Restoration of the masticatory function is the most important indication for the insertion of oral implants. Wherever, implant is the only alternative treatment options, then it is termed as Absolute indication. In all the other clinical situations, it should be considered as one of the viable alternatives, then it is called Relative indication. Complete edentulous jaws and posterior unilateral or bilateral edentulous spaces are examples of absolute indications. All the other forms of edentulousness like single or multiple tooth loss bounded by teeth on either side are examples of relative indications.
A predictable prognosis is the main criteria for advocating implant-supported prosthesis in all the above-mentioned clinical situations.
For the oral rehabilitation some other factors play an important role apart from the restoration of the chewing function. Esthetics seems to be the most important motivation – factor for many patients who need prosthetic replacement of anterior teeth. To get an esthetically acceptable rehabilitation, sometomes, we have to reconstruct the recipient bed, including the augment the bone and soft tisues. Many preprosthetic reconstructive procedures require bone grafting. It is an established fact that, only loaded bone does not resorb. Therefore, implants insertion on the grafted bone can help to avoid bone resorpton. The biological basis of the bone healing and clinical experience form the basis for this indication.
In cases of functional and restorative indications, we speak about longterm prognosis. On the contrary, the aim of palliative indication is to improve the quality of life of the patient, so long as the patient lives in comfort. For example, patients with oral malignancy undergo jaw resection. If these patients are reconstructed to avoid oro-facial deficit, provision of dentition is a defficult proposition.Implants in the reconstrcted jaws help the patient to live in comfort with prosthesis. Like wise, implants can be placed in the irradiated bone, even though the bone is of inferior quality. Similarly, implant-borne prosthesis in patients with strokes, hemiplegia form excellent pallaitive indications.
It is time for us to consider the transition from the conventional implant-supported prosthesis to the functional, restorative and palliative indications as a realistic proposition in implantology practice.
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