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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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Dentogingival complex and biologic width

The peri-implant mucosa consists of an externally located keratinized oral epithelium, which is connected to the peri-implant junctional epithelium facing the abutment. The latter extends approximately 2 mm apical to the...

Soft tissue management
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Treatment guidelines

Edentulous

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Veneering with Acrylic

Frameworks are veneered with veneering materials, to design the esthetics and shape of the definitive restoration. Framework material options for acrylic veneering include titanium, (CrCo) Cobalt - Chrome and precious alloys...

CAD/CAM
Prosthetic materials
Implant prosthetics
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Treatment guidelines

Edentulous

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Veneering with Ceramic

Frameworks can be made from titanium, zirconia, precious alloys and Co-Cr base alloys and can be cement-retained or screw-retained. With minimal bone resorption, a ceramo-metal restoration is preferable to accommodate interarch...

CAD/CAM
Prosthetic materials
Implant prosthetics
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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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Secondary splinting

Implant overdentures are an excellent treatment option for edentulous patients and lead to significant improvement of quality of life. There are various options for their retention mechanism...

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Prosthetic materials
Implant prosthetics
Removable prosthetics
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Treatment guidelines

Edentulous

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Implant placement with open flap procedure - mandible

The surgeon should be standing or be seated behind the supine patient. Bilateral truncular anesthesia is needed. The incision can be crestal or at a distance in the labial fold. Presence of keratinized tissue both labially and palatally should...

Edentulous treatments
Soft tissue management
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Treatment guidelines

Edentulous

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Implant placement - maxilla

Incision can be made either on top of the crest or at some distance in the labial fold. The outcome for both approaches seems comparable. A sagittal release incision at the midline eases the reflection of the labial mucoperiosteum. It is logical to try to achieve...

Edentulous treatments
Soft tissue management
Implant prosthetics
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Treatment guidelines

Edentulous

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Crestal/paracrestal Incision

Any intra-oral surgical intervention begins with the incision and finishes with a suture or gluing. Indications for a crestal incision include one-stage surgeries where the implant or abutment is non-submerged and is piercing into the oral...

Edentulous treatments
Soft tissue management
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Treatment guidelines

Edentulous

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Soft tissue management

The aims of peri-implant soft tissue management in the edentulous mandible are the eventual reconstruction of attached gingiva or immobilizing the soft tissue at the implant-soft tissue interface. Vestibuloplasty means deepening of the...

Soft tissue management
Peri-implant therapy
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Treatment guidelines

Edentulous

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Soft tissue and hard tissue

Removable prostheses should always be removed over night. Since the acrylic denture base is tightly covering the keratinised mucosa, it often leads to fungal/candida infections of the ginigiva under the prosthesis....

Aftercare / follow up
Fixed prosthetics
Removable prosthetics
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Treatment guidelines

Edentulous

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Biologic complications

This is the reversible inflammatory process in the soft tissues around functioning implants. Peri-implant mucositis occurs in almost 60% of subjects (± 30% of sites), restored with implants. Diagnosis is stated by clinical examination: redness, ...

Peri-implantitis
Peri-implant therapy
Local factors
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Treatment guidelines

Edentulous

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Implant overdenture maintenance

The objective of systematic periodic recalls for patients wearing overdentures are three-fold...

Aftercare / follow up
Removable prosthetics
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Treatment guidelines

Edentulous

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Inflammation and infection

Inflammation can be limited to the soft tissue around the implant (mucositis) or involve the underlying bone tissue as well (peri-implantitis). Infection can be caused by various risk factors, such as inadequate hygiene and patient compliance...

Peri-implantitis
Aftercare / follow up
Peri-implant therapy
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Treatment guidelines

Edentulous

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Infection - microbiological diagnostics

Presence/number of implants influences aerobe and anaerobe species in saliva and on tongue in edentulism. Subgingival microbiota in periimplantitis vary according to studies. Less periodontal pathogens than in partial edentulism. Prevotella nigrescens,...

Peri-implantitis
Aftercare / follow up
Peri-implant therapy