Introduction

The goal of modern dentistry is to restore normal contour, function, comfort, esthetics, speech
and health, regardless of the atrophy, disease or injury of the stomatognathic system.
Throughout history, humans have attempted to replace missing or diseased tissue with natural or
synthetic substances. There are two elements in tooth replacement materials for the
replacement of tooth and some form of attachment mechanism. Various materials have been used
for replacement of missing teeth, including carved ivory, bone and also natural extracted teeth.
An alternative attachment mechanism was discovered by means of an accidental finding by
Prof.Per Ingvar Branemark and his colleagues during 1950s 1960s. The metallic structure
becomes incorporated in living bone, Branemark called it Osseointegration.
Osseointegration is a direct bone anchorage to an implant body which can provide a foundation
to support the prosthesis and it has the ability to transmit occlusal forces directly to the bone.
Since then, there is vast research and innovation in the implant systems1.
Overdentures supported by implants are a comparatively new arrival in the prosthodontic scene.
It is found to have increasing application in prosthodontics, which may be a reflection on
population trends and the demand for better treatment.
Overdenture treatment is a notion which precludes the inevitability of floating plastic in
edentulous mouths. It has always offered a sensible and prudent appeal for dental practitioners.
Several prosthodontists around the world chose to develop the notion of implant supported
overdentures. As a result a new standard of prosthodontic services for the edentulous patients has
emerged2.

According to 10-year survival surveys, decay of abutment teeth indicated as the most frequent
reason for replacement. Implant supported prosthesis preserves adjacent natural teeth, further
limiting the complications such as decay or porcelain fracture and poorer esthetics, which are the
most common causes of fixed prosthesis failure. A major advantage of the implant supported
prosthesis is that the abutments cannot decay.3
Chewing efficiency with implant prosthesis is greatly improved compared with that of a soft
tissue-borne restoration. The masticatory performance of dentures, overdentures, and natural
dentition was evaluated by Rissin et al.4Overdenture loses only 10% of chewing efficiency
compared with natural teeth. These finding are similar with implant-supported overdentures. In
addition, rigid, implant-supported fixed bridges may function the same as natural teeth. 5
Beneficial effects such as a decrease in fat, cholesterol and the carbohydrate food groups have
been reported as well as marked improvement in eating, enjoyment and social life.6
Manal A Awad, et al. compared the efficacy of mandibular implant-retained overdentures and
conventional dentures among middle-aged edentulous patients
They found mandibular two-implant overdenture opposed by a maxillary conventional denture is
a more satisfactory treatment than conventional dentures for edentulous middle-aged adults.7
Overdentures have been shown to improve the quality of life for edentulous patients and
contribute significantly to the patients psychological well-being. Patients reported increased
satisfaction with the implant-retained overdenture rather than conventional complete denture. 8 In
a randomized clinical trial comparing the efficacy of these overdentures and conventional
dentures in diabetic patients, patients reported that the overdentures provided better masticatory
function than conventional complete dentures and there was improved general satisfaction. 9
Moreover, Takanashi et al.10 estimated that the time required to fabricate a mandibular

overdenture retained by implants with ball attachments was not significantly different than the
time needed for conventional denture treatment.
The implant-retained overdenture is a treatment option for edentulous patients in the following
situations: poorly retained and unstable mandibular dentures, poor bone quality or insufficient
available bone to accommodate 4 or more implants, as the original Branemark protocol
suggests.11
The success rate of implant prostheses varies, depending on a host of factors that change for each
patient. However, compared with traditional methods of tooth replacement, the implant
prosthesis offers increased longevity, improved function, bone preservation, and better
psychologic results.