Hybrid Prosthetic Treatment of the Edentulous Mandible with Two or Four Implants - A Literature Review

Treatment of an edentulous mandible is an important standard area of indication for implants. The aim of the present study was to discuss various aspects of this very important topic using a literature research and possibly derive a recommendation for hybrid prosthetic treatment of the edentulous mandible. Though evaluation of the literature produced a large number of publications with case histories and survival rates, there were only a few prospective randomised clinical studies that compared different treatment concepts in the edentulous mandible to allow an evidence-based statement. Despite all the limitations imposed on the interpretation of the study, the following statements could be made with regard to implant-supported dentures in the edentulous mandible: Two implants represent the easiest, most inexpensive treatment and are adequate for stabilizing a denture in an edentulous mandible. This type of restoration is easy to maintain for the patient with regard to oral hygiene and surgery stress is reduced to a minimum. The disadvantages of this treatment are increased mobility and instability of the denture in the dorsal region. Apart from increased intraoral comfort, the advantages of treatment using four implants include the stable fit of the denture and the option of immediate restoration.