Dental implants and decision making

Treatment choice and effectiveness in prosthodontics has largely depended on educated anecdote and asseveration. Still, this approach has to a very large extent enabled dentists to enrich the quality of their patients' lives. However, the trade-off between the need for prosthetic intervention per se and the biologic price inherent in certain therapeutic endeavors has demanded strict concerns regarding clinical decision making and treatment outcomes. The technique of implant prosthodontics is certainly one that has focussed such concerns, particularly since the concept of osseointegration was introduced to North American dentists at the 1982 Toronto Conference. Clinical research and opinion in this area have elicited both clinical euphoria and polarization vis-a-vis newer possibilities for resolving the predicaments of partial or complete edentulism. The past decade has witnessed clinical trials, as well as highly relevant exemplary reports, on the application of the osseointegration technique. It is now necessary to compare the merits of implant prosthodontics to traditional therapies, and to determine those criteria which comprise optimal functional and aesthetic restoration, with minimal risk of morbidity, along with cost concerns. This paper seeks to provide a systematic and rational basis for the identification of such criteria.