Prosthodontics is a dental specialty recognized by the ADA National Commission on Recognition of Dental Specialties and Certifying Boards and is the area of dentistry that focuses on dental prosthetics. The ADA has defined prosthodontics as “the dental specialty pertaining to the diagnosis, treatment planning, rehabilitation, and maintenance of oral function, comfort, appearance, and health of patients with clinical conditions associated with missing or deficient teeth and/or oral and maxillofacial tissues using biocompatible substitutes.”
A prosthodontist has three years of extended training in several areas of restorative dentistry, including dental implants, crowns, bridges, complete dentures, partial dentures, esthetics, occlusion, and facial and dental birth developmental defects. Prosthodontists are also trained in the technical and technological aspects of laboratory fabrication of complex dental prosthetics and complex restoration of dental and facial esthetics. Maxillofacial prosthetics is a branch of prosthodontics that requires one additional year of fellowship training with a focus on treatment of patients who have acquired and congenital defects of the head and neck region due to cancer, surgery, trauma, and birth defects.
Prosthodontics has an emphasis on the diagnosis and treatment planning of patients who have complex dental needs and on providing treatment services that primarily involve the repair or replacement of natural teeth with a variety of fixed or removable prosthetic options. Increased patient demand for esthetic services and for implant-supported prostheses has caused an increased emphasis on these types of procedures in prosthodontic training programs and practices. To successfully manage these patient needs, prosthodontists collaborate with all members of the dental team, including other specialty colleagues, general dentists, dental hygienists, and laboratory technicians. Through consultation and collaboration with the dental team, prosthodontists provide patients with a customized treatment plan and alternative options, with associated advantages, disadvantages, prognosis, risks, and time involved.
Through ongoing research and material development, the specialty of prosthodontics has strengthened and has taken advantage of new procedures and processes. The application of digital innovation in dentistry has been a major factor in the evolution of prosthodontics. As an example, in the area of dental implants prosthodontists routinely utilize cone beam computed tomography (CBCT) in the planning and placement of dental implants. Continuing beyond digital imaging, computer aided image capture, design and manufacturing of restorations has become the logical pathway for prosthodontics to follow. Innovative methods to help with the treatment of sleep apnea and temporomandibular joint disorders have also evolved over time as have the educational responsibilities to provide those services to patients served by prosthodontists.
Prosthodontics has evolved into its current form through the gradual assimilation of multiple distinct areas of dental practice. Fixed prosthodontics, removable prosthodontics, maxillofacial prosthetics and esthetic dentistry are unique aspects of the broader specialty of prosthodontics in its modern form. The application of dental implant therapy to patients with prosthodontic needs has, perhaps, been the greatest single advance and addition to the treatment procedures provided by the specialty. The ability to replace a tooth or multiple teeth with restorations supported by prosthetic root replacements has dramatically improved the ability of prosthodontists to serve their patients. The surgical placement of implants as prosthetic replacements for natural tooth roots has become standard practice in prosthodontics. The review/defense of the specialty document published in 1999 stated, “Virtually every active practitioner of the specialty of prosthodontics is heavily involved with planning, placement and restoration of dental implants on a daily basis (data obtained from ACP membership database).” Dental implant planning, placement and restoration will continue to be an important focus of the specialty into the foreseeable future.
Prosthodontics continues to evolve as a dental specialty and it is anticipated that the services provided by the specialty will continue to be of value to the profession and the public.