Prosthodontic planning for adults with functional limitations: a feasibility and maintenance framework

Some patients with cognitive, developmental, neurologic, or physical conditions require modified prosthodontic care. However, they often receive less restorative and prosthodontic treatment than needed. This narrative review explores how conventional prosthodontic treatment planning should be complemented when treatment delivery and long-term maintenance depend on functional capacity and caregiver support. The available treatment options─including restorations of natural teeth, tooth-supported fixed dental prostheses, removable dental prostheses, implant-assisted removable prostheses, implant-supported fixed dental prostheses, and limited or deferred treatment─are broadly similar to those offered to the general population. However, treatment selection should additionally consider whether the proposed procedures can be completed, whether the restoration or prosthesis can be used safely and effectively, and whether long-term maintenance can be sustained by the patient, caregivers, and available support services. Treatment decisions should balance the anticipated benefits against the treatment burden while respecting patient preferences, decision-making capacity, informed consent or assent, and the potential need for definitive treatment under sedation or general anesthesia. Current evidence is largely retrospective, indirect, and derived from a limited number of centers. Accordingly, this review proposes a feasibility- and maintenance-oriented framework to support clinical decision-making, complementing, rather than replacing, conventional anatomical and biomechanical treatment planning.