[Evolving in prosthetics with the Brånemark system]

The incorporation of the Brånemark root-form osseointegrated implant into the practice of Prosthodontics has opened up a new range of treatment options previously unavailable to our patients. No longer limited to their original use in restoring the completely edentulous arch, the role of implants now includes the replacement of one or more missing teeth in partially edentulous situations. Implants may also be incorporated into periodontal prostheses as supplemental support where the number or strength of existing natural abutments is inadequate, and used as a means of salvaging prostheses which have failed as a result of the loss of strategically important abutments. These newer applications, however, combined with patient demands for the optimum in esthetics as well as function, have served to challenge our ingenuity and resourcefulness in this rapidly evolving field. The objective of this paper is to provide an overview of the evolution of our implant experiences in recent years, and to illustrate the ways in which the Brånemark system has been utilized and adapted as the number and complexity of clinical situations have increased. Simply stated, the technical aspects of prosthetic treatment, those involving impression techniques, materials, etc., have remained fairly constant throughout our implant experience. The more dramatic changes have occurred through the utilization of newer components as they have become available, as well as through a growth in our application of the system and in our approach to treatment planning. The Brånemark system has been in use for just over 25 years at this point in time and has proven itself to be reliable, predictable and at the same time versatile enough to admirably meet the challenges placed on us by the new and varied clinical situations we are now undertaking to treat. It is by using our imaginations to stretch the limits of the system without overstepping its boundaries that we have reached the point where osseointegration is truly becoming a part of our basic armamentarium in the practice of Prosthodontics.