Twenty Years of Progress in Implant Prosthodontics

Twenty Years of Progress in Implant Prosthodontics
Implant Dentistry: Volume 12(1) March 2003 p 9
Loughlin, Robert M. DDS
Lippincott Williams & Wilkins, Inc.
In 1982, North American dentists discovered dental implants to be predictable and successful on a long-term basis. This led to its widespread use in North America and a dramatic change in how patients were diagnosed and treated prosthodontically. This article gives a historical description and a rational for various aspects of implant treatment. The authors also provide an explanation of how these ideas have evolved and changed over 20 years of implant therapy. The rational for a hybrid prosthesis in the mandible is discussed and explains why this treatment option is infrequently used in the maxilla. It discusses submerged versus nonsubmerged healing and the development of different abutment designs, specifically the UCLA abutment. The evolution of implant designs such as the Core-vent and IMZ implants, as well as implants incorporating an internal connection, are discussed. Initially, the use of metallic and ceramic occlusal surfaces was discouraged because of a belief that these materials would transmit traumatic forces to the osseointegrated surface. Resin occlusal surfaces as well as the IMZ implant were proposed as solutions. However, as treatment for partially edentulous patients increased, resin occlusal surfaces possessed too many disadvantages and eventually clinicians began using metal-ceramic restorations. The evolution from screw-retained to cement-retained restorations is examined. The fit of the restoration was looked at next. Initially, it was believed that the restoration must fit passively, without inducing strain, because it would lead to the breakdown of the surrounding bone. The authors point out that this belief has not been demonstrated by the research. Lastly, the authors impress upon the reader how much knowledge has been gained about dental implants in 20 years but emphasize that much more work and research are needed.