Single-implant Overdentures Retained by the Novaloc Attachment System

Single-implant Overdentures Retained by the Novaloc Attachment System: Study Protocol for a Mixed Methods Randomized Cross-over Trial

The objective of this explanatory mixed methods study is to compare a novel attachment system (Novaloc) to a traditional alternative (Locator) for single implants in the mandible of edentate elders. The investigators will carry out a randomized cross-over clinical trial comparing Novaloc attachments to Locators for single-implant mandibular overdentures in edentate elders. Participants will be followed for three months with each attachment type; patient-based, clinical and economic outcomes will be gathered. A sample of 26 participants is estimated to be required to detect clinically relevant differences in terms of the primary outcome (patient ratings of general satisfaction). Participants will choose which attachment they wish to keep, then be interviewed about their experiences and preferences with a single implant prosthesis and with the 2 attachments. Data from the quantitative and qualitative assessments will be integrated through a mixed-methods explanatory strategy. A last quantitative assessment will take place after 12 months with preferred attachment; this latter assessment will enable the observation of attachments' long-term wear and maintenance events.

Inclusion Criteria:

• Not have had a tooth extraction within the past six months
• Request implant stabilization of a mandibular conventional complete denture
• Have clinically acceptable maxillary and mandibular complete dentures
• Have adequate bone in the anterior mandible for the placement of a single 3.3 mm wide implant in the midline
• Be able to maintain adequate oral hygiene and clean dentures;
• Present no systemic conditions for which minor oral surgery would be counter-indicated
• Have an adequate understanding of written and spoken English or French;
• Be capable of giving written informed consent

Exclusion Criteria:

• Severe/serious illness that requires frequent hospitalization
• Impaired cognitive function
• Unable to return for evaluations/study recalls
• Have a history of radiation therapy to the orofacial region
• Have specific conditions that may jeopardize the treatment, such as alcoholism or smoking (>10 cigarettes/day)
• Have acute or chronic symptoms of parafunctional or temporomandibular disorders
• Previous dental implant treatment

Following radiographic exam, investigators will exclude volunteers with bony pathologic lesions, less than 11 mm of minimum vertical mandibular bone height in the midline or width for planned implants, evident endosseous vascular structures or mandibular ridges with remaining alveolar sockets