Edentulous patients are amputees just as surely as those who have lost limbs. It is a great credit to the dental profession and the stoicism of the patients that so many make light of this disfiguring and disabling condition. Our ability to offer treatment to edentulous patients has in this sense been such a success story that it has been taken for granted and undervalued by politicians, health service administrators and increasingly by the leaders of the profession particularly those involved in education and curriculum planning. Osseointegrated implants have offered a great advance in oral rehabilitation, particularly for the edentulous, but
relatively few patients have benefited from them. There are many reasons why patients do not have implants including medical, biological and economic. Indeed relatively few are offered implants and of those a number choose not to have them because they donÂ’t want to undertake the surgery involved or the prolonged treatment. The most economical strategy for the edentulous would be to use implant supported overdentures. Even those patients who are able to have implants to support their lower dentures need access to clinicians capable of constructing complete dentures. These patients need well made prostheses which then use the extra retention, support and stability gained from the implants to bring positive benefits to the patient. A very real challenge for the foreseeable future, however, will be treatment of those edentulous patients who are not able to have or donÂ’t want implants.
Robert Clark