The positive long-term prognosis for implant dentistry has provided dentists with an optimum treatment option for patients with missing teeth. For decades, the standard of care for a patient presenting with an edentulous space in the area of tooth #3 and #4 would be: a 4-unit fixed dental prosthesis spanning teeth #2–5, or a removable partial denture. This has sufficed to provide patients with the necessary posterior chewing surfaces, but has done little to address other systemic issues that accompany partial edentulism, such as mesial drift of an existing distal tooth, supereruption of opposing dentition, or the atrophy of the residual ridge with bone and soft-tissue loss. Additionally, the fixed dental prosthesis solution required the preparation of adjacent teeth for use as abutments, placing excess stress on the natural teeth and, in concert with bone resorption and possible recurrent decay, compromising the restoration to a 10–15-year shelf life.
With the advent and popularity of root-form dental implants, clinicians now have a better alternative, albeit one that thus far has often been relegated to the purview of specialists. Like many dental disciplines, however, the properly trained general practitioner is potentially well-suited to handle most of these straightforward cases, with the more complicated iterations requiring experienced intervention. In this photo essay, the patient presented with a posterior edentulous space, along with PFM restorations abutting mesial and distal to this space. By restoring the area with two implants rather than a 4-unit fixed dental prosthesis, the patient was restored with four single-unit monolithic crowns, serving to improve the prognosis and address all of the chief functional and restorative concerns.
By adhering to proper protocol and using materials with adequate rigidity, studies have shown the accuracy of the less labor-intensive closed-tray impression to be statistically equal to that of an open-tray impression.
The restorative phase of implant dentistry has become routine in a general practitioner’s office. With the proper training, implant placement can also be more commonplace in the general practice. As with any field within dentistry, acquiring the skills to both place and restore implants takes dedication, time and patience. Organizations such as the American Academy of Implant Dentistry and the Academy of Osseointegration help to promote such learning, and often provide hands-on training to aid with continuing education for general dentists and specialists. For clinicians interested in dedicating a portion of their practice to implant dentistry, that achievable goal can come to fruition because of the commitment we have invested in our field that have made these opportunities available.