Conventional complete dentures work, but they work poorly for many patients. Implant retention solves the problems of instability, poor retention, reduced chewing efficiency, and progressive bone resorption under the denture base.
Clinical Decision Factors
- Mandibular denture: Two implants with Locator attachments is the minimum standard of care. Even two implants dramatically improve retention and quality of life.
- Maxillary denture: Requires four implants minimum due to softer bone quality and palatal coverage needs.
- Ridge morphology: Severely resorbed ridges benefit most from implant retention.
- Patient factors: Gag reflex, psychological intolerance of loose dentures, occupational demands.
Cost-Benefit Analysis
The cost of two mandibular implants with Locator overdenture is approximately 3-4x a conventional denture, but patient satisfaction scores improve from 3/10 to 9/10. For most patients, the improvement in quality of life justifies the investment.