A completely edentulous patient may have more than one implant-supported option. But once the decision has been made to move beyond a conventional complete denture, another question comes up: fixed or removable?
Fixed implant-supported prostheses offer stability and chewing efficiency. Implant overdentures are removable, easier to clean and generally less demanding from a hygiene standpoint. So, when the two are compared, does one clearly come out on top?
A recent systematic review suggests the answer is not quite that simple.
The review looked at clinical and patient-reported outcomes of fixed and removable prosthetic rehabilitation in completely edentulous patients. PubMed/MEDLINE, Scopus, Embase and Web of Science were searched for studies published up to December 2025. Ten studies met the inclusion criteria.
Because the studies differed considerably in prosthetic designs, follow-up periods, patient populations and outcome measures, the authors did not perform a meta-analysis. Instead, they carried out a narrative synthesis.
Fixed prostheses had the functional advantage
When it came to chewing function, the evidence favoured fixed prostheses.
One randomized clinical trial included in the review compared a fixed implant-retained mandibular prosthesis with a removable implant overdenture. Both improved occlusal equilibration and muscle activity, but the fixed prosthesis produced significantly greater masticatory efficiency.
The survival figures for fixed full-arch implant prostheses were also high. Across the studies reporting this outcome, implant survival ranged from 96.2% to 100%, with follow-up extending to six years in some cases.
But high implant survival did not mean an absence of prosthetic problems.
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