Statement of problem: Restoring the edentulous maxilla with a fixed complete denture or a removable overdenture is a complex and challenging procedure.
Purpose: This article presents and discusses the crucial factors involved in deciding whether a fixed or removable implant prosthesis should be planned in fulfilling the patient's preference for optimal esthetics, phonetics, comfort, and function.
Methods and material: A concept for treatment planning is presented that enables the practitioner to check the decisive parameters during the first examination and to make the final decision with the help of the reformatted computerized tomography scan.
Conclusion: If this treatment plan is followed, implants can be placed to comply with the selected prosthetic solution and compromised solutions can be avoided. The fixed design for implant prosthesis is only appropriate for patients with minimal resorption of the alveolar bone and an optimal maxillomandibular relationship. The removable overdenture may be indicated from the outset and is no longer restricted to patients with a compromised situation in which fixed implant prostheses are not feasible.