Pierre de Grandmont: Missing multiple posterior teeth: treatment planning considerations

The lecture discusses the need for treatment and the treatment options in multiple posterior missing teeth cases, as well as the barriers to such treatments. Treatment of missing teeth is not necessary in all cases, as long as there is adaptive capacity to maintain oral function with at least 4 occlusal units left, preferably in a symmetric position. However, patients seek treatment mainly for social and esthetic reasons. When treating, the factors longevity/evidence based prognosis, patient mediated factors and local&systemic factors have to considered. Comparison of available long-term study data suggest that implant based FPD perform better than FPD or RPD. However there is still lack of evidence to support a specific treatment choice. Barriers to treatment may be patient's preferences, perceived lack of need for treatment, previous experiences with dental treatment and financial considerations, as well as anatomical and medical considerations. Dr de Grandmont concludes that simplified procedures and reduced cost could allow more patients to benefit from implant treatment.