Abstract
It is well known that implant treatment based on the concept of osseointegration is an effective option in contemporary dentistry. The original protocol of the Brånemark system recommends the shortened dental arch (SDA) in a totally edentulous jaw. Several Japanese patients were unsatisfied with thelack of second molars in terms of masticatory function and self-confidence. The author started theapplication combined with anterior and posterior fixtures even in the totally edentulous jaw in orderto restore second molars in 1985. There were thought to be some disadvantages of such applicationin the beginning, but these were verified by the long-term clinical cases to be imaginary. Furthermore, restoration with second molars brings functional and mental satisfaction to patients. Installation intomaxillary tuberosity, pterygoid process and/or palatine process has been done and shows excellentresults. This paper discuss several options of design of the superstructure, in order to avoid SDA thatis not acceptable for old-fashioned prosthodontists.
