Implantology and the Severely Resorbed Edentulous Mandible
Open Access
- 1 July 2004
- journal article
- review article
- Published by SAGE Publications in Critical Reviews in Oral Biology & Medicine
- Vol. 15 (4), 240-248
- https://doi.org/10.1177/154411130401500406
Abstract
Patients with a severely resorbed edentulous mandible often suffer from problems with the lower denture. These problems include: insufficient retention of the lower denture, intolerance to loading by the mucosa, pain, difficulties with eating and speech, loss of soft-tissue support, and altered facial appearance. These problems are a challenge for the prosthodontist and surgeon. Dental implants have been shown to provide a reliable basis for fixed and removable prostheses. This has resulted in a drastic change in the treatment concepts for management of the severely resorbed edentulous mandible. Reconstructive, pre-prosthetic 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 implants to be placed at the most optimal positions from a prosthetic point of view. The aim of this paper is to review critically the literature on procedures related to the severely resorbed edentulous mandible and dental implant treatment. The study includes the transmandibular implant, (short) endosseous implants, and reconstructive procedures such as distraction osteogenesis, augmentation of the mandibular ridge with autogenous bone, and bone substitutes followed by the placement of implants. The number of patients participating in a study, the follow-up period, the design of the study, the degree of mandibular resorption, and the survival rate of the dental implants all are considered evaluation parameters. Although numerous studies have described the outcome results of dental implants in the edentulous mandible, there have been few prospective studies designed as randomized clinical trials that compare different treatment modalities to restore the severely resorbed mandible. Therefore, it is not yet possible to select an evidence-based treatment modality. Future research has to be focused on long-term, detailed follow-up clinical trials before scientificaly based decisions in treating these patients can be made. This will contribute to a higher level of care in this field.Keywords
This publication has 79 references indexed in Scilit:
- Histologic and Radiographic Evidence of Vertical Ridge Augmentation Utilizing Distraction Osteogenesis: 10 Consecutively Placed DistractorsThe Journal of Periodontology, 2001
- Muscular reconstruction to improve the deterioration of facial appearance and speech caused by mandibular atrophy: technique and case reportsBritish Journal of Oral and Maxillofacial Surgery, 1999
- Outcomes and Their Measurement in Clinical Trials of Endosseous Oral ImplantsAnnals of Periodontology, 1997
- A controlled clinical trial of implant‐retained mandibular overdentures: clinical aspectsJournal of Oral Rehabilitation, 1997
- Simultaneous placement of endosteal implants and mandibular onlay grafting for treatment of the atrophic mandible: A preliminary reportInternational Journal of Oral & Maxillofacial Surgery, 1996
- One-step reconstruction of the severely resorbed mandible with onlay bone grafts and endosteal implants: A 5-year follow-upInternational Journal of Oral & Maxillofacial Surgery, 1996
- Patient satisfaction with implant-retained mandibular overdentures. A comparison with new complete dentures not retained by implants— a multicentre randomized clinical trialBritish Journal of Oral and Maxillofacial Surgery, 1995
- Reconstruction of the severely resorbed mandible prior to vestibuloplasty or placement of endosseous implants: A 2 to 5 year follow-upInternational Journal of Oral & Maxillofacial Surgery, 1991
- Shelf‐life of tooth‐coloured restorative materials in Papua New GuineaAustralian Dental Journal, 1989
- Reconstruction of the severely resorbed mandible with interposed bone grafts and hydroxylapatiteInternational Journal of Oral & Maxillofacial Surgery, 1988