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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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Number of implants maxilla and mandible

The tradition to insert 6 implants, and eventually more, in an arch-wide pattern dates back to the early days of osseointegration when implants with a machined surface were used and risk for early...

Implant prosthetics
Biomechanics and occlusion
Success & failure
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Treatment guidelines

Edentulous

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Healed vs fresh extraction socket

The treatment of the edentulous jaw can be a mixture of placing implants in healed and fresh extraction sockets. Unequal hard and soft tissue levels around the implants (Fig. 1&2), especially in the interforaminal region, can be adjusted by leveling the bone...

Immediate implant placement
Success & failure
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Treatment guidelines

Edentulous

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Occlusal schemes

A choice of occlusal schemes can be employed for the prosthodontic rehabilitation of the edentulous patient. Clinical outcomes with different schemes continue to be debated and no one scheme has emerged as clearly superior. However, although the...

Biomechanics and occlusion
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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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Occlusion check

In the rush to meet patient demands for functional rehabilitation, the importance of occlusion is often overlooked. A check of the occlusion should be performed at every visit from insertion onwards because many problems with fixed dental prostheses can...

Biomechanics and occlusion
Aftercare / follow up
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Treatment guidelines

Edentulous

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Overdenture retention devices, overview

Attachment selection

The relative merits of different prosthodontic treatment objectives - resilient versus rigid attachments - are controversial and empirical. A resilient retention mechanism is recommended on the assumption that this will protect implants from overload; while in...

Prosthetic materials
Implant prosthetics
Biomechanics and occlusion
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Treatment guidelines

Edentulous

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Immediate dentures

The patient with a terminal dentition and who faces total teeth extractions can choose from a number of treatment options from immediate complete denture to one of the implant supported protocols.
Immediate dentures are chosen by patients who are unwilling...

Biomechanics and occlusion
Immediate loading / provisionalization
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Treatment guidelines

Edentulous

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Mucosally supported removable - complete denture

Research and clinical experience show that conventional complete dentures are acceptable for a large segment of the edentulous population. Satisfied complete denture wearers are well adapted to their prosthodontic experience and have...

Biomechanics and occlusion
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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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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