Radiographic monitoring of marginal peri-fixture bone is mandatory during prospective evaluation of different dental implant systems. Unyielding, uni-directional focus towards identifying the credibility of implant-supported overdenture therapy for the management of the edentulous predicament, has often neglected correct standardization of follow-up radiographs. Techniques for truly accurate location of film-holding devices have often not been applied to both unicentre and multicentre reports on mandibular implant-supported overdentures using Brånemark implants. An innovative improvement on existing methods using conventional and custom-made components, shows a procedure to accurately and simply standardize follow-up radiographs, for both free-standing and bar designs for mandibular implant-supported overdentures.

A variety of terms have been used to describe changes in the oral mucosa around abutments underneath fixed and removable implant prostheses such as mucosal inflammation, peri-implant mucosal hyperplasia, gingival hyperplasia, hyperplastic tissue, mucosal proliferation, proliferative gingivitis and peri-implant mucositis. Although such terms have become part of the evidence-based literature, there is no histological evidence to support the descriptive terminology used by authors. The use of the alternative term mucosal enlargement for clinical observations underneath mandibular implant overdentures is proposed. Prospective and retrospective reports have failed to use similar criteria to measure periodontal parameters in relation to these mucosal changes, both in keratinized or non-keratinized tissues. Therapeutic remedies for mucosal enlargement are dictated by authors' opinions on the possible aetiology. This literature review, coupled with clinical observations during a 5-year prospective study, prompts this proposal of the term mucosal enlargement underneath splinted and unsplinted mandibular implant overdentures.