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Treatment guidelines

Edentulous

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Primary splinting

Implant supported overdentures are an evidence-based treatment option for edentulous patients leading to a significantly increased quality of life.
There are various retention elements available which connect the implants directly...

CAD/CAM
Prosthetic materials
Implant prosthetics
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Treatment guidelines

Edentulous

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Secondary splinting

Implant overdentures are an excellent treatment option for edentulous patients and lead to significant improvement of quality of life. There are various options for their retention mechanism...

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Prosthetic materials
Implant prosthetics
Removable prosthetics
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Treatment guidelines

Edentulous

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Sinus lifting

Less than 4-6 mm of vertical residual bone height in the posterior segment of the maxilla is an indication for a sinus augmentation procedure [Esposito]. The external access to the maxillary sinus is carried out at a lateral buccal alveolar...

Posterior implants
Sinus augmentation
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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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Grafting, maxilla

In the edentulous upper jaw implant insertion can be limited due to the adjacent anatomical structures (nasal floor, maxillary sinus). Less than 5-6 mm in height and 6 mm in width requires augmentation before implant placement....

Bone grafting and regeneration
Sinus augmentation
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Treatment guidelines

Edentulous

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Soft tissue and hard tissue

Removable prostheses should always be removed over night. Since the acrylic denture base is tightly covering the keratinised mucosa, it often leads to fungal/candida infections of the ginigiva under the prosthesis....

Aftercare / follow up
Fixed prosthetics
Removable prosthetics
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Treatment guidelines

Edentulous

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Radiological Control

At the beginning of the recall control it is necessary to define the intention of a radiograhical control and if it is needed. Radiological controls are only justified in the presence of certain symptoms, anamnesis and/or clinical examination...

Radiology
Aftercare / follow up
Peri-implant therapy
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Treatment guidelines

Edentulous

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Post operative soft tissue management

After treatment of edentulous patients, there is no need to schedule specific recalls for soft tissue control. Traditional post-operative controls at day 1 - 3, day 7 - 14 and week 4 - 6 after surgery involve soft tissue control and...

Aftercare / follow up
Success & failure
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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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Implant overdenture maintenance

The objective of systematic periodic recalls for patients wearing overdentures are three-fold...

Aftercare / follow up
Removable prosthetics
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Treatment guidelines

Edentulous

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General health check

Patient health can change considerably over time - therefore at every recall visit, check and get updated information on general health of patient, and if needed adapt maintenance policy adequately. Information (for example a poster)...

Aftercare / follow up
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Treatment guidelines

Edentulous

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Inflammation and infection

Inflammation can be limited to the soft tissue around the implant (mucositis) or involve the underlying bone tissue as well (peri-implantitis). Infection can be caused by various risk factors, such as inadequate hygiene and patient compliance...

Peri-implantitis
Aftercare / follow up
Peri-implant therapy
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Treatment guidelines

Edentulous

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Suture removal

Suture removal for mucoperiosteal wounds, depending on the age of the patient and the extent of the wound takes place after 8 to 12 days. Even resorbable sutures may benefit after such healing time from removal of remnants...

 

Aftercare / follow up
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Treatment guidelines

Edentulous

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Bleeding

Damage of sublingual arteries can lead to intense hemorrhage. Subsequent elevation of floor of the mouth can lead to (fatal) airway obstruction ! An early symptom of sublingual swelling may be a muffled speech. In such situation ensure free airways (intubation, tracheotomy),...

Aftercare / follow up
Success & failure
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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