A review of clinical and technical considerations for fixed and removable implant prostheses in the edentulous mandible.
OBJECTIVE
The aim of the present article is to review some of the technical treatment options for implant prostheses restoring the edentulous mandible, mainly based on the Brånemark system.


METHODS
Clinical and technical aspects are discussed for the three established concepts: (1) implant-supported fixed prosthesis, (2) removable implant-supported overdenture, and (3) combined implant-retained and soft tissue-supported overdenture prosthesis.


RESULTS
The framework of an implant-supported fixed screw-retained prosthesis can be processed in gold, Co-Cr alloy, or titanium with casting, laser-welding, or milling techniques. To improve the stability and retention of a conventional complete denture, one to four implants are indicated, and unsplinted (single attachments) or splinted designs (bar systems) can be applied. The design of the overdenture prosthesis must be carefully planned according to the requirements to ensure adequate stability and optimal form, contour, and esthetics, and the patient's best comfort.


CONCLUSIONS
A large variety of different treatment modalities exist for both the fixed and removable mandibular implant prosthesis. Clinical and technical aspects should be considered at the beginning of the treatment to: (1) select the optimal implant position, (2) establish an adequate number of functional units, (3) select the appropriate retainers, and (4) apply the best technique for framework processing and veneering.
Zitzmann
Nicola Ursula
NU
Clinic of Reconstructive Dentistry, Dental School, University of Basel, Hebelstrasse 3, CH-4056 Basel, Switzerland. N.Zitzmann@unibas.ch
Marinello
Carlo Paolo
CP
D003722:Dental Alloys; D016734:Dental Clasps; D017267:Dental Prosthesis Design; D017268:Dental Prosthesis Retention / Q000295:instrumentation*; D019094:Dental Prosthesis, Implant-Supported; D003826:Denture, Complete, Lower; D003828:Denture, Overlay; D006801:Humans; D007575:Jaw, Edentulous / Q000534:rehabilitation*; D008334:Mandible; D014025:Titanium
D003722:Dental Alloys; D014025:Titanium