Transitioning Patients from a Failing Dentition to Implant-Supported Restorations

Dental implants have been successfully used in the replacement of teeth in both partially and completely edentulous patients. When transitioning from a failing dentition to implant-supported restorations, there are various options for provisional/transitional restorations. Achieving osseointegration is no longer the challenge that it seemed to be 50 years ago with more predictable implant integration today. Thus, providing an implant-supported restoration which is in harmony with the surrounding hard and soft tissues is the goal. In preparation for implant placement, bone and gingival grafting procedures are routinely used to optimize the site. This chapter discusses how interim removable prostheses can hamper these procedures as pressure from these removable restorations can deter proper healing of grafts. Following careful diagnosis and treatment planning, the progression of a patient’s treatment via various interim prostheses is important to both patients and clinicians in order to successfully transition the patient from the initiation of treatment to the delivery of definitive implant-supported restorations. Since there is no single answer as to which provisional option is suited for each clinical scenario, this chapter poses guiding questions that will aid the clinician’s thought process in considering all involved factors before selecting the most appropriate interim prosthesis for each presenting situation. In further reading this chapter, readers should be able to grasp the advantages and the disadvantages of each version of interim prostheses, recognize additional functions of certain provisional types during implant treatment and select the appropriate choice of interim prosthesis for a given clinical scenario.