Dental implants have risen as the gold standard for oral rehabilitation, offering predictable outcomes and improved quality of life for patients with missing teeth. However, postmenopausal women constitute a distinct patient population due to the systemic effects of estrogen deficiency, particularly on bone metabolism. The decline in estrogen levels following menopause can negatively impact bone remodeling, potentially influencing osseointegration and the long-term success of dental implants. This review aims to evaluate the current evidence regarding implant outcomes in postmenopausal women, examine the biological implications of hormonal changes on bone physiology, quality, and quantity, and provide evidence-based clinical recommendations to enhance treatment planning and optimize outcomes in this demographic segment.
Objectives: This review examines the current role of stackable surgical guides in full-arch implant rehabilitation, with particular attention to what these systems can reliably achieve in clinical practice and where the available evidence remains insufficient to support broader claims. Materials and methods: A critical narrative review of PubMed/MEDLINE and Scopus was conducted and updated through August 2026. The search combined the terms “stackable,” “sequential,” and “modular” surgical guides with “dental implant,” “full arch,” “bone reduction,” “accuracy,” and “immediate loading.” Clinical studies, evidence syntheses, and relevant laboratory investigations were assessed individually. Because of the heterogeneity of the available literature and the narrative design of the review, no meta-analysis or formal risk-of-bias assessment was performed. Results: Stackable systems use a stable base with interchangeable components to maintain the planned reference throughout bone management, implant placement, and prosthetic transfer. The available clinical evidence remains limited. A 2024 scoping review identified only 12 case reports or case series, including 25 patients, 27 arches, and 173 implants, and accuracy was quantified in only four of these reports. More recent clinical studies provide additional information, although their findings remain specific to the protocols investigated. In one retrospective series involving 60 implants placed with a rigid, bone-fixed base, mean angular, neck, and apical deviations were 1.25°, 0.96 mm, and 1.07 mm, respectively. The first in vivo comparison with other forms of static guide support found no overall accuracy advantage for stackable guides and reported the greatest vertical discrepancy in the stackable group (0.26 mm; P<.001). In the 43-arch STAGE cohort, approximately 93% of arches were loaded on the day of surgery, while 274 of 284 implants had osseointegrated at four months. Implant replacements and provisional fractures were nevertheless reported. Conclusions: Current evidence supports stackable guides primarily as a method for maintaining a common planned reference throughout successive surgical and restorative steps. In appropriately selected cases, they can facilitate prosthetically driven implant placement, guided or selective bone reduction, and immediate provisionalization. Available studies, however, do not establish superiority over conventional guidance, identify one stackable design as preferable to another, provide validated criteria for bone reduction, or demonstrate advantages in patient-reported outcomes or cost-effectiveness
The use of dental implants as a treatment for replacing missing teeth has been increasingly prevalent. Historical evidence suggests that the Mayans were among the first to create implants around 600 AD. Over time, this technique has evolved, offering numerous benefits to humanity. Regardless of the causes of tooth loss and the patient's age, it significantly impacts various aspects of an individual's life, including nutrition, psycho-emotional well-being, and social interactions. One of the primary consequences is the negative effect on self-esteem due to the aesthetic concerns associated with missing teeth. Additionally, pronunciation difficulties can lead to communication challenges, reducing the desire and ability to engage with others. Extensive research in the specialized literature explores the psychological impact of dental implant usage. It is widely acknowledged that the dental implant technique is complex and carries inherent risks and potential adverse effects. An illustrative case serves to underscore the significance of psychological considerations in dental implant treatment. In this instance, a 55-year-old woman attempted suicide by throwing herself down the stairs of her home after receiving dental implants in both sections of her oral cavity. The distress she experienced stemmed from the inability to consume anything beyond fluids and semisolid food for an extended period of eight months. This alarming incident underscores the importance of recognizing and addressing the psychological impact that dental implant procedures can have on vulnerable individuals.
