There are two options for the treatment of the edentulous patients using dental implants, e.g. a fixed type prosthesis vs. a removable type overdenture which needs relatively less numbers of implants than fixed type.

The criteria of the selection of the fixed type vs. removable type prosthesis depends on a patient's esthetic needs, financial status, age, the quality and quantity of the remaining alveolar bone, treatment time and dentist's ability.

Even though most of the patients might want a fixed type prosthesis, when there is a severe alveolar resorption, it takes time and money to restore the original alveolar bone volume to place implants for a favorable esthetic result. Without those efforts, it is sometimes hard to have a better esthetic result than a removable prosthesis.

When there is a bulky alveolar ridge, that means even after extractions, somewhat protruded face, a fixed type prosthesis is recommended rather than a removable type because a removable overdenture may aggravate the alveolar protrusion.

If an old aged patient use a full denture and he is happy about the esthetics at least, we can predict there seems to be a severe bone resorption and can be simply turned to be an overdenture after implantation.

If we treat the patient from the start, a temporary denture during the healing period after extraction can be a criteria for the future prognosis or decision making tool.

In this lecture. on the basis of my clinical cases, I'd like to discuss about the decision making of the implant prosthesis.