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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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Anatomical location

Oral implants are usually placed in the mandibular and maxillary bone and sometimes in additional bone structures such as the zygomatic, pterygoid or vomer bone. In order to identify relevant anatomical structures, diagnostic evaluation of the anatomy...

Radiology
Implants in compromised sites
Patient assessment
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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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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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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 present an alternative option to use residual bone for implant anchorage and to overcome the need for...

Posterior implants
Implants in compromised sites
Success & failure
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Treatment guidelines

Edentulous

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Zygomatic implants

Indications

Zygomatic implants have been documented as a an alternative for the rehabilitation of the atrophic posterior maxilla with both the classical two stage and immediate loading protocols. Zygomatic implants avoid grafting and sinus lift procedures and therefore contribut

Posterior implants
Implants in compromised sites
Success & failure
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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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Digital treatment planning protocols, introduction

Spiral or Cone Beam CT (CBCT) data sets of the patient jaw bones and of the scan template are transcoded by a specific software to produce three-dimensional (3-D) images of the jaw bones and thickness of the mucosa. Software planning... 

Radiology
CAD/CAM
Diagnosis and treatment planning
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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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Anesthesia

The choice of anesthesia depends on many variables including the complexity of treatment, duration of treatment, need for patient awareness and the response during treatment, only to name a few. In general, the clinician and patient should discuss the...

Patient assessment
Preoperative procedures
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Treatment guidelines

Edentulous

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Hard tissue management - mandible

The scientific literature shows that short implants with a length of ≥ 6 mm are able to support prosthetics in the edentulous mandible. After tooth removal the mandible displays different degrees of atrophy (Fig 1&2). Regarding hard tissue management...

Radiology
Bone grafting and regeneration
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Treatment guidelines

Edentulous

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Need for grafting

There are three main indications for grafting from an anatomical perspective...

Radiology
Bone grafting and regeneration
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Treatment guidelines

Edentulous

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Hard tissue management - maxilla

3-D imaging seems the best option unless clinical examination reveals an ample bone volume. The bone quality can be derived from density measurements if CT scan images are available or approximately from the trabecular pattern of 2-D images. Pano....

Radiology
Bone grafting and regeneration
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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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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