Removable implant-supported overdentures (IOD) are a valuable treatment option for edentulous patients. Modern computer-aided design and computer-aided manufacturing (CAD/CAM) techniques to fabricate IODs have evolved, including additive or subtractive manufacturing. The implementation of a digital workflow not only supports clinical backward planning but also increases the efficiency of the laboratory workflow. This article highlights modern fabrication processes and available materials for IODs. Concerning the manufacturing procedure, dentures fabricated subtractively from industrially polymerized polymethylmethacrylate (PMMA) resin blanks have consistently demonstrated highest flexural strength, modulus of elasticity and lowest surface roughness compared to conventionally fabricated or 3D printed dentures. Various attachment systems are available for IODs including bar, stud, and double crown systems. Proper backward planning and ideal implant positioning are essential to select the appropriate attachment system and ensure sufficient vertical and horizontal spacing. For conventional framework designs precious alloys (gold alloys), cobalt-chromium alloys (CoCr) or titanium are widely used materials that have been recently complemented with polyetheretherketone (PEEK), polyetherketoneketone (PEKK) or fiber-reinforced composite materials (FRC). These novel developments underline the integration of digital technologies and material innovations in contemporary prosthodontics, aiming to improve patient outcomes and longevity of implant-supported overdentures.
The global burden of edentulism has doubled over the past 20 years, reaching an estimated incidence rate of 26.6 million cases in 2021 (Yan et al. 2025). It is expected to increase further over the next 30 years, particularly among the elderly population (Yan et al. 2025). People treated with removable implant-supported overdentures (IOD) demonstrate superior clinical effectiveness with enhanced bite forces and elevated chewing efficacy compared to complete denture wearers (Boven et al. 2015). Nonetheless, conventionally produced IODs incur high treatment costs and it remains uncertain whether the elevated treatment costs outweigh the clinical benefits (Van de Winkel et al. 2021). Recent advances in material sciences and digital technology transformed the fabrication of removable IODs, with various computer-aided design and computer-aided manufacturing (CAD/CAM) methods and materials available (Bilgin et al. 2024). IODs offer, in contrast to fixed implant-supported restorations, the advantage of compensating tissue deficits by individually shaping the buccal flange to provide lip and soft-tissue support (Stilwell et al. 2025). They also allow for individual palatal coverage tailored to phonetic requirements which vary according to the extent of alveolar ridge resorption (Heydecke et al. 2003; Zitzmann & Marinello 1999). According to a recent consensus report, survival rates of IOD’s are reported between 80-100%, however, success criteria of the prothesis and implants varied widely across studies (Stilwell et al. 2025). Various attachment systems are available for removable IODs including bar, stud, and double crown systems. While stud abutments offer only limited compensation for divergent implant angulations (approximately 15–25°), bar-supported overdentures accommodate greater angulation discrepancies and provide a defined insertion path, facilitating reliable patient-managed placement and removal. Bars may additionally incorporate distal cantilevers when implants are confined to the anterior region, which is particularly relevant in Class II jaw relationships (Sadowsky & Zitzmann 2016). Proper backward planning and ideal implant positioning are essential to ensure the vertical and horizontal dimensions required by the attachment systems. Nonetheless, IOD’s require regular maintenance, including activation or replacement of the matrix of the attachment system, relining of the denture base or managing fractures of the framework, denture base or veneering resin (Stilwell et al. 2025). By implementing a digital workflow, not only the clinical, but mainly the laboratory workflow has become more efficient (Van de Winkel et al. 2025). This article summarizes the current evidence on the choice of materials and fabrication methods for removable IODs. It focuses on technical advances and material choices by implementing CAD/CAM technology.