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Mandibular overdentures when treating failing dentition with immediate prosthetic loading.

Patients may present with failing mandibular dentition either involving the entire arch, partial arch that currently has a partial denture to replace the prior missing teeth or wearing a full denture. Finances may limit restoration of the arch with an All-on-X concept and the patient's goals are a stable prosthesis that does not move whenconcept and the patient's goals are a stable prosthesis that does not move when eating or speaking is the patient's expressed goal. Overdentures can fulfil that goal and provide a stable restored arch at a lower treatment cost than treatment with a fixed hybrid prosthesis. Traditionally, when these type cases have been treated, the remaining dentition has been extracted, depending on availability of bone, implants are placed. Those typically were left to osseointegrate and loaded several months later with a delayed loading approach. This requires relining the denture and the patient having a loose, non-stable prosthesis during that healing phase. An alternative approach utilizes immediate activation of the implants with overdenture attachments thus, providing an immediate stable retentive full arch mandibular removable prosthesis (overdenture) by immediate activation of overdenture attachments (ie.Locators) aids the patient in their goals without delays in treatment. This article will present two case examples of mandibular arches with failing dentition related to caries and periodontal issues and their treatment with immediate implant placement and loading with Locator attachments. Long-term follow-up of 1-year 8-months in one case and 33-months in the other case demonstrate crestal bone stability with this immediate overdenture loading protocol.

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