Treatment planning of the edentulous mandible

Edentulism can be a debilitating handicap. Zarb described endentulous individuals who could not function as 'denture cripples'.(1) Most difficulty with complete denture prostheses arises from the inability to function with the mandibular prostheses. Factors that adversely affect successful use of a complete denture on the mandible include: 1) the mobility of the floor of the mouth, 2) thin mucosa lining the alveolar ridge, 3) reduced support area and 4) the motion of the mandible (Figs 1,2). These factors alone can explain the difficulty of wearing a denture on the mandibular arch compared to the maxillary arch. The maxilla exhibits much less mobility on the borders of the denture than the mandible, moreover having a stable palate with thick fibrous tissues available to support the prostheses and resist occlusal forces. These differences explain most of the reasons why patients experience difficulty with using a complete denture on the mandibular arch compared to the maxillary arch.