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Treatment guidelines

Edentulous

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Cement-retained restorations, overview

Cement-retained restorations are a traditional design to attach a restoration (crown, bridge) to an implant-retained abutment, similar to cementing a crown or bridge restoration on a natural tooth. With the traditional, relatively...

CAD/CAM
Prosthetic materials
Implant prosthetics
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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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Abutment materials

Implant-based prostheses can be cement-retained, screw-retained or a combination of both (Fig 1). By definition, an abutment is a component that is intermediate between the implant and the restoration and it is usually screw...

CAD/CAM
Prosthetic strategies
Prosthetic materials
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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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Direct to implant vs. abutment

Advantages of abutment-supported prostheses are 1) When implants are not parallel to each other, the use of angulated abutments can "correct" for the non-parallelism 2) Angulated abutments are available for a screw-retained prosthesis and 3) Custom abutments can be...

Prosthetic strategies
Prosthetic materials
Implant prosthetics
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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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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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Post-placement

At this appointment, a careful evaluation of the patient's oral hygiene and soft tissue response is performed and adjustments made as needed. A daily home-care program must be customized to the individual's ability to clean the...

Aftercare / follow up
Fixed prosthetics
Oral hygiene instructions
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Treatment guidelines

Edentulous

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Placement

Placement of a provisional prosthesis takes place by attaching the conversion denture (either patient's exisiting prosthesis or a new conversion denture) to the implants or to implant abutments. The provisional prosthesis can be...

Implant prosthetics
Fixed 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
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Treatment guidelines

Edentulous

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Professional oral hygiene

The regular recall control appointment, at least every 6 months, should comprise a hygiene check by the dental/oral hygienist or other auxiliary, and include professional cleaning of the restoration, prosthetic components, sulcus and any...

Aftercare / follow up
Fixed prosthetics
Oral hygiene instructions
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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