# 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

## TL;DR

This paper presents clinical guidelines for rehabilitating the edentulous maxilla using dentures and implant-supported prostheses, developed through expert consensus and patient input.

## Contribution

The paper introduces 14 evidence-based clinical recommendations for maxillary rehabilitation, developed via international consensus methods.

## Key findings

- Six recommendations reached consensus with ≥75% agreement.
- Eight recommendations achieved strong consensus with >95% agreement.
- Key evidence gaps include standardized patient-reported outcomes and long-term maintenance protocols.

## Abstract

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.

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.

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).

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.