Future therapeutic directions for management of the edentulous predicament

The 1982 Toronto Conference on Tissue-Integrated Prostheses introduced the technique of osseointegration to the academic dental community. Subsequently, prosthodontists have played a leading role in the educational and clinical development of implant-supported fixed and removable prostheses for the treatment of the edentulous jaw. The success rates of treatment in the mandible have been replicated in many parts of the world and results are rewarding when compared with conventional complete denture therapy. Unfortunately, treatment results in the maxilla do not parallel those in the mandible and the shortfall requires the development of alternative strategies in diagnosis, treatment planning, surgery, and prosthetic management. As these treatment concepts become an everyday practice reality, osseointegrated implants have predictably found their way into the curriculum of all dental specialties. However, in many localities, the role of the prosthodontist in continuing education and research and development has become diluted as other areas of dentistry realize the enormous potential for treatment with osseointegrated implants. Accordingly, prosthodontists need to reevaluate their clinical mind-set if the specialty is to provide a lead role in future therapeutic endeavors.