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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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All-on-4® treatment concept

Patients wearing complete dentures often suffer from esthetic and functional discomfort and compromised denture retention and chewing function. Denture adhesives are often applied. Many patients perceive this...

Edentulous treatments
Implants in compromised sites
Immediate loading / provisionalization
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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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Grafting, mandible

In the edentulous lower jaw implant insertion can be limited due to bone resorption processes and the resulting superficial alveolar nerve topography. In the anterior region less than 5-6 mm in height and 6 mm in width requires bone grafting before implant placement...

Edentulous treatments
Implants in compromised sites
Bone grafting and regeneration
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Treatment guidelines

Edentulous

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Placement of implants - Angulation

The primary goal of angulated implant placement concepts is the implant-based prosthodontic rehabilitation of the edentulous maxilla and mandible and avoiding grafting procedures and thereby offering a more simple and less invasive treatment...

Edentulous treatments
Implants in compromised sites
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Treatment guidelines

Edentulous

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Intra-operative complications

In the atrophic mandible soft tissues become prominent and the inferior alveolar nerve is located more superficially.
Fractures of the atrophic edentulous mandible can occur during implant insertion. Especially in hard bone...

Implants in compromised sites
Success & failure
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Treatment guidelines

Edentulous

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Flap or flapless

Flapless implant surgery is a minimally invasive procedure that can be performed either using guided surgery or custom fabricated surgical guides made of casts taken at the first patient visit. Several clinical papers reported excellent short- and long...

Radiology
Guided Surgery
Edentulous treatments
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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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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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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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Parafunction

Parafunctional activities can apply high forces to both implant and prosthetic components. These forces can lead to fracture or loosening of screws and abutments, chipping of the veneering material or fracture of the prosthetic reconstruction...

Temporomandibular Joint
Implant designs
Biomechanics and occlusion