Choosing Between Fixed and Removable Prosthetic Modalities for Completely Edentulous Patients
(Ali Hassan et al., 2026)
Why is this article important?
Complete edentulism remains a significant challenge for dental professionals, affecting mastication, speech, facial aesthetics, nutrition, and overall quality of life.
As patient expectations continue to rise and implant therapy becomes increasingly accessible, clinicians are frequently faced with an important treatment planning question:
Should we recommend a fixed implant-supported prosthesis or a removable overdenture?
This review provides valuable insight into this clinical dilemma by comparing the outcomes of fixed and removable prosthetic modalities in completely edentulous patients.
The Aim
This systematic review, published in 2026, analyzed 10 studies from multiple countries and compared clinical outcomes and patient-reported experiences associated with fixed implant-supported prostheses, implant-retained overdentures, and conventional complete dentures.
Key Findings
Implant-Supported Treatment Outperforms Conventional Dentures
Across the reviewed studies, both fixed and removable implant-supported prostheses demonstrated superior outcomes compared with conventional complete dentures, particularly in oral health-related quality of life and patient satisfaction.
Fixed Prostheses Deliver Superior Function
Patients restored with fixed implant prostheses experienced:
- Greater masticatory efficiency
- Improved occlusal stability
- Better muscle activity during function
- Enhanced chewing performance
- Greater patient-perceived quality of life
These findings suggest fixed restorations more closely replicate natural dentition and provide the highest level of functional rehabilitation. Survival rates range from 96.2% to 100%, reinforcing the predictability of fixed full-arch implant prostheses. Although there are many advantages, there are still considerations with screw loosening, prosthetic chipping or fracture, occlusal issues, peri-implant complications, and more demanding hygiene procedures.
Implant Overdentures Offer Important Advantages
While fixed prostheses showed superior functional outcomes, removable overdentures provided meaningful benefits, including:
- Easier hygiene access
- Lower prosthetic complexity
- Strong improvements in quality of life
- Favorable balance of function and maintenance
For many patients, implant overdentures may represent an excellent compromise between performance, cost, and long-term maintenance requirements. Again, there are still potential complications that include attachment wear, occlusal wear, relining needs, and prosthetic maintenance requirements.
Conventional Dentures Remain Dependent on Retention and Comfort
Among patients wearing conventional complete dentures, satisfaction was strongly linked to:
- Retention
- Stability
- Aesthetics
- Comfort
- Denture quality
The evidence suggests that while patients can adapt to conventional dentures over time, implant-supported options consistently provide superior patient-reported outcomes.
Key Clinical Takeaways
- ✅ Implant-supported prostheses consistently improve quality of life compared with conventional dentures.
- ✅ Fixed restorations provide the greatest improvement in chewing function and stability.
- ✅ Overdentures offer excellent outcomes while simplifying hygiene and maintenance.
- ✅ Technical complications differ between prosthetic modalities and should be discussed during treatment planning.
- ✅ Shared decision-making remains essential to long-term treatment success.
Conclusion
As populations age and demand for implant-supported solutions grows, clinicians are increasingly expected to provide personalized treatment recommendations that consider both objective clinical outcomes and patient preferences.
Treatment selection should not be framed as fixed versus removable, but rather as which solution best aligns with an individual patient's anatomy, functional demands, hygiene capabilities, expectations, and financial considerations.
The evidence supports implant-supported therapy as the preferred rehabilitation strategy for edentulous patients, but the optimal prosthetic choice remains highly individualized. Successful outcomes depend on matching the treatment approach to the patient's specific clinical needs and personal priorities.
This summary of a scientific article by Ali Hassan et al. (2026) is presented by Heather Wong, MSDH, RDH, TePe USA Professional Relations Manager.
Reference:
Ali Hassan MA, Elhadi RM, Osman M, Mohammed Abdalrahman SA, Elzibair Eltahir MA, Nureldinn S. Choosing Between Fixed and Removable Prosthetic Modalities for Completely Edentulous Patients: A Systematic Review of Evidence-Based Outcomes. Cureus. 2026 Jan 10;18(1):e101213. doi: 10.7759/cureus.101213. PMID: 41669595; PMCID: PMC12884350.
Article can be read using the link below.
