Treatment Planning of the Edentulous Maxilla

The predictability of successful osseointegrated implant rehabilitation of the edentulous jaw as described by Branemark et al. (Scand J Plast Reconstr Surg Suppl 16:1–132, 1977) introduced a new era of management for the edentulous predicament. Implant rehabilitation of the edentulous maxilla remains one of the most complex restorative challenges because of the number of variables that affect both the aesthetic and functional aspects of the prosthesis (Bosse and Taylor, Dent Clin North Am 42(1):117–127, 1998). Among the prosthesis designs used to treat the edentulous maxilla are fixed or removable implant-supported restorations. Since the aesthetic requirements and preoperative situation of each patient vary, considerable time must be spent on accurate diagnosis to ensure that patient desires are satisfied and predictable outcomes are achieved. The purpose of this chapter is to compare the treatment options and prosthesis designs for the edentulous maxilla. Emphasis will be placed on diagnosis and treatment planning. Criteria will be given to guide the practitioner in deciding whether a fixed or removable restoration should be placed. Material considerations will be discussed. This objective will be accomplished through the review of cases regarding varying design considerations and factors that influence the decision-making process.