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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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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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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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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
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Treatment guidelines

Edentulous

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Immediate dentures

The patient with a terminal dentition and who faces total teeth extractions can choose from a number of treatment options from immediate complete denture to one of the implant supported protocols.
Immediate dentures are chosen by patients who are unwilling...

Biomechanics and occlusion
Immediate loading / provisionalization
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Treatment guidelines

Edentulous

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Provisionals

Conceptually, a provisional prosthesis for an edentulous patient is a convenient tool that offers the patient a satisfactory level of function and esthetic appearance while definitive treatment is undertaken...

Guided Surgery
Immediate loading / provisionalization
Diagnosis and treatment planning
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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
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Treatment guidelines

Edentulous

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Local history

The key questions in a complete anamnesis are related to: mouth opening, salivary output, presence of mucosal diseases, gingival health, signs of previous periodontal surgeries, tooth hypermobility, TMJ problems, orthodontic...

Temporomandibular Joint
Local factors
Systemic factors