Examination includes cancer screening and should note favorable and unfavorable aspects of the current dentures (if available), clinical ridges, peripheral areas and TMJ, denture-supporting tissues, patient factors such as health, medications, diet, personality, denture experience, habits and expectations.
A word about the Class 4 edentulous mandible patient: implant protocols that would be predictable and successful for these patients are extensive and may not be appropriate, due to financial and/or health constraints. These patients want and need a new denture, even though the prognosis is poor. Inevitably the clinic is involved in numerous difficult mandibular denture projects, which challenge the treatment team because of high demand for skillful patient management and procedural finesse. A positive attitude is useful: don't expect a miracle and don't make any guarantees, but assure the patient that everyone involved will do their best.