A wide range of indications for dental implant treatment and high patient acceptance of this modality rely upon the safety of the surgical and prosthetic procedures employed. Therefore, the clinician should only implement well-established, predictable procedures with high success rates, low complication rates, minimal invasiveness, and low cost. Procedures satisfying these prerequisites employ the use of prosthetic-driven planning, optimized surgical techniques and highly evolved implant technology. 

In the absence of trauma or pathology, the posterior mandible is characterized by sufficient cortical bone density to sustain dental implant-supported reconstructions but is subject to demanding loading conditions. The loading conditions in the posterior mandible are the same as in the posterior maxilla but the bone density in the posterior maxilla is lower (Cordaro et al. 2009). A risk inherent in placing an implant in the edentulous posterior mandible is injury to the inferior alveolar nerve. Hence, the use of short implants has considerably facilitated surgery in this area (Block 2014). Furthermore, it is well established that the anterior and posterior mandibles exhibit the highest cumulative implant success rate (Buser et al. 1997).

This article focuses on the surgical management of implant placement in the posterior mandible. Options are described with reference to the literature and to practical experience derived from more than 20 years of close collaboration between a team of oral surgeons, general practitioners and dental laboratory technicians in a large private clinic setting.