Revisiting maxillary implant overdentures in 2022: A topic review

Objectives: The challenge for general dental practitioners to provide maxillary implant overdenture treatment for their patients is complicated by multiple, diverse parameters, compared to mandibular implant overdentures. This topic review on maxillary implant overdentures takes into consideration the specifications and challenges of different prosthodontic treatment options for clinicians in 2022. Data sources: A broad search of the published literature was performed using MEDLINE and PubMed to identify pertinent articles published in English from 1990 to 2021. From an original total of 1176 titles, 106 references were selected. They were reviewed and categorized with respect to seven factors related to the prosthodontic design. These were interarch restorative space, implant number, implant distribution and spread, overdenture base reinforcement, palatal coverage, selection of attachment system and splinted/unsplinted prosthodontic designs. They influence clinical and patient outcomes in terms of implant and prosthesis success, support, retention, prosthodontic maintenance and satisfaction. Conclusion: Maxillary implant overdentures are a reliable treatment option for general dental practitioners, once competent with mandibular overdentures. The decision for adequate treatment for each individual patient is influenced by a diversity of parameters with clinicians needing to have a thorough knowledge and understanding of the anatomic obstacles, facial aesthetics, phonetics, and complete denture principles for essential pre-surgical and prosthodontic treatment planning. Currently there is no optimal number of implants, nor preferred attachment system, regardless of palatal coverage design. There are emerging trends of more evidence for use of reduced number of unsplinted implants simplifying procedures for general dental practice.