Implant prosthodontics for edentulous patients : current and future directions

Abstract

Osseointegration has had a dramatic influence on prosthodontic practice. With its emphasis on scientific rigor, osseointegration now provides expanded treatment management strategies for virtually all partially and completely edentulous patients (Plates 30-1 through 30-5). The clinical yield from osseointegration as summed up in Box 30-1 reflects the results of numerous studies on its efficacy and effectiveness. In 1990 we reported the results of the first North American long-term prospective implant study in prosthetically maladaptive edentulous patients (Zarb and Schmitt, 1990). One particularly compelling finding was that successful prosthodontic treatment outcomes exceeded individual implant survival ones, and all of the treated patients demonstrated ongoing long-term comfortable and successful prostheses wear. This study and subsequent ones strongly suggested that the provision of a fixed or quasi-fixed (overdenture) prosthesis was the optimal solution to complete denture problems of a functional nature (prosthetic maladaptation). It was concluded that the major determinant of success in wearing removable prostheses was patient perceived comfort and stability. The latter objective would be readily achieved irrespective of the number of successfully osseointegrated fixtures and underscored the merits of diverse applications of a technique that has arguably revolutionized prosthodontic treatment.