Consensus Report of Group 4 of the 1st Global Consensus for Clinical Guidelines for the Rehabilitation of the Edentulous Maxilla: Conventional Dentures, Implant Overdentures and Implant-Supported Fixed Dental Prostheses

Abstract

Objectives The 1st Global Consensus for Clinical Guidelines (GCCG) in Implant Dentistry introduced an innovative, evidence-based, patient-centred approach to developing practical recommendations for the rehabilitation of the edentulous maxilla. Within this framework, Group 4 focused on formulating clinical recommendations for the planning and delivery of conventional dentures (CD), implant overdentures (IOD) and implant-supported fixed complete dentures (IFCD) for patients with an edentulous maxilla. Materials and Methods Group 4 followed the S2k-level guideline framework of the Association of the Scientific Medical Societies in Germany (AWMF), applying a structured nominal group technique. The evidence base included two systematic reviews synthesising patient-reported outcomes (PROs) and clinician-reported outcomes (ClinROs) and their respective measures in patients with an edentulous maxilla. In addition, single-round international surveys were conducted involving expert clinicians, patients and cross-disciplinary experts. Draft recommendations were developed during the in-person consensus meeting in Boston (June 16-18, 2025) and finalised through anonymous plenary voting. Consensus thresholds were predefined at >= 75% and <= 95% agreement for a consensus and > 95% agreement for a strong consensus. Results Group 4 participants formulated 14 clinical recommendations covering five stages of treatment: (i) patient selection, (ii) diagnostics, (iii) treatment planning, (iv) treatment procedures and (v) maintenance. During plenary voting, 6 recommendations reached consensus and eight achieved strong consensus. Voting participation per recommendation ranged from 60 to 84 participants (mean 75). Conclusions Group 4 consensus statements provide structured guidance on the use of removable and fixed implant-supported dental prostheses for the rehabilitation of the edentulous maxilla. The recommendations reflect current evidence, expert opinion on clinical practice across disciplines and patient perspectives. Key evidence gaps-especially regarding standardised PROMs, long-term outcomes and maintenance protocols-identify priorities for future clinical research.