PeriImplant Soft Tissue and Marginal Bone Loss of Single Implant Mandibular Overdenture

Inclusion Criteria: * Completely edentulous male or female patients between the ages of 50 to 69. * No contraindications for implantation. * Each patient has to perform both a random blood sugar and Glycosylated Hemoglobin analysis. Patients with a Glycosylated hemoglobin test HbA1c up to 8% and a normal blood sugar level (79 to 110) or controlled diabetic patients (90-130 fasting according to American Association of Diabetes) will be included. * Sufficient bone width (≥ 6 mm) in the anterior region to place an implant. It could be either normally present or achieved by bone plateauing. This will be confirmed by cone beam computed tomographic (CBCT) scans. * Residual bone height ranging from 11-20 mm with the lowest vertical height in the midline of the mandible not less than 13 mm (Class II or III according to McGarry et al\[16\] 1999). This will be confirmed by the CBCT. * Patients seeking to install a single symphyseal implant and for whom new dentures will be constructed. * Patients, who are dissatisfied with the retention and stability of their technically satisfactory dentures. * Patients, who already have existing maxillary and mandibular complete dentures, and after examination of the mandibular dentures, it is found that there are technical problems with regard to denture design and/or occlusion; then new maxillary and mandibular dentures will be fabricated * All patients should have adapted to their dentures for at least six weeks before being included in the trial. * Patients providing written informed consents to participate in the trial and this will be done before the scheduled date for implant installation. Exclusion Criteria: * Patients with a systemic or local contra-indication for implant placement. * Satisfied patients with the retention of their mandibular denture as well as unsatisfied patients with their maxillary denture. * Patient with a mandibular denture height less than 6 mm between the base of the denture and the incisal edge of the central incisors (as measured by a caliper) or with 12 mm crown height space as measured by a ruler from the incisal edge till the crest of the ridge. This will be done from a putty index of the diagnostic set up. * Incompliant and not cooperative patients. * Patients smoking more than 10 cigarettes per day.