Fixed vs removable complete arch implant prostheses: A literature review of prosthodontic outcomes

Aim: To compare implant fixed complete dentures with implant overdentures relative to prosthodontic outcomes. Material and methods: An electronic Medline (PubMed) with MeSH terms, and Cochrane library search was performed, focusing on studies that included implant fixed complete dentures and implant overdentures in the same study, with the results based on studies that included both types of prostheses. Results: The following six categories of comparative studies were identified in the literature: 1) Implant and prosthesis survival; 2) Prosthesis maintenance/complications; 3) Bone changes; 4) Patient satisfaction and quality of life; 5) Cost-effectiveness; and 6) Masticatory performance. It was determined that both the fixed and removable treatments were associated with high implant survival rates. However, both types of prostheses were impacted by the need for post-placement mechanical maintenance or prosthetic complications. More maintenance/complications occurred with implant overdentures than with fixed complete dentures. Residual ridge resorption was greater with implant overdentures. Patient satisfaction was high with each prosthesis, with three studies revealing higher satisfaction with fixed complete dentures and five studies finding no difference. All but one study on cost-effectiveness indicated implant overdentures were more cost-effective. Based on two studies, it appears the masticatory performance of implant fixed complete dentures and implant overdentures is comparable. Conclusions: Multiple factors must be considered when determining whether an implant-fixed complete denture or implant overdentures are best suited for patients with completely edentulous jaws. Keywords: bone changes, cost-effectiveness, masticatory performance, patient satisfaction, prosthesis complications, prosthesis survival, quality of life Conflict-of-interest statement: The authors declare they have no conflicts of interest.