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Treatment guidelines

Edentulous

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Abutment materials

Implant-based prostheses can be cement-retained, screw-retained or a combination of both (Fig 1). By definition, an abutment is a component that is intermediate between the implant and the restoration and it is usually screw...

CAD/CAM
Prosthetic strategies
Prosthetic materials
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Treatment guidelines

Edentulous

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Direct to implant vs. abutment

Advantages of abutment-supported prostheses are 1) When implants are not parallel to each other, the use of angulated abutments can "correct" for the non-parallelism 2) Angulated abutments are available for a screw-retained prosthesis and 3) Custom abutments can be...

Prosthetic strategies
Prosthetic materials
Implant prosthetics
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Treatment guidelines

Edentulous

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Choice of implant

The majority of commercially available implants are variations of Brånemark’s original design of a screw which he coined as 'fixtures'. This has been the starting point for numerous current market variations that incorporate convergent themes of implant material...

Implant designs
Implant surfaces
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Treatment guidelines

Edentulous

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Alveolar atrophy and insufficiency

Teeth extractions are followed by a reduction of the bucco-lingual as well as the vertical dimension of the residual alveolar ridge. The ensuing resorption is progressive and even the basal jaw may become involved. In the lower jaw, the....

Radiology
Systemic factors
Patient assessment
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Treatment guidelines

Edentulous

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Post-placement

At this appointment, a careful evaluation of the patient's oral hygiene and soft tissue response is performed and adjustments made as needed. A daily home-care program must be customized to the individual's ability to clean the...

Aftercare / follow up
Fixed prosthetics
Oral hygiene instructions
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Treatment guidelines

Edentulous

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Post-surgical recommendations

Inform patient about adequate actions after surgery. Leave around the clock emergency contact numbers in case of urgent complications. Plan or delegate to the referring dentist postoperative recall visits, at day 1 or 2, day 8 - 14 and 4 – 6 weeks...

Aftercare / follow up
Oral hygiene instructions
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Treatment guidelines

Edentulous

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Oral hygiene instructions

All tissue surfaces, prosthesis surfaces and implant surfaces should be accessible by oral hygiene aids like toothbrushes, interdental brushes and dental floss or dental tape. It is paramount that, during treatment planning...

Aftercare / follow up
Fixed prosthetics
Oral hygiene instructions
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Treatment guidelines

Edentulous

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Professional oral hygiene

The regular recall control appointment, at least every 6 months, should comprise a hygiene check by the dental/oral hygienist or other auxiliary, and include professional cleaning of the restoration, prosthetic components, sulcus and any...

Aftercare / follow up
Fixed prosthetics
Oral hygiene instructions
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Treatment guidelines

Edentulous

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Head-neck cancer

Head and neck cancers is mainly represented by head and neck squamous cell carcinoma (HNSCC). Incidence in males is higher than in females (2,8:1). Human papilloma virus (HPV) has been demonstrated to be related to the increased...

Implants in compromised sites
Systemic factors
Patient assessment
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Treatment guidelines

Edentulous

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Mouth opening

Most patients’ mouth opening readily permits access for routine prosthodontic and surgical treatment interventions. Limited mouth opening or microstomia is encountered in patients exposed to sclerodermia, diffuse systemic...

Temporomandibular Joint
Systemic factors
Patient assessment
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Treatment guidelines

Edentulous

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Risk factors

Relevant risk factors for implant treatment:

  • Children and adolescents (during ongoing bone/skeletal development), unless in selected anodontia patients. However, implant placement for orthodontic treatment purposes is indicated.
  • Uncontrolled metabolic diseases such as Diabetes Mellit...
Local factors
Systemic factors
Patient assessment
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Treatment guidelines

Edentulous

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Radiotherapy

Radiotherapy

Rehabilitation of patients with oral cancers is usually done in a combined way with surgical, chemo- and radio-therapy. Radiotherapy predisposes to fibrotization, ischemia and xerostomia. The latter side-effect renders mucosally supported dentures even more difficult to...

Systemic factors
Patient assessment
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Treatment guidelines

Edentulous

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Steroids

A steroid is an organic compound and a type of lipid substance. Steroids play a critical role in metabolism, for example, as the dietary fat Cholesterol, as bile acids or as steroid hormones (e.g. Cortisone/Glucocorticoids, Estrogens, Testosterone). The more complex...

Systemic factors
Patient assessment
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Treatment guidelines

Edentulous

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BRONJ / ARONJ

A critical side effect in the oro-maxillo-facial region observed in patients undergoing administration over a long period of time and especially intravenously, bisphosphonate therapy may predispose to ‘bisphosphonate-related osteonecrosis of the...

Systemic factors
Patient assessment
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Treatment guidelines

Edentulous

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Bisphosphonates

Bisphosphonates (BP) inhibit osteoclast activity and remain in the bone for a prolonged period. Bisphosphonates are the most commonly prescribed drugs to treat osteoporosis, bone fragility disorders, like Paget’s disease, osteogenesis imperfecta...

Systemic factors
Patient assessment