A classification system of patients for esthetic fixed implant-supported prostheses in the edentulous maxilla

Edentulous maxillary fixed rehabilitation using dental implants is challenging and requires meticulous planning because of anatomic variations and the importance of facial and dental esthetics. This article reviews the application of facial esthetics, lip support, smile lines, residual ridge position, tooth proportions, and tooth positions for different types of patients. Based on these parameters, a simple new classification system is proposed to classify patients into four categories, which will help facilitate an easier diagnostic and communicative system. It will also enable the clinician to understand when and why gingiva-colored prosthetic material is needed. Using this classification system, a stepwise method of diagnosis and management techniques are described in detail for each of the four classes. The proposed classification system has been based on an analysis of various successfully treated patients with a minimum follow-up period of 2 years.