Prosthodontic Complications with Implant Overdentures: A Systematic Literature Review

Purpose: Problems associated with a complete denture, such as lack of stability and retention, can be solved with the use of implant-retained or implant-supported overdentures. However, controversy exists as to the anchorage system used and indications for both the maxilla and mandible. The purpose of this review was to identify the prosthetic complications associated with the different attachment mechanisms used for implant-supported or implant-retained overdentures. Materials and Methods: A search of the MEDLINE and PubMed databases was conducted to find articles in English and German peer-reviewed journals published between 1980 and 2008. The search focused on randomized controlled clinical trials and prospective studies with follow-up periods of at least 5 years that contained clinical data regarding success, failure, and prosthetic complications. Results: The search yielded a limited number of randomized controlled clinical trials referring to implant-supported or implant-retained overdentures. Very few studies have prospectively compared prosthetic complications for a period longer than 5 years after delivery of the prosthesis. Conclusions: Implant-supported or implant-retained overdentures in the mandible provide predictable results with improved stability, retention, and patient satisfaction. Scientific evidence shows a lower rate of implant survival and a higher frequency of prosthetic complications for maxillary implant-retained or implant-supported overdentures. Although the literature presents considerable information on complications of implant prostheses, variations in study design preclude proper analysis of certain complications. Well-designed longitudinal studies are required to establish evidence-based treatment planning principles.