A common problem with long-term edentulism is advanced osseous atrophy, especially in the mandible. Removable complete dentures are likely to be unstable and lack sufficient retention for adequate function.1–4  The mandibular bone can be very thin and unable to accept endosseous implants for prosthetic support1–4  (Figures 1 and 2). As the mandible resorbs, the osseous ridge crest moves medially and apically. The facial and lingual cortices approach each other. The symphysis may become prominent, and the genial tubercles can be at or above the ridge crest. Vertical dimension of occlusion can decrease, producing facial and functional detriments. In jaw overclosure, the position of the mandible can move closer to the maxilla and can lead to angular cheilitis, aesthetic compromises and decreased function.

With the mandibular osseous crest now lingual to proper tooth position, prosthetic fabrication needs to be designed and...

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