Implant-supported mandibular denture: planning to delivery – a case report

Rehabilitation of the edentulous mandible with a conventional mucosa-supported complete denture may not always be successful. The main problems with this treatment regime are inadequate denture support and retention, which results in patients experiencing pain during function or social embarrassment. Research has shown a higher success rate and greater patient satisfaction when mandibular dentures are retained or supported by implants.1^,2^,3^,4^,5 A recent review of the literature has found that mandibular ridge-form can be an indicator for treatment success when providing a complete denture,6 although it is accepted that edentulous patients will benefit more from an implant overdenture in the mandible, regardless of the amount of mandibular bone present.7 The McGill Consensus Statement states that the minimum standard of care for the edentulous mandible should be the provision of a two-implant overdenture.8 This has become the accepted norm and studies comparing two-and four-implant mandibular overdentures have come to the conclusion that there is little or no additional benefit in placing four-implants in the edentulous mandible when restored by a removable overdenture.9^,10^,11^,12 A further literature search has uncovered evidence from review articles suggesting that four-implant mandibular overdentures are indicated in patients with certain anatomic and complicating factors (Table 1).13^,14^,15 This is supported by a case highlighting the use of a four-implant overdenture in the atrophic mandible.16