Ramona Elena Constantin, Agop-Forna Doriana, Rotaru Costin Alice
ABSTRACT
Aim of the study: Total overdentures supported by natural teeth or dental implants represent an established and evidence-based prosthodontic rehabilitation modality for edentulous and severely compromised dentitions. This narrative review aimed to synthesize current evidence on the biological principles, clinical indications, attachment systems, prosthetic outcomes, and complications of tooth-retained and implant-retained overdentures, with emphasis on patient-centered outcomes and oral rehabilitation. Material and methods: A comprehensive literature search was performed across PubMed/MEDLINE, Scopus, and Web of Science. A total of 50 peer-reviewed references published until 2025 were selected, covering systematic reviews, meta-analyses, randomized controlled trials, consensus statements, prospective clinical studies, and authoritative narrative reviews. Results: Tooth-retained overdentures preserve alveolar bone, maintain periodontal proprioception, and improve masticatory function; the most frequent complications are root caries and attachment matrix loosening. Two-implant mandibular overdentures represent the minimum international standard of care per the McGill (2002) and York (2009) Consensus Statements. Attachment system selection — locator, ball/stud, bar-clip, or telescopic — critically determines retention, complication profiles, and patient satisfaction. Single-implant overdentures offer a viable cost-effective alternative for geriatric patients. Digital CAD/CAM workflows are increasingly applied in overdenture fabrication with favorable outcomes. Conclusions: Both tooth-retained and implant-retained overdentures provide documented functional, biological, and psychosocial advantages over conventional complete dentures. Individualized treatment planning integrating clinical, systemic, and socioeconomic factors is essential to optimize rehabilitation outcomes.
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