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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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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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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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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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Time to function

Traditional endosseous oral implant treatment protocols ad modum Brånemark required a variable healing period (usually 3-6 months) before prosthesis placement. The healing period was considered necessary to achieve osseointegration and establish a load-bearing interface...

Immediate loading / provisionalization
Success & failure
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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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Grafting, maxilla

In the edentulous upper jaw implant insertion can be limited due to the adjacent anatomical structures (nasal floor, maxillary sinus). Less than 5-6 mm in height and 6 mm in width requires augmentation before implant placement....

Bone grafting and regeneration
Sinus augmentation
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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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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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Oral hygiene instructions

All tissue surfaces, prosthesis surfaces and implant surfaces should be accessible by oral hygiene aids like toothbrushes, interdental brushes and dental floss or dental tape. It is paramount that, during treatment planning...

Aftercare / follow up
Fixed prosthetics
Oral hygiene instructions
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Treatment guidelines

Edentulous

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Provisionals/temporary prosthesis

Whenever possible, provisional restorations should be fabricated to simulate the desired definitive prosthesis in form, albeit with different and less durable materials. The lessened durability and functional capacity of a provisional restoration...

Immediate loading / provisionalization
Aftercare / follow up