Prosthodontic Solutions for Elderly Patients

Buser, Ramona; Yue, Qin; Zimmermann, Patrick; Suter, Valérie; Abou-Ayash, Samir; Schimmel, Martin (2018). Prosthodontic Solutions for Elderly Patients. Forum implantologicum, 14(2), pp. 130-140. Quintessence Publishing Group

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With the so-called “baby boomer” generation reaching retirement, a new challenge in implant dentistry has emerged. Predominantly, tooth loss occurs later in life, accompanied by increased demand for partial dental prostheses. Edentulous patients are more difficult to treat due to advanced age, functional dependence, illness, and financial instability. Prosthetic planning becomes more complex as interindividual diversity increases with age. Considerations such as resilience, physical and mental status, medical history, and drug prescriptions must be individually assessed. Treatment planning and restoration design should fulfill both functional requirements and esthetic demands. Prosthesis design should prevent further harm to the patient. This tertiary prevention approach should prevent local inflammation of the oral tissues, but also prevent secondary systemic infections, such as aspiration pneumonia. There are many prosthetic options for partially or fully edentulous patients. Dental technicians should be aware of the advantages and disadvantages of the various treatment concepts and materials and contribute professional knowledge to the patient, dentist, and often third-party milling centers. Using CAD/CAM technology, customized attachments and prostheses can be individualized according to each patient’s requirements. Utilizing a combination of manual and digital production techniques, oral reconstructions can be rationally manufactured. The duration of implant osseointegration remains unknown, but reports of up to 30 years’ follow-up are emerging. Hence, the environment of the implant – the patient – will change significantly, and implant restorations should be flexibly designed to meet the changing needs of an aging patient. This “back-off strategy” should be implemented, and prostheses should be continuously subjected to critical reevaluations and adaptation.

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