Treatment Planning the Edentulous Mandible

Edentulism can be a debilitating handicap. Zarb described persons who could not function normally in life due to an inability to use complete dentures as “denture cripples” (Zarb, J Prosthet Dent 49(6):825–31, 1983). Most difficulty with complete denture prostheses arises from the inability to function with the mandibular prostheses. Factors that adversely affect successful use of a complete denture on the mandible include (1) the mobility of the floor of the mouth, (2) thin mucosa lining the alveolar ridge, (3) reduced support area and (4) the motion of the mandible (Figs. 16.1 and 16.2). The maxilla exhibits much less mobility on the borders of the denture than the mandible; moreover, a stable palate with thick fibrous tissues is available to support the prostheses and resist occlusal forces. These differences describe most of the reasons why patients experience difficulties in using a complete denture on the mandibular arch compared to the maxillary arch.