We inserted an implant-supported overdenture on a gold bar retainer splinting four implants. However, the patient was not satisfied with this prosthesis because of the mucosal pain and discomfort that developed over time. In such cases, prosthetic loading of atrophic mucosa is often not well tolerated. As such, we proposed replacement with an implant-fixed prosthesis. Initially, the patient elected not to proceed with this option because of the additional economic burden. However, the patient eventually opted for rehabilitation with a fixed implant-supported prosthesis, as this provided the psychological advantage of a prosthesis that felt similar to the natural teeth. In this case, an implant-supported overdenture, which was provided to rehabilitate the edentulous mandibular region after marginal mandibulectomy for treatment of gingival carcinoma of the mandible, was replaced by an implant-fixed prosthesis.

Pjetursson et al. performed a systematic review of the survival and complication rates of implant-fixed prostheses after a mean observation period of at least 5 years. They concluded that implant-fixed prostheses are a safe and predictable treatment method with high survival rates. However, biological and technical complications were frequent in their review (33.6 %). To minimize the incidence of complications, dental professionals should make great effort to choose reliable components and materials for implant-fixed prostheses, and patients should undergo a well-structured maintenance protocol after treatment. In the present case, professional teeth cleaning with individual instruction every 3 months improved the patient’s oral hygiene. Maintenance care may have motivated the patient to improve her oral home care regimen. This case report indicates that occasionally, even after definitive therapy has been completed, the clinician must re-evaluate and sometimes alter the direction of treatment to provide the best possible outcome for the patient. In conclusion, we have herein reported a case illustrating our long-term clinical experience and the concept of switching therapy.

Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.