temporomandibular joint dysfunction, head/neck radiation history, substance abuse, or poor implant stability (\u0026lt;\u0026thinsp;30 Ncm).\u003c/p\u003e \u003cp\u003eIn the SIMO group, implants were placed using CBCT-guided surgical templates via an open-flap technique under local anesthesia (Fig.\u0026nbsp;1,2), achieving 30\u0026ndash;35 Ncm insertion torque, and retained with ball attachments (Fig.\u0026nbsp;3,4). The CCD group received conventionally fabricated dentures. Both groups followed identical prosthetic protocols for denture fabrication, except for implant placement in SIMO. Occlusal analysis was performed using a computerized system (Fig.\u0026nbsp;5) at 48 hours (T1), 3 months (T2), and 6 months (T3) post-insertion, assessing number of occlusal tooth contacts, percent biting occlusal force, percent bilateral force difference (left vs. right), and percent force distribution on left and right sides. Adjustments were made using articulating paper as needed. Data were analyzed using Stata 14.0, with intergroup comparisons via independent t-tests and intragroup changes assessed using repeated measures ANOVA (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). All procedures were performed by a single operator to ensure standardization, and all enrolled participants completed the 6-month follow-up without attrition.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThis study compared occlusal stability between single-implant overdentures (SIMOs) and conventional dentures (CCDs) across three timepoints (T1:48h, T2:3mo, T3:6mo). Intragroup analysis (Table\u0026nbsp;1) via repeated measures ANOVA revealed no significant temporal changes in either group for occlusal contacts (SIMO P\u0026thinsp;=\u0026thinsp;0.73; CCD P\u0026thinsp;=\u0026thinsp;0.54), force distribution (SIMO left P\u0026thinsp;=\u0026thinsp;0.14/right P\u0026thinsp;=\u0026thinsp;0.59; CCD left/right P\u0026thinsp;=\u0026thinsp;0.27), bilateral force difference (SIMO P\u0026thinsp;=\u0026thinsp;0.45; CCD P\u0026thinsp;=\u0026thinsp;0.32), or biting force (SIMO P\u0026thinsp;=\u0026thinsp;0.98; CCD P\u0026thinsp;=\u0026thinsp;0.95), confirming treatment stability over time. Intergroup comparisons (Table\u0026nbsp;2) using unpaired t-tests demonstrated no significant differences between SIMOs and CCDs at any time point for occlusal contacts (T1 P\u0026thinsp;=\u0026thinsp;0.66; T2 P\u0026thinsp;=\u0026thinsp;0.63; T3 P\u0026thinsp;=\u0026thinsp;0.97), force distribution (left side T1-T3 P\u0026thinsp;=\u0026thinsp;0.37\u0026ndash;0.90; right side P\u0026thinsp;=\u0026thinsp;0.37\u0026ndash;0.90), bilateral force difference (T1 P\u0026thinsp;=\u0026thinsp;0.23; T2 P\u0026thinsp;=\u0026thinsp;0.47; T3 P\u0026thinsp;=\u0026thinsp;0.87), or biting force (T1 P\u0026thinsp;=\u0026thinsp;0.70; T2 P\u0026thinsp;=\u0026thinsp;0.60; T3 P\u0026thinsp;=\u0026thinsp;0.48), with all 95% CIs crossing zero and effect sizes indicating trivial-to-small differences (Graph 1). These findings suggest equivalent occlusal performance between SIMOs and CCDs during the 6-month observation period.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe study results supported the null hypotheses, demonstrating no statistically significant differences in occlusal parameters between conventional complete dentures (CCDs) and single implant-retained mandibular overdentures (SIMOs) over the six-month observation period (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). At 48 hours post-insertion, occlusal contacts averaged 16.80\u0026thinsp;\u0026plusmn;\u0026thinsp;3.85 for CCDs and 17.36\u0026thinsp;\u0026plusmn;\u0026thinsp;1.68 for SIMOs (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05), with comparable stability maintained at 3 and 6 months (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). This consistency likely reflects the effectiveness of bilateral balanced occlusion achieved through laboratory remounting procedures, a finding consistent with previous reports suggesting such stability typically persists for at least one year before requiring rebalancing (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). The mucosal resiliency observed in our study participants further contributed to this stability by accommodating minor occlusal discrepancies, supporting earlier observations by Heartwell and Rahn regarding tissue adaptation (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eMasticatory efficiency, quantified through percentage mean biting force, showed remarkable similarity between groups at all evaluation points (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). Initial values of 99.16\u0026thinsp;\u0026plusmn;\u0026thinsp;1.00% for CCDs and 99.02\u0026thinsp;\u0026plusmn;\u0026thinsp;0.68% for SIMOs (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05) with minimal subsequent fluctuations suggest both prosthetic approaches facilitate comparable functional adaptation (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). These findings align with Borie et al.'s documentation of force pattern stabilization within the first month of denture use (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eForce distribution analysis revealed consistent bilateral balance in both treatment modalities (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). The \u0026lt;\u0026thinsp;10% discrepancy threshold for adequate occlusion, as proposed by Floriani et al., was consistently maintained throughout the study period (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). Notably, the single implant in SIMOs did not compromise occlusal harmony, indicating that proper attachment selection and occlusal adjustment can effectively balance the different support mechanisms (mucosal versus ridge support) of these prostheses (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eWhile these results demonstrate equivalent short-term occlusal performance, several limitations warrant consideration (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). The six-month follow-up period precludes assessment of long-term outcomes, and the modest sample size may limit generalizability. Furthermore, the T-Scan system's inability to measure absolute forces or dynamic occlusal patterns suggests areas for methodological refinement in future investigations (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). Nevertheless, our findings corroborate existing evidence that both CCDs and SIMOs can provide satisfactory functional outcomes when meticulously fabricated and adjusted (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e).\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eWithin the limitations of this study, there were no significant differences between single implant-supported mandibular overdentures (SIMOs) and conventional complete dentures (CCDs) in terms of occlusal parameters, including occlusal contacts, biting force, force distribution, and bilateral force difference, over six months. Both treatments demonstrated comparable outcomes when bilateral balanced occlusion was implemented.This suggests that the choice between SIMOs and CCDs can be guided by other clinical or patient-specific criteria, as both provide similar occlusal functionality and stability in centric occlusion.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eInformed consent was obtained from all individual participants included in the study. Furthermore, consent for publication of their data and any associated images was also secured.\u003c/p\u003e\n\u003ch3\u003e\u003cstrong\u003eData Availability Statement\u003c/strong\u003e\u003c/h3\u003e\n\u003cp\u003eThe data supporting the findings of this study are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003ch3\u003e\u003cstrong\u003eConceptualization:\u003c/strong\u003eGoel A*,\u0026nbsp;Jain V;\u003c/h3\u003e\n\u003ch3\u003e\u003cstrong\u003eMethodology:\u003c/strong\u003e \u0026nbsp;Koli DK, Jain V, Nanda A;\u003cbr\u003e\u003cstrong\u003eFormal Analysis:\u003c/strong\u003e \u0026nbsp;Koli DK, Jain V, Nanda A;\u003cbr\u003e\u003cstrong\u003eInvestigation:\u003c/strong\u003e \u0026nbsp;Jain V, Nanda A;\u003cbr\u003e\u003cstrong\u003eResources:\u0026nbsp;\u003c/strong\u003eAlIMS New Delhi;\u003cbr\u003e\u003cstrong\u003eWriting \u0026ndash;\u003c/strong\u003e \u003cstrong\u003eOriginal Draft:\u003c/strong\u003e \u0026nbsp;Goel A*,\u0026nbsp;Jain V, Nanda A;\u003cbr\u003e\u003cstrong\u003eWriting \u0026ndash; Review \u0026amp; Editing:\u003c/strong\u003e \u0026nbsp;Goel A*,\u0026nbsp;Koli DK;\u003cbr\u003e\u003cstrong\u003eSupervision:\u0026nbsp;\u003c/strong\u003eKoli DK, Jain V, Nanda A.\u003c/h3\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements:\u003cbr\u003e\u003c/strong\u003eNone\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of Interest Statement:\u003cbr\u003e\u003c/strong\u003eThe authors declare no conflict of interest.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eGupta A, Felton DA, Jemt T, Koka S. Rehabilitation of edentulism and mortality: a systematic review. J Prosthodont. 2019;28(6):526-35.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eHantash RO, AL-Omiri MK, Yunis MA, Dar-Odeh N, Lynch E. Relationship between impacts of complete denture treatment on daily living, satisfaction and personality profiles. J Contemp Dent Pract. 2011;12(3):200-7.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eBasso MFM, Giampaolo ET, Vergani CE, Pavarina AC, Machado AL, Jorge JH. Occlusal pressure analysis of complete dentures after microwave disinfection: a clinical study. J Prosthodont. 2017;26(7):606-10.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eWalton JN, Glick N, Macentee MI. A randomized clinical trial comparing patient satisfaction and prosthetic outcomes with mandibular overdentures retained by one or two implants. Int J Prosthodont. 2009;22(4):331-9.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eAlqutaibi AY, Esposito M, Algabri R, Alfahad A, Kaddah A, Farouk M, et al. Single vs two implant-retained overdentures for edentulous mandibles: a systematic review. Eur J Oral Implantol. 2017;10(3):243-61.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eNogueira TE, Dias DR, Leles CR. Mandibular complete denture versus single-implant overdenture: a systematic review of patient-reported outcomes. J Oral Rehabil. 2017;44(12):1004-16.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eAarts JM, Payne AG, Thomson WM. Patients\u0026apos; evaluation of two occlusal schemes for implant overdentures. Clin Implant Dent Relat Res. 2008;10(3):140-56.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eK\u0026uuml;rkl\u0026uuml;arpacay D, Bayindir F, Din\u0026ccedil;kalyanikoğlu N. Evaluation of premature contacts using the T-Scan III. Open J Stomatol. 2019;9:136-45.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eGonz\u0026aacute;lez Sequeros O, Garrido Garc\u0026iacute;a VC, Garc\u0026iacute;a Cartagena A. A study of occlusal contact variability within individuals in a position of maximum intercuspation using the T-scan system. J Oral Rehabil. 1997;24(4):287-90.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eZayed MA, Shakal EA, Abutaleb FA. The effect of computer guided occlusal adjustment on radiographic outcome and masticatory efficiency of implant-supported overdentures. J Oral Health Dent. 2018;2:106-10.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eKabbua P, Aunmeungtong W, Khongkhunthian P. Computerised occlusal analysis of mini-dental implant-retained mandibular overdentures: a 1-year prospective clinical study. J Oral Rehabil. 2020;47(7):757-65.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eAssun\u0026ccedil;\u0026atilde;o WG, Bar\u0026atilde;o VA, Delben JA, Gomes EA, Tabata LF. A comparison of patient satisfaction between treatment with conventional complete dentures and overdentures in the elderly: a literature review. Gerodontology. 2010;27(2):154-62.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eIsmail HA, Mahrous AI, Banasr FH, Soliman TA, Baraka Y. Two years retrospective evaluations of overdenture retained by symphyseal single implant using two types of attachments. J Int Oral Health. 2015;7(1):4-8.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eRocha COM, Longhini D, Pereira RP, Lima ALO, Bonaf\u0026eacute; FSS, Arioli Filho JN. Masticatory efficiency in complete denture and single implant-retained mandibular overdenture wearers with different occlusion schemes: a randomized clinical trial. J Prosthet Dent. 2021;126(3):345-50.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eKm S, Koli DK, Jain V, Pruthi G, Nanda A. Comparison of ridge resorption and patient satisfaction in single implant-retained mandibular overdentures with conventional complete dentures: a randomized pilot study. J Oral Biol Craniofac Res. 2021;11(1):71-7.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eBryant SR, Walton JN, MacEntee MI. A 5-year randomized trial to compare 1 or 2 implants for implant overdentures. J Dent Res. 2015;94(1):36-43.\u003c/li\u003e\n \u003cli\u003eAlsabeeha N, Atieh M, Swain MV, Payne AG. Attachment systems for mandibular single-implant overdentures: an in vitro retention force investigation on different designs. Int J Prosthodont. 2010;23(2):160-6.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eEl-Sheikh A, Shihabuddin OF, Ghoraba SMF. A prospective study of early loaded single implant-retained mandibular overdentures: preliminary one-year results. Int J Dent. 2012;2012:236409.\u003c/li\u003e\n \u003cli\u003eFouda K, Fahmy A, Aziz K, Aal MA, Naguib A, Nabi NA. Implant stability changes for a single implant mandibular overdenture. Eur J Dent. 2021;15(3):515-20.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eKashyap S, Mittal S, Sharma N, Sukhija U, Kamra M, Gupta N. Evaluation of patient satisfaction and masticatory performance in mandible single implant-assisted overdenture. Tzu Chi Med J. 2021;33(4):406-11.\u003c/li\u003e\n \u003cli\u003eSingh S, Mishra SK, Chowdhary R. Patient satisfaction and crestal bone changes with one-piece and two-piece single implant-retained mandibular overdenture: a randomized controlled clinical study. J Prosthodont Res. 2022;66(1):115-23.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eAfrashtehfar KI, Qadeer S. Computerized occlusal analysis as an alternative occlusal indicator. Cranio. 2016;34(1):52-7.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eBozhkova TP. The T-SCAN System in evaluating occlusal contacts. Folia Med (Plovdiv). 2016;58(2):122-30.\u003c/li\u003e\n \u003cli\u003eChaturvedi S, Addas MK, Alqahtani NM, Al Ahmari NM, Alfarsi MA. Computerized occlusal forces analysis in complete dentures fabricated by additive and subtractive techniques. Technol Health Care. 2021;29(5):781-95.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eIbraheem EM, ElGabry HS. Effect of mandibular complete dentures relining on occlusal force distribution using T-scan system. Bull Natl Res Cent. 2021;45:93.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eFloriani F, Sabatini GP, Oliveira Dos Santos TT, Philippi AG, Gonzaga LH, Mezzomo LA. Digital and analog analysis of occlusion in conventional and implant-retained complete dentures: preliminary results of a prospective clinical trial. Int J Prosthodont. 2022;35(1):27-36.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eKhuder T, Yunus N, Sulaiman E, Ibrahim N, Khalid T, Masood M. Association between occlusal force distribution in implant overdenture prostheses and residual ridge resorption. J Oral Rehabil. 2017;44(5):398-404.\u003c/li\u003e\n \u003cli\u003eResnik R. Misch\u0026apos;s contemporary implant dentistry. 4th ed. St. Louis: Elsevier; 2020.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eLiddelow GJ, Henry PJ. A prospective study of immediately loaded single implant-retained mandibular overdentures: preliminary one-year results. J Prosthet Dent. 2007;98(1):62-4.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eCheng T, Sun G, Huo J, He X, Wang Y, Ren YF. Patient satisfaction and masticatory efficiency of single implant-retained mandibular overdentures using the stud and magnetic attachments. J Dent. 2012;40(11):1018-23.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eCordioli G, Majzoub Z, Castagna S. Mandibular overdentures anchored to single implants: a five-year prospective study. J Prosthet Dent. 1997;78(2):159-65.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eNaguib AA, El Khourazaty NS, El Monaem AA. Cost-effectiveness of CM-LOC attachment versus ball attachment retaining single implant mandibular overdentures. Maced J Med Sci. 2019;7(21):3655-8.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eGoiato MC, Garcia AR, Dos Santos DM, Zuim PR. Analysis of masticatory cycle efficiency in complete denture wearers. J Prosthodont. 2010;19(1):10-3.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003ePesun IJ. Occlusal consideration for mandibular implant overdentures. In: Feine J, Carlsson G, editors. Mandibular implant prostheses. Berlin: Springer; 2018. p. 249-60.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eFontijn-Tekamp FA, Slagter AP, van\u0026apos;t Hof MA, Geertman ME, Kalk W. Bite forces with mandibular implant-retained overdentures. J Dent Res. 1998;77(10):1832-9.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eCompagnoni MA, de Souza RF. Kinesiographic study of complete denture movement related to mucosa displacement in edentulous patients. Pesqui Odontol Bras. 2003;17(4):356-61.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eMaeda Y, Okada M, Makishi A, Nokubi T, Okuno Y, Aoki T. Using mandibular kinesiograph for measuring complete denture movements: a preliminary report. J Osaka Univ Dent Sch. 1984;24:123-9.\u003c/li\u003e\n \u003cli\u003eAtashrazm P, Ansari LH, Khorsand M. An evaluation of occlusal contacts of remounted complete denture before final occlusal adjustment. Shiraz Univ Dent J. 2009;9(2):1-5.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eMpungose SK, Geerts GA. Analyzing complete denture occlusal contacts: accuracy and reliability. Int J Prosthodont. 2016;29(1):50-2.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eRuttitivapanich N, Tansalarak R, Palasuk J, Pumklin J. Correlation of bite force interpretation in maximal intercuspal position among patient, clinician, and T-Scan III System. Eur J Dent. 2019;13(3):330-4.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eBorie E, Orsi IA, Fuentes R, Beltr\u0026aacute;n V, Navarro P, Pareja F. Maximum bite force in elderly indigenous and non-indigenous denture wearers. Acta Odontol Latinoam. 2014;27(3):115-9.\u0026nbsp;\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTables 1 and 2 are available in the Supplementary Files section\u003c/p\u003e"},{"header":"Graph","content":"\u003cp\u003eGraph 1 is available in the Supplementary Files section.\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"ALL INDIA INSTITUTE OF MEDICAL SCIENCES NEW DELHI","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Complete denture, Implant overdenture, Occlusal analysis, T-Scan","lastPublishedDoi":"10.21203/rs.3.rs-6415885/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6415885/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eObjectives: \u003c/strong\u003eThis study aimed to compare the occlusal characteristics of conventional complete dentures (CCD) and single implant-retained mandibular overdentures (SIMO) using computerized occlusal analysis over a six-month period.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMaterials and Methods: \u003c/strong\u003eA randomized controlled study included 22 edentulous patients divided into SIMO (n=11) and CCD (n=11) groups. Randomization used computer-generated tables.Dentures were fabricated following standardized protocols, with post-insertion occlusal adjustments. Digital occlusal analysis (T-Scan) was performed at three time points: 48 hours (T1), 3 months (T2), and 6 months (T3) post-insertion. The primary outcomes measured were the number of occlusal tooth contacts, percent biting occlusal force, percent bilateral force difference (left vs. right), and percent force distribution on left and right sides. Independent t-tests compared groups at each time point (p\u0026lt;0.05). For longitudinal analysis, repeated measures ANOVA assessed changes from T1 to T3 within groups.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003eNo significant differences were observed between groups in terms of number of occlusal contacts (P\u0026gt;0.05), percent biting occlusal force (P\u0026gt;0.05), percent bilateral force difference (P\u0026gt;0.05), and percent force distribution (P\u0026gt;0.05) at all time points.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions:\u003c/strong\u003e The findings suggest that CCD and SIMO provide comparable occlusal performance over six months when properly adjusted. Clinicians may consider patient-specific factors such as cost, comfort, and anatomical conditions rather than occlusal outcomes alone when selecting between these treatment options.\u003c/p\u003e","manuscriptTitle":"A Comparative Computerized Occlusal Analysis of Conventional Complete Denture and Single Implant Retained Mandibular Overdenture","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-04-23 06:21:59","doi":"10.21203/rs.3.rs-6415885/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"101e9f64-c3de-4529-a856-1cd6893113a0","owner":[],"postedDate":"April 23rd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":46943217,"name":"Dentistry"}],"tags":[],"updatedAt":"2025-04-23T06:22:00+00:00","versionOfRecord":[],"versionCreatedAt":"2025-04-23 06:21:59","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6415885","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6415885","identity":"rs-6415885","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}