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Treatment guidelines

Edentulous

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Implant placement with open flap procedure - mandible

The surgeon should be standing or be seated behind the supine patient. Bilateral truncular anesthesia is needed. The incision can be crestal or at a distance in the labial fold. Presence of keratinized tissue both labially and palatally should...

Edentulous treatments
Soft tissue management
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Treatment guidelines

Edentulous

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Semi-guided surgery with prosthetic template

Hand-made templates are duplicates obtained from the denture/tooth arrangement with access holes or titanium tubes. These are located in the correct positions and axes of the planned prosthetic teeth according to the CBCT a...

Guided Surgery
Edentulous treatments
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Treatment guidelines

Edentulous

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Implant placement - maxilla

Incision can be made either on top of the crest or at some distance in the labial fold. The outcome for both approaches seems comparable. A sagittal release incision at the midline eases the reflection of the labial mucoperiosteum. It is logical to try to achieve...

Edentulous treatments
Soft tissue management
Implant prosthetics
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Treatment guidelines

Edentulous

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Guided vs non-guided

Accurate implant planning is the first step to achieve an optimum prosthetic result. Well-fitting, well-designed dentures can directly be used for planning and pre-surgical analysis or a new tooth arrangement and mock-up have to be considered...

Guided Surgery
Edentulous treatments
Diagnosis and treatment planning
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Treatment guidelines

Edentulous

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Crestal/paracrestal Incision

Any intra-oral surgical intervention begins with the incision and finishes with a suture or gluing. Indications for a crestal incision include one-stage surgeries where the implant or abutment is non-submerged and is piercing into the oral...

Edentulous treatments
Soft tissue management
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Treatment guidelines

Edentulous

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Soft tissue management

The aims of peri-implant soft tissue management in the edentulous mandible are the eventual reconstruction of attached gingiva or immobilizing the soft tissue at the implant-soft tissue interface. Vestibuloplasty means deepening of the...

Soft tissue management
Peri-implant therapy
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Treatment guidelines

Edentulous

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Guided surgery with drill guides

Surgery using a drill guide fabricated on the basis of CT scan images transformed by a planning software offers several clinical advantages...

Radiology
Digital workflow
Guided Surgery
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Treatment guidelines

Edentulous

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Wound closure

Wound closure ensures and accelerates wound healing by protecting the site and influencing migration of keratinocytes over the granulation tissue. Some wound eversion maximizes epidermal approximation. Square knots, with two ties in one direction and a reverse...

Soft tissue management
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Treatment guidelines

Edentulous

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Flap or flapless

Flapless implant surgery is a minimally invasive procedure that can be performed either using guided surgery or custom fabricated surgical guides made of casts taken at the first patient visit. Several clinical papers reported excellent short- and long...

Radiology
Guided Surgery
Edentulous treatments
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Treatment guidelines

Edentulous

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Provisionals

Conceptually, a provisional prosthesis for an edentulous patient is a convenient tool that offers the patient a satisfactory level of function and esthetic appearance while definitive treatment is undertaken...

Guided Surgery
Immediate loading / provisionalization
Diagnosis and treatment planning
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Treatment guidelines

Edentulous

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Splints for imaging and surgery

The primary goal of creating a preliminary teeth arrangement for a try-in diagnostic evaluation is the opportunity to visualize those specific morphological features that impact functional and esthetic considerations for each treated patient...

Radiology
Guided Surgery
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Treatment guidelines

Edentulous

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Muco-gingival junction

The gingiva is tightly connected to the underlying periosteum. It is globally keratinized and has a stippled surface. Its color varies from pink to brown or even black, depending on race and/or melanin deposits. It can be distinguished from alveolar mucosa, which...

Soft tissue management
Patient assessment