The main focus of this article lies on elderly, partially dentate and edentulous patients with implant-supported or implant-retained reconstructions. Individual patient needs and how they are met are discussed, as are fabrication technologies, questions regarding choice of material, and the conceptual collaboration between the dentist and the dental technician. Ultimately, this article makes a case for modern reconstructive dentistry that offers a sophisticated treatment concept adapted to the needs of each patient. It intends to raise awareness of the variety and versatility of the available approaches.

At what age is an individual considered elderly or old? There is no hard and fast rule, as this question has a philosophical component in which medical, social, and psychological factors play a role (Bürger 1960; Rowe et al. 1997). The natural process of aging is progressive and irreversible, and pathological changes may influence and accelerate the process.

The far-reaching consequences of the aging process are also felt in the field of dentistry. Physiological and pathological changes can affect teeth, nerves, muscles, and hard and soft tissues. Aging can thus influence the ability to chew, swallow, and interact as well as esthetics (Müller et al. 2016a). Poor chewing efficiency and/or pain related to teeth or dentures affect food intake, which may have consequences for general health (Schimmel et al. 2015). Missing teeth or poorly fitting dentures can have a negative effect on social interactions and self-esteem (Stenman et al. 2012). Dental care is an indispensable aspect of maintaining quality of life in old age.

Oral hygiene to maintain oral and general health is the primary goal in care for elderly patients. Well-designed and well-fitting prosthetic reconstructions of missing teeth are further important factors to restore function, esthetics, and quality of life. Whereas in former decades, prosthetic treatment for elderly patients meant in most cases full denture prosthodontics, the picture has changed in recent years. An increasing number of individuals retain their natural dentition until late in life, and the relative number of edentulous patients is decreasing at a high rate (Jordan et al. 2016; Schneider et al. 2017; Slade et al. 2014). However, the total number of elderly patients is increasing dramatically due to demographic changes; hence, edentulism is not likely to be eliminated in the near future. In the United States alone, it is estimated that 10% of the total adult population is edentulous, i.e. 32-35 million edentulous patients (Slade et al. 2014).

Each member of the reconstructive team must naturally be familiar with the basics of partial and full denture prosthetics, static and dynamic load and occlusion, as well as phonetics. Equally important are the “soft” factors when dealing with patients that make personal contact with the patient advisable, if not indispensable. Here, it is worth considering some characteristics of the age group. Among these are possible difficulties associated with the loss of a partner, physical or psychological illness, use of medication, eating habits, or a change in the ability to adapt and react. Dealing with (older) patients demands empathy and understanding for their situation. Dentists and dental technicians should, therefore, periodically update their awareness of the basic tasks carried out by natural teeth, and the oro-facial system in general (Chen et al. 2012). Tooth loss leads to anatomical and morphological changes with which many patients have difficulty coping. Quality of life is restored only when patients are in possession of a functional prosthesis tailored to their individual needs.

The expectations of young-old patients, the so-called baby boomers now reaching retirement age, has increased with respect to the quality, function, and esthetics of their prosthetic restorations. We are currently observing the transition from one generation of older patients – the post-war generation – to the next – the baby boomers (Schimmel et al. 2017a). The latter are accustomed to a high level of service from dentists and dental technicians that they do not intend to forego as they grow older. Many older people are looking for an esthetic restoration that looks perfectly natural (Fig. 1). As a result, a stronger focus on implant prosthetics is developing in the rehabilitation of elderly patients. Implant therapy renders various therapy options possible to edentulous patients – from simple and functional to functionally and esthetically high-end solutions. In order to provide this kind of restoration, dental technicians need detailed knowledge of the positioning of prosthetic teeth, materials, and function as well as of the above-mentioned soft factors. They must also understand how these individual aspects interact, and appraise the significance of the restoration to the patient.

Regrettably, the manufacture of removable partial and full dental prostheses is frequently given little attention by the dental laboratory. What is achieved to perfection by dental technicians in other areas such as fixed restorations, should also be a matter of course for removable prostheses. This is where priorities need to be set in an age cohort in which up to 50% wear removable dental prostheses (RDP) (Schneider et al. 2017). Highly qualified dental technicians are needed within the treatment team that looks after partially dentate and edentulous patients in order to assist in finding the single optimal choice from the variety of restoration options available. As both the complexity of reconstructive work and average patient age continue to increase, one person needs to take the lead and maintain an overview of the entire process. This influences communications between the dentist, patient, and dental technician in which digital channels of communications are playing an increasingly greater role.