Aesthetics and osseointegration for the completely edentulous

The completely edentulous patient who has been fitted with osseointegrated implants poses new challenges for the restoratie dentist. Besides having to make up for loss of teeth and alveolar bone, the prostheses have to provide function and aesthetics, and be designed to facilitate oral hygiene procedures. The metal superstructure should be strong, have a passive fit, be resistant to corrosion and be easy to clean. Three designs are proposed: the sanitary bridge, the aesthetic bridge and the removable overdenture. The patient's expectations regarding function and aesthetics should be assessed initially by the restorative dentist. General principles of aesthetics in complete dentures are still to be followed: proper upper anterior tooth selection (shape and shade), and correct tooth positioning in relationship to lip line, smile line and profile. Lower teeth should be level with the lower lip and the retromolar pad. Success is based on the patient's capacity to adapt and the dentist's sound application of basic principles.