title: Addressing the atrophied mandible: a proposal for a treatment approach involving endosseous implants.
abstract: OBJECTIVE
  Since the introduction of endosseous dental implants, the treatment concepts for management of the edentulous mandible have changed drastically. Reconstructive, preprosthetic surgery has changed from surgery aimed to provide a sufficient osseous and mucosal support for a conventional denture into surgery aimed to provide a sufficient bone volume enabling placement of dental implants at the, from a prosthetic point of view, optimal position. Moreover, the currently applied implant based prosthodontic concepts for the edentulous mandible are based on prospective randomized clinical trials comparing the treatment outcome of a variety of treatment modalities. This study reviews the various treatment concepts that are currently in use to rehabilitate the extremely atrophied mandible.
  
  
  METHODS
  A comprehensive review of human studies published in the international peer-reviewed literature up to March 2010 regarding procedures related to implant treatment in the extremely atrophied edentulous mandible was made. A MEDLINE search was completed, along with a manual search, to locate relevant literature.
  
  
  RESULTS
  There are advantages and disadvantages that are specific to removable implant-supported overdentures and fixed implant-supported full prostheses. The choice of an overdenture or a fixed full-arch prosthesis should be made on an individual basis. Once this choice has been made, the surgical procedure and the number of implants to be placed have to be determined.
  
  
  CONCLUSIONS
  On the basis of the best evidence currently available, a treatment concept is proposed on how to deal with the edentulous mandible in order to provide patients with a mandibular overdenture supported by endosseous implants.
authors.affiliation: Department of Oral and Maxillofacial Surgery and Maxillofacial Prosthetics, University Medical Center Groningen, The Netherlands. g.m.raghoebar@kchir.umcg.nl
authors.forename: Gerry M
authors.initials: GM
authors.lastname: Raghoebar
authors.forename: Henny J A
authors.initials: HJ
authors.lastname: Meijer
authors.forename: Kess
authors.initials: K
authors.lastname: Stellingsma
authors.forename: Arjan
authors.initials: A
authors.lastname: Vissink
mesh_terms: D016301:Alveolar Bone Loss / Q000473:pathology / Q000628:therapy*; D000540:Alveolar Ridge Augmentation / Q000379:methods; D003758:Dental Implantation, Endosseous / Q000379:methods*; D015921:Dental Implants; D003779:Denture Design; D006801:Humans; D007575:Jaw, Edentulous / Q000534:rehabilitation* / Q000601:surgery; D008334:Mandible / Q000473:pathology / Q000601:surgery*; D013516:Oral Surgical Procedures, Preprosthetic / Q000379:methods*; D010043:Outcome and Process Assessment, Health Care
chemical_list: D015921:Dental Implants