Strategic Implants under Existing Partial Removable Dentures, Why, How Many, and Which Type?

Abstract

Inserting strategic implants under existing removable partial dentures requires a comprehensive understanding of removable prosthodontic basics and possible designs, as well as a thorough understanding of implant therapy. Prior to the widespread adoption of implants as standard prosthetic therapy, remaining roots were preserved and used to minimize bone resorption under the removable denture. Root-supported overdentures become less common after the overwhelming clinical studies that emphasize dental implants’ reliability and high success and survival rate. Fixed prostheses cannot be used to treat a severely decreased dentition unless a significant number of implants can be inserted, sufficient bone quantity and quality are available, and the patients can afford the treatment. On the other hand, using strategic implants under existing RPD upgrades the design to a more favorable support type. It improves patient satisfaction with the RPD in speaking, chewing, retention, stability, and RPD support. This improvement could be reached earlier if the patient received immediate loading. Strategic implants can also improve chewing ability, stabilize the occlusion, increase bite force and improve patient oral health-related quality of life. Moreover, better distribution of occlusal forces that may reduce bone resorption may be gained. Furthermore, strategic implants can improve comfort, confidence, and esthetics by reducing the RPD size and removing the retainers from the esthetic zone.