[A PhD completed. Maxillary overdentures: with a bar attachment system or locators?].

An overdenture on implants is the treatment of choice for patients with complaints about their conventional complete dentures. While a lot is known regarding the performance of implant-supported mandibular overdentures, much less is known regarding the performance of implant-retained maxillary overdentures. In this doctoral dissertation, various aspects of overdentures on 4 dental implants in the maxilla are discussed. From a systematic review of the literature, it appeared that an overdenture (maxillary or mandibular) on implants improved chewing efficiency, increased maximum bite force and increased patient satisfaction. Implants placed with a maximum dehiscence of two thirds of the buccal implant surface also appeared to function well after 5 years. An overdenture with a bar attachment system was associated with less marginal bone loss, a better subjective chewing efficiency and greater patient satisfaction than an overdenture retained by locators. The differences were, however, small and from a cost-effectiveness point of view, the use of overdentures retained by locators would not be a bad choice.