Implant Supported Mandibular Overdentures

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Implant supported/retained mandibular overdentures have three crucial components: the implant fixtures (02 or more), the choice of attachment ( bars, studs or magnets) and the prosthesis. The Mc Gill consensus reported a minimal treatment objective, the mandibular two-implant overdenture (as opposed to a conventional denture) should be considered as a first-choice standard of care for the edentulous patient5. Mericske-Sterne also concluded that retention, stability and occlusal equilibration of the implant supported mandibular overdentures improved only slightly by increasing the number of implants.7 Implant survival rates did not vary with number of implants and ranged between 93% to 100%.8-19 These findings suggest that the number of implants is more important for supporting a prosthetic superstructure which may be in the form of bar, stud or magnets for optimal load distribution. The results in this study showed that interocclusal space and interforaminal distance dictated the number of implants and the superstructure selection for mandibular implant supported/retained overdentures. Prosthetic complications in mandibular overdentures has remained a topic of interest in literature. Berglundh in 2002 in their systematic review concluded that prosthetic complications reported in mandibular implant overdentures were 4 to 10 times greater as compared to implant supported fixed prosthesis20. Looking at the above literature it becomes increasingly important to give added consideration in the treatment planning phase of implant supported/ retained mandibular prosthesis. The individual anatomic variations in the patients should be respected and the treatment plan regarding number of implants and choice of superstructure should be base... ... middle of paper ... ...mm. For Class IIIa, an option of four implants could be used with Ball or locators attachments when designing the prosthesis Class IIIb wherein IFD ≤ 30 mm and IOS is between 6-8 mm. For Class IIIb, an option of two could be used with locator type of attachments when designing the prosthesis. The deciding factor for rehabilitating the edentulous patients with implant supported mandibular overdenture is interforaminal space, however the final selection is modified by IOS . Conclusion The classification system described here is intended to assist the clinicians to evaluate and communicate their patient’s dimensional relationship effectively. This classification system would also facilitate decisions regarding pre-surgical tissue manipulation, the design of final prostheses, choice of number of implants and attachment systems early in the treatment planning stage.

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