Prosthetic management of the partially dentate patient with fixed implant restorations

The aim of this chapter is to discuss the current prosthetic management of the partially dentate patient by means of fixed implant restorations in the scope of the ITI(R) Dental Implant System. For that purpose, the related s tatements defined by the participants of the prosthodontic section of the 1 997 ITI Consensus Conference in Vitznau, Switzerland, will be presented, co mpleted by explanatory comments where appropriate. Distinct conceptual diff erences will be made between the esthetic zone (areas of the dental arches where esthetic considerations are of primary concern) and the non-esthetic zone (regions of the jaws where esthetic aspects do not represent a priorit y), and between single tooth replacement and multiple unit implant restorat ions. Furthermore, it is underlined that current clinical concepts should b e based on both predictable treatment outcome and cost-effectiveness. In th is context, a straightforward surgical and prosthetic protocol is generally preferred in posterior locations of the oral cavity, using a nonsubmerged implant placement comprising an easily accessible implant shoulder location , and subsequently cemented implant restorations, basically according to a traditional prosthodontic approach. In esthetically demanding indications, where normally a distinctly submucosal implant shoulder location is advocat ed, screw-retained restorations are preferred, based on prefabricated prost hetic components (e.g, machined cast-on copings) to assure optimum surface properties and contour, and to achieve adequate marginal adaptation.