Basic Principles for Implant Supported Overdentures

Aims: Implant supported overdentures combine the retention and support provided by implants with the advantages of removable prostheses and demand careful preoperative planning. The aim of the present article is to provide a clinically based rationale while designing or fabricating such a rehabilitation.

Methodology: In order to conduct this narrative review, evidence based research articles regarding implant supported overdentures published from January 1990 until December 2020 were searched via the MEDLINE (Pubmed) database. The keywords used were “overdentures”, “implant overdentures”, “implant supported overdentures”, implant retained overdentures”, “implant assisted overdentures”.

Results: Implant supported overdentures have high success rates and compared to conventional ones they provide superior quality of life, well-being, satisfaction and adequate masticatory efficiency. Α crucial factor that should be determined preoperatively is the number and position of implants that need to be placed. Preoperative three-dimensional assessment is of utmost importance to avoid mistakes like the construction of bulky restorations or the absence of adequate material in crucial areas of the restoration with the subsequent acrylic tooth/connector detachment and aesthetic compromise. Selection of the appropriate retentive system depends on the number and the distribution of implants, the desired retention, the morphology of the ridge, the intermaxillary relation, the available prosthetic space, the vertical and horizontal dimensions, the patient’s needs and desires, the oral hygiene and the cost. Special care should be given to impression making procedures as well as framework design and fabrication. If the abovementioned are taken into account, subsequent complicatons are reduced. However, frequent maintenance appointments should be scheduled.

Conclusion: Several concerns arise when choosing an implant supported overdenture that mainly refer to the special characteristics defining its function. The key element is the careful preoperative planning of the restoration since it affects the long-term behavior of the prosthesis in terms of technical and biological complications and the frequency of the clinicians reinterventions.