The best way to avoid many of the problems that come up is, to begin with planning the prosthetics. The prosthetic options and available space must be addressed first, then the surgical plan should attempt to support the restorations planned.

Approaching implant dentistry as a prosthetically driven discipline, not just as a surgically driven one, is the only way to accomplish predictable restorative results. Yet more often than not, the restorative dentist defers to the specialist to place the implant in the “right place”. This all too often leads to restorative challenges. Defining restorative goals and evaluating existing parameters must be the first steps in the treatment progression.

Dr. Carl Misch defined a prioritized order of progression for implant dentistry.  Misch’s evaluation criteria are listed below in descending order of importance, beginning with prosthetic design.