Clinical evidence and Science 37 Dental implant restorations can be differentiated in three main categories: crowns, bridges, and dentures. They can replace any number of missing teeth fixed to dental implants. To restore a dental implant multiple prosthetic treatment solutions and abutments can be selected by the dentist/prosthodontist. Modern treatment protocols focus on immediate restorations. With improved implant geometries and surface technologies better implant stability and faster osseointegration could be attained. Thanks to these further developments the possibility to shorten the healing time and immediately restore the implants was created. This allows to treat the patients with fewer visits and to satisfy their need to have immediate functional and aesthetic restorative solutions. A consensus report by Schwarz et al. (2016) documented in general high survival rates for immediate and conventional loaded implants (1). For edentulous patients, implant-supported over- dentures with four implants in the mandible and six implants in the maxilla are recommended as the standard treatment. Removable overdentures with retention methods like ball abutments, Locator abutments, or bars supported by implants with Promote® Surface were scientifically evaluated in various publications in the past. A tendency to fixed prostheses may be explained by the fact that the better stability and retention as well as the comfort led to more satisfied patients. The following publications impressively document the clinical success of immediate and early loading protocols as well as fixed complete prostheses on CAMLOG® and CONELOG® implants. Additionally, interesting facts regarding fabrication of the prostheses are given. Modern treatment protocols like immediate and early loading allow functional and aesthetic outcomes with high clinical success in multiple indications. Loading protocols Clinical success with the immediate loading concept De Lange et al. presented at the EAO Congress 2010 their data of four treatment protocols (2): CAMLOG® implants in group 1 and 2 were placed in fresh extraction sockets followed by either immediate or delayed loading; in group 3 and 4 the implants were inserted in normal healed bone with immediate or delayed loading, respectively. They examined the risk ratio of failure for several parameters and concluded after five years of follow-up that individual risk factors such as smoking, inflammation from cement excess, or endodontic treatments were much more critical to success than the time points of implant placement and loading. Ricken et al. retrospectively collected clinical data from immediately loaded CAMLOG® implants in edentulous patients with a follow-up of up to five years (3). At least four abutments were always splinted together with a provisional on PEEK abutments. After final loading no implants were lost giving a survival rate of 99.2%. Commonly with de Lange et al., the authors concluded that with adequate bone quality and quantity at the implant site and good primary stability high success rates can be achieved with immediately loaded implants in edentulous patients. PROSTHETIC RESTORATIONS: SCIENTIFICALLY BASED TREATMENT OPTIONS
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