Article

Feature Article
Feb 04, 2026 // 11 min read
Conventional vs Digital Impressions for Implant-Supported Overdentures: Clinical Workflows, Advantages, and Limitations
Najla Chebib
Xhenis Kurti
Alexandre Perez
Alessio Casucci
DOI: 10.63580/ITI.FI.45772
implant-supported overdenture intraoral scan digital scans conventional impressions CAD/CAM workflow removable denture
Abstract

Implant-supported overdentures remain an essential treatment option for edentulous patients, particularly when anatomical, functional, esthetic or financial considerations limit fixed implant reconstructions. Careful prosthetic planning is required to ensure stability and long-term success, considering esthetics, occlusion, vertical dimension, and restorative space. This article provides clinicians with a structured overview of workflows for implant overdentures using conventional and digital impressions, highlighting their advantages, limitations, and clinical indications.

Impression strategies for different attachment systems – single retentive abutments (studs), splinted abutments with a bar, and double crowns – are discussed with an emphasis on accuracy requirements. Both conventional and digital workflows remain valid approaches. Workflow selection should be guided by case complexity, the type of attachment system, and available resources. Continued advances in CAD/CAM technology are expected to further streamline fully digital protocols for implant overdentures. Conventional impressions remain the gold standard for complex cases requiring splinted abutments or double crowns. Digital recordings offer advantages in terms of patient comfort, simplified workflow, and integration with CAD/CAM systems. A comparative summary outlines key factors influencing impression accuracy, including implant distribution, scan body design, coping splinting, material selection, tray rigidity, operator experience, and post-processing steps.

A step-by-step clinical case illustrates the digital workflow for a complete maxillary implant overdenture (IOD) retained using four non-splinted single retentive abutments. Diagnostic and pre-surgical planning procedures included denture duplication with radiopaque markers, CBCT-based planning, and allowed for guided implant placement. Further steps begin with intraoral scan, progressing through framework design and digital denture fabrication, and concluding with the final prosthesis retained by four single retentive abutments and their matrices (Novaloc® – Straumann Group, Basel, Switzerland).

Introduction

For a long time, implant-supported overdentures (IODs) were considered to be the second choice after fixed reconstructions on implants for full-arch rehabilitations. The decision to undertake a prosthetic rehabilitation with a removable IOD is influenced by several factors, including lip support, available interocclusal distance and bone volume. The cleanability of the reconstruction, the often increased morbidity associated with a fixed reconstruction and the likely future maintenance requirements are all important considerations. As described by Dr. Kavlekar, the overdenture is the unsung hero of full arch replacement; it is often the last hope for edentulous older adults (Kavlekar 2025).

Careful prosthetic planning prior to implant placement is essential for the short- and long-term clinical success of removable implant-retained prostheses. This includes evaluating esthetics, occlusal planes, vertical dimension, and intermaxillary relationships to guide the number, position, and angulation of implants to ensure both functional stability and sufficient restorative space.

The purpose of this article is to provide clinicians with a step-by-step overview of the workflows for implant overdentures using conventional and digital impressions. The advantages, disadvantages, and indications of each approach are discussed, with practical guidance on when and how to implement them. A clinical workflow for a maxillary IOD using four implants will illustrate the step-by-step digital workflow. Fig. 1 shows the initial situation with the upper edentulous ridge and a Kennedy CLI partial edentulism in the lower arch.

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Fig. 1a: Initial patient clinical status: upper complete denture
Fig. 1b: Initial patient clinical status: upper edentulous arch
Fig. 1c: Initial patient clinical status: upper complete denture prosthesis
Fig. 1d: Initial patient clinical status: lower Kennedy CLI partial edentulism
Fig. 1a Fig. 1b Fig. 1c Fig. 1d