Chapter 1

Introduction

The primary focus of attention in implant dentistry has shifted from the achievement of osseointegration, since this can be achieved so predictably,1–11 and has now become centred on the creation of aesthetic implant-supported restorations that mimic the tooth being replaced. A host of supplementary treatment options has been devised in an aim to achieve this goal. Many of these techniques are supported by research that documents a high degree of predictability. Others, however, are mainly based on case studies without any long-term clinical follow-up.

Clinicians, therefore, need to be able to discrimin­ate between those techniques that will be of benefit to patients with a minimal risk of failure. Furthermore, the clinician needs to function within a framework that offers him or her clear-cut options which can be followed when presented with a problem that needs to be solved. The assessment of the patient is, therefore, critical and should accurately define the problem, which will, in turn, make the ideal treatment self-evident.

The ultimate goal of the treatment is to produce teeth that are aesthetically and functionally acceptable. It is, therefore, appropriate to start any treatment planning by first determining th/>