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Treatment guidelines

Edentulous

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Skeletal consequences of edentulism

Teeth loss in the maxilla initiates residual ridge/alveolar resorption, especially in the anterior region, which is flared labially. The consequences of this resorption is a gradual medial or palatal shift of the crest of the maxilla. This...

Patient assessment
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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

Single tooth

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Anterior and posterior location considerations

Missing single teeth imply a variety of bone sites for implant placement. Incisor regions are frequently impeded by inadequate mesio-distal and/or bucco-lingual bone dimensions, whereas second bicuspid/molar regions are generally affected by inadequate...

Radiology
Patient assessment
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Treatment guidelines

Single tooth

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Patient communication requirements

The process of informed consent requires a thorough communication between healthcare professional and patient. The communication should minimally comprise...

Patient assessment
Preoperative procedures
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Treatment guidelines

Single tooth

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Alternative treatment options

There are several treatment options for a single missing tooth; the most common are an implant-supported crown, a 3-unit fixed partial denture supported by two natural teeth, a fixed resin-bonded fixed partial denture, a removable partial denture...

Patient assessment
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Treatment guidelines

Single tooth

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Benefits and limitations of single implant treatment

The application of implants for single-tooth replacements has evolved into a viable surgical and prosthodontic treatment option with reporting of excellent implant survival rates and satisfied patients. Psychological benefits of restoring the dental...

Diagnosis and treatment planning
Patient assessment
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Treatment guidelines

Single tooth

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General patient history

It is helpful if a clinician is situated so that his/her eyes are at the level of the patient's eyes. For example, if the patient is seated, the clinician should also be seated. It is beneficial if the interview between clinician and...

Systemic factors
Patient assessment
Preoperative procedures
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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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Overarching considerations

The primary goal is a proper oral function. This implies not only chewing but also speaking, smiling. Patients’ adaptability varies enormously. Some are satisfied with removable dentures, others object to the esthetics of...

Local factors
Patient assessment
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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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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
icon-treatment_guides_article

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