Development of gingival esthetics in the terminal dentition patient prior to dental implant placement using a...

Despite significant advances in dental therapeutics, there are patients for whom no reasonable treatment is available that will reliably restore or maintain their existing dentition. The causes of future edentulism include advanced caries, failing root canal therapy, inadequate numbers of teeth to support a fixed prosthesis, untreatable periodontal disease, or a history of failed previous rehabilitations. For these patients, dental implants may provide a more predictable future than retention of their remaining teeth. It is proposed that transitional fixed prostheses designed specifically for a patient with terminal dentition offer the advantage of maintenance and development of proper gingival esthetics with improved function. Prior to implant placement, the gingival frame is established, enhancing the overall appearance of the final, full-arch implant rehabilitation. The specific prosthodontic and surgical techniques required for successful treatment of these patients are presented.