Changes in the edentulous maxilla in persons wearing implant-retained mandibular overdentures

It has been suggested that risk for severe resorption in the anterior maxilla is increased in persons wearing mandibular implant-retained overdentures. However, little information is available about the changes in the edentulous maxilla after mandibular implant treatment.

This study determined the possible changes in the width of the maxillary residual ridge 6 years after receiving mandibular implant-supported or implant-mucosa-supported overdentures and evaluated the association between the anatomic changes and subjective complaints with maxillary complete dentures.

The subjects for this study (n = 55), enrolled among the participants of a prospective clinical trial, were randomly assigned into 3 groups treated with: (a) implant-supported overdentures on a transmandibular implant system (n = 21); (b) implant-mucosa-supported overdentures on 2 IMZ implants (n = 20); or (c) conventional complete dentures (n = 14). A lingual contact occlusion concept with anterior open bite was used for tooth arrangement in all subjects. Diagnostic casts were made at baseline, and again at the 6-year follow-up. Most prominent points perpendicular to the crest of residual ridge were located in the incisor, canine, and premolar regions, after which the width of the ridge was recorded at these points with a Boley gage. Subjects' opinions on their dentures were evaluated with a questionnaire.

Significant reduction in the width of the ridge was found in all measurement areas (mean difference = 0.4 to 0.6 mm; P <.0001). However, changes were small and not associated with the type of prosthetic restoration in the mandible. In subjects with implant-mucosa-supported overdentures, complaint of loose maxillary denture correlated with the decrement of residual ridge width.

The width of residual ridge decreases with time, despite the type of mandibular prosthetic restoration.