Complete denture is a real challenge for any practitioner. The aim of implantology is to optimize prosthetic balance and ensure that prostheses are perfectly integrated from a bio-functional viewpoint, despite an unfavorable anatomophysiological context. Here, we present a case managed in our department concerning a mandibular complete removable denture retained by a medial symphyseal implant. A 61-year-old fully edentulous mandibular patient with a Kennedy Applegate class I edentulous maxilla in good general health consulted for the renewal of his mandibular complete denture, which was deemed unstable and non-retentive. The exo-oral examination was normal. The mandibular crest was heavily resorbed, especially posteriorly, and covered with slightly inflammatory fibromucosa. The patient refused bone augmentation surgery. We performed a piezographic mandibular prosthesis retained by a single standard implant at the level of the mandibular symphysis. The prosthesis was stable and retentive. Masticatory comfort and efficiency were satisfactory and the psychological integration of the prosthesis was improved. Several studies have shown that a single symphyseal implant is a therapeutic alternative that completes the therapeutic range in specific cases. It should be limited to the mandibular arch in elderly patients with reduced bone volume. Given the lack of randomized controlled trials, routine use of this new approach is not recommended, and further studies are required.
Keywords: complete denture; mandibular complete denture; mandibular overdenture; single implant; symphyseal single implant.
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