DENTAL EDUCATION: Successful 4-Year Implant-Retained Overdenture Case in an Edentulous Patient with Reduced Manual Dexterity
Implant-supported fixed bridges are gaining popularity for edentulous patients. However, in elderly individuals—especially those with reduced manual dexterity—a fixed solution may not always be practical. This case highlights a restorative-driven, collaborative approach to implant-retained overdentures in an 81-year-old male patient, followed over four years, with a focus on long-term success, optimal oral hygiene, and patient satisfaction.
Case Overview
Clinician: Dr Manuel Man
Duration: 2020–2025
Patient Profile: 81-year-old edentulous male with reduced manual dexterity
The patient presented in 2020, reporting an inability to tolerate his conventional complete dentures, despite being satisfied with their appearance and tooth positioning. The implant treatment aimed to enhance retention and support without compromising familiar esthetics and comfort.
Treatment Strategy
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Copy Denture Technique
Rationale: The patient valued the existing dentures’ appearance and tooth setup. The copy denture technique was chosen to replicate these features while improving retention.
Implementation: Features from the old dentures were transferred to the new prosthesis, minimising changes and ensuring a smooth patient adaptation.
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Space Analysis and Upper Implant Splinting
Maxillary Implant Planning: Given the lower bone density in the upper jaw, implants were planned to be splinted using a bar to distribute functional loads and minimise bone loss.
Procedures: Four implants were placed in the maxilla and two in the mandible after thorough space analysis to ensure adequate room for a connecting bar.
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Long-Term Maintenance Planning
Upper Bar Design: The maxillary milled bar was designed to allow for future incorporation of additional attachment systems, should retention decrease over time.
Use of Locator System in the lower implants: A universal system known for adequate retention and easy maintenance.
Forward Thinking: This proactive approach means retention and functionality can be enhanced in the future as needed without major prosthesis overhaul.
Key Factors for Clinical Success
- Simplified Oral Hygiene
The removable overdenture design allowed the patient—despite limited dexterity—to maintain excellent hygiene around both the implants and prosthesis, supporting long-term peri-implant health.
- Patient-Centric Denture Design
By replicating the patient’s existing denture features, adaptation was smooth, and functional satisfaction remained high. Implant-retained overdenture allows horseshoe design of overdenture instead of full palatal coverage which enhances patient’s comfort.
- Occlusal Control
Bilateral balanced occlusion was established to enhance denture stability, distributing forces evenly and reducing the rate of prosthetic wear.
- Precision Digital Workflow
Digital planning enabled a precise fit of the prosthesis. Retention was achieved by friction between the digitally milled Atlantis bar and the denture sleeve, omitting the need for additional attachments at the outset, but leaving the option open for the future.
Clinical Outcome at 4 Years
At the 4-year review in 2025, the clinical assessment demonstrated:
Excellent oral hygiene maintained by the patient.
Minimal wear and tear of the prosthetic components.
No evidence of peri-implantitis or other complications.
Overdentures remained functional and highly retentive with minimal loss of retention.
Takeaways
For dental professionals treating edentulous elderly patients—particularly those with diminished dexterity—implant-retained overdentures provide a highly effective, maintainable alternative to fixed solutions. This case underscores the importance of:
- Restorative-driven planning using copy denture techniques to respect patient preferences.
- Careful space and prosthetic planning for splinted attachment systems in the upper arch.
- Designing for long-term adaptability and ease of hygiene.
- Integration of digital workflows for precision and predictability.
By prioritising patient comfort, prosthesis adaptability, and long-term oral health, a high-quality functional and aesthetic outcome can be achieved—even in challenging cases.
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