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Treatment guidelines

Edentulous

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Microbiology

Epithelial desquamation in the oropharynx limits bacterial accumulation, except on the tongue dorsum and in the tonsillar crypts. Loss of teeth dramatically reduces the load of periodontal pathogens except for Aggregatibacter actinomycetemcomitans and to a...

Implants in compromised sites
Local factors
Patient assessment
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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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Occlusion

A universally accepted definition of ideal occlusion has been elusive. This is because an ideal occlusion can only be defined in broad terms of a physiological range of form and function. Functional aspects of occlusion, rather than specific anatomical...

Biomechanics and occlusion
Patient assessment
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Treatment guidelines

Edentulous

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Hyposalivation and Xerostomia

Saliva plays a significant role in the preservation and maintenance of oral health and function. It supports digestion by preparing food for mastication and swallowing, contributes to taste perception, facilitates speech communication and provides oral tissues...

Local factors
Patient assessment
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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
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Treatment guidelines

Edentulous

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Existing prosthesis

Examination of existing dentures provides invaluable information on patients’ perceptions of teeth and soft tissue esthetics, including facial vertical dimension support. It also informs clinicians regarding their patients’ overall...

Diagnosis and treatment planning
Patient assessment
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Treatment guidelines

Edentulous

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Temporo-mandibular disorders (TMD)

Routine evaluation of a patient’s temporo-mandibular joint function is an integral part of any oral examination.
Moreover, good muscular control and painless coordination of jaw movements are desirable in the management of edentulism...

Temporomandibular Joint
Patient assessment
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Treatment guidelines

Edentulous

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The Maxillo-mandibular relationship

The key to understanding maxillo-mandibular jaw relations from a patient-centered treatment point of view is to recognize the inseparable nature of the mandible’s two positions - vertical and horizontal. They can be discussed...

Patient assessment
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Treatment guidelines

Edentulous

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Vertical dimension

The recording of patient-specific vertical and horizontal jaw relations is a necessary starting point when planning for the occlusal rehabilitation. They are integral components of the mandible’s centric relation (CR)...

Diagnosis and treatment planning
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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Lip line

Optimal esthetic treatment outcomes require a harmonious reconciliation between lip morhology and teeth positioning. Lips provide a picture frame for the anterior teeth that support them; with mouth size and labial contours depending on genetically...

Diagnosis and treatment planning
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