The Choice of the Ideal (Implant) Restoration

Prof. Carlo Marinello, Switzerland - MIS Global Conference, Barcelona 2016.

The choice of a so called ”ideal restoration” is the biggest challenge for a prosthodontist today and needs a comprehensive and sophisticated decision making process running on many different levels (team patient-dentist-technologist, general esthetic aspects, functional and biologic situation, intra- and intermaxillary situation; tooth and implant situation and antagonistic relationship, soft and hard tissues situations, biomaterial used).
The aim, to copy nature by choosing the many different periodontally- and implant supported prosthodontic solutions and by applying certain rules, supports our efforts for an ideal restoration. However there still are many compromises to be accepted by the whole team. The restoration of natural teeth in general and the placement and the restoration of dental implants in special remains a challenge not only because of esthetic and functional demands but mostly because of difficult pre-existing anatomy. Anatomic factors such as horizontal or vertical bone deficiencies and iatrogenic factors such as improper implant selection (under- or oversized) or the malpositioning of dental implants (mesiodistal, apicocoronal, and orofacial dimensions with defining “comfort” and “danger” zones for proper implant position) for an esthetic implant restoration may further hinder the ideal restoration. A short historical overview followed by a treatment concept and decision making process based on literature evidence (clinical aspects to be respected), is presented.