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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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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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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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Number of implants maxilla and mandible

The tradition to insert 6 implants, and eventually more, in an arch-wide pattern dates back to the early days of osseointegration when implants with a machined surface were used and risk for early...

Implant prosthetics
Biomechanics and occlusion
Success & failure
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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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Occlusal schemes

A choice of occlusal schemes can be employed for the prosthodontic rehabilitation of the edentulous patient. Clinical outcomes with different schemes continue to be debated and no one scheme has emerged as clearly superior. However, although the...

Biomechanics and occlusion
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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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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
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Treatment guidelines

Edentulous

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Occlusion check

In the rush to meet patient demands for functional rehabilitation, the importance of occlusion is often overlooked. A check of the occlusion should be performed at every visit from insertion onwards because many problems with fixed dental prostheses can...

Biomechanics and occlusion
Aftercare / follow up