FIXED AND REMOVABLE PROSTHESES IN THE EDENTULOUS MANDIBLE : CHOICES BASED ON EVIDENCE

This paper highlights some key studies comparing different forms of implant rehabilitation, as well as comparisons between implant based therapy and conventional complete dentures. Patients have reported that fixed prostheses are significantly better than removable long bar overdentures for chewing harder foods, but reported no difference in their general satisfaction with the two types of prostheses. Patient general satisfaction with long-bar overdentures was significantly higher than for short bar overdentures. However, the ratings for the short-bar were high and within 10mm of those for the long-bar overdenture. These highly favorable responses for the overdentures on 2 implants were confirmed in a series of studies in which they were compared to conventional complete dentures. Both middle aged and older groups of edentulous patients were significantly more satisfied with mandibular prostheses supported by 2 implants than with conventional dentures. These results strongly support the concept that this form of treatment is more effective for edentulous patients than conventional dentures. Currently available evidence suggests that the restoration of the edentulous mandible with a conventional denture is no longer the most appropriate first choice prosthodontic treatment. There is now overwhelming evidence that a 2-implant overdenture should become the first choice of treatment for the edentulous mandible.