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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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General patient history

It is helpful if a clinician is situated so that his/her eyes are at the level of the patient's eyes. For example, if the patient is seated, the clinician should also be seated. It is beneficial if the interview between clinician and...

Systemic factors
Patient assessment
Preoperative procedures
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Treatment guidelines

Edentulous

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Framework materials

A commonly used option for fixed restorations is a metal or zirconia framework with ceramic or acrylic veneering. The amount of alveolar bone resorption determines whether teeth or teeth and soft tissue must be replaced...

Digital workflow
CAD/CAM
Prosthetic materials
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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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Alveolar atrophy and insufficiency

Teeth extractions are followed by a reduction of the bucco-lingual as well as the vertical dimension of the residual alveolar ridge. The ensuing resorption is progressive and even the basal jaw may become involved. In the lower jaw, the....

Radiology
Systemic factors
Patient assessment
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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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Implant overdenture impressions

Impression making in implant overdenture therapy simultaneously records healthy available denture-bearing tissue surfaces and implants’ positions in edentulous arches. The objective is a shared retention and...

Digital workflow
Implant prosthetics
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Treatment guidelines

Edentulous

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Complete denture impressions

Impression taking for a complete denture records available denture-bearing tissue surfaces. An ideal force distribution pattern based upon the load bearing capacity of supporting tissues is desirable while avoiding dislodging by the oro-facial...

Digital workflow
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Treatment guidelines

Edentulous

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Wax-up, arrangement, mock-up

Treatment planning for the edentulous patient requires a diagnostic tooth arrangement which provides valuable information for pre-surgical planning (surgical guide fabrication), facilitates discussion regarding...

Digital workflow
CAD/CAM
Diagnosis and treatment planning
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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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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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Risk factors

Relevant risk factors for implant treatment:

  • Children and adolescents (during ongoing bone/skeletal development), unless in selected anodontia patients. However, implant placement for orthodontic treatment purposes is indicated.
  • Uncontrolled metabolic diseases such as Diabetes Mellit...
Local factors
Systemic factors
Patient assessment
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Treatment guidelines

Edentulous

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Radiotherapy

Radiotherapy

Rehabilitation of patients with oral cancers is usually done in a combined way with surgical, chemo- and radio-therapy. Radiotherapy predisposes to fibrotization, ischemia and xerostomia. The latter side-effect renders mucosally supported dentures even more difficult to...

Systemic factors
Patient assessment