Investigation of the psychological impact of implant-retained overdentures has demonstrated some positive benefits over traditional prosthetic treatment (ie, conventional complete dentures). The aim of the present study was to determine whether treatment response could be understood by controlling the degree of alveolar ridge resorption present. In a cross-sectional single-wave study by means of a questionnaire, patients who had received implant-retained mandibular dentures were compared with patients who had conventional mandibular dentures. For purposes of comparison, all patients in both groups wore conventional maxillary dentures. From the 87 patients who were invited to complete a postal questionnaire, 76 replies were received (85% response rate). The implant (n = 41) and denture (n = 35) patients were assessed on self-rated symptoms, denture satisfaction, psychological distress, body satisfaction, and self-esteem using standardized scales. All patients had the extent of alveolar bone loss classified according to Cawood and Howell's (1991) system during a clinical examination. The results indicated that the response of patients to implants or dentures was influenced by the degree of bone loss. Patients with extensive resorption who received implants appeared, from a psychological perspective, to receive more benefit than their nonimplant counterparts. Hence, there is some evidence to support the inclusion of clinical measures of alveolar bone loss when considering the psychological impact accruing from implant-based treatments. Keywords: anatomy, classification, implants, psychological distress, satisfaction, self-esteem