Little information exists to define the minimum number of implants required for sufficient anchorage of mandibular overdentures. To date, 2 implants placed in the interforaminal region have been considered the minimum. The aim of this study was to examine whether a single symphyseal implant would suffice for adequate anchorage of a mandibular complete denture in elderly patients (octogenarians), and whether this surgically, prosthetically, and financially simple concept would also satisfy patients needing replacement of the mandibular dentition. Nine patients with a mean age of 82.2 years underwent placement of a single symphyseal endosseous implant and anchorage of a complete denture using a ball attachment. Standardized recall examinations, including patient response and inspections of the peri-implant soft tissue and bone conditions, were carried out at 3- to 6-month intervals for a period of 11/2 years. It was found that anchorage with a single implant led to both a significant improvement in patients subjective satisfaction (P .01) and a significant reduction in reported symptoms (P .01). During the observation phase, pocket depth and bone resorption initially increased around implants but stabilized after the sixth month. Denture management (placement and removal) also improved during the recall period (P .01). The results of this study indicate that oral rehabilitation by mandibular complete dentures anchored on a single implant can be considered an economical therapeutic alternative to a conventional mandibular complete denture for very old (octogenarian) patients. Keywords: geriatric dentistry, implant-supported dental prosthesis, mandibular complete denture, mandibular symphysis, single-tooth dental implant