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Treatment guidelines

Single tooth

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Biologic complications

Extraction of teeth with persistent periapical lesions requires a specific drilling protocol to remove infected bone, to reach healthy trabecular bone and start up a bleeding. Residual dens sclerotic bone may harbor latent pathogenic microorganisms for a...

Complications & long-term success
Peri-implant therapy
Peri-implantitis
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Treatment guidelines

Edentulous

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Comprehensive treatment concepts, Zygomatic implants

Conventional dentures are a common treatment option, but, when bone is missing, they may not meet functional, psychological and social needs of the individual. Classical surgical approaches include different...

Radiology
Edentulous treatments
Implants in compromised sites
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Treatment guidelines

Edentulous

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Comprehensive treatment concepts, Pterygoid implants

In the edentulous upper jaw the placement of implants can be challenging due to limited bone quantity and the presence of the maxillary sinus. Pterygoid implants have high success rates, similar bone loss levels to those of ...

Posterior implants
Edentulous treatments
Implants in compromised sites
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Treatment guidelines

Edentulous

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All-on-4® treatment concept

Patients wearing complete dentures often suffer from esthetic and functional discomfort and compromised denture retention and chewing function. Denture adhesives are often applied. Many patients perceive this...

Edentulous treatments
Implants in compromised sites
Immediate loading / provisionalization
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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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Grafting, mandible

In the edentulous lower jaw implant insertion can be limited due to bone resorption processes and the resulting superficial alveolar nerve topography. In the anterior region less than 5-6 mm in height and 6 mm in width requires bone grafting before implant placement...

Edentulous treatments
Implants in compromised sites
Bone grafting and regeneration
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Treatment guidelines

Edentulous

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Tapered implant placement

With appropriate pre-drilling based on their shape upon insertion into the bone, tapered implants will achieve a gradually increasing contact pressure with the surrounding bone and thus provide a high primary stability. This primary...

Immediate implant placement
Edentulous treatments
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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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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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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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Biologic complications

This is the reversible inflammatory process in the soft tissues around functioning implants. Peri-implant mucositis occurs in almost 60% of subjects (± 30% of sites), restored with implants. Diagnosis is stated by clinical examination: redness, ...

Peri-implantitis
Peri-implant therapy
Local factors
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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