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Treatment guidelines

Edentulous

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Skeletal consequences of edentulism

Teeth loss in the maxilla initiates residual ridge/alveolar resorption, especially in the anterior region, which is flared labially. The consequences of this resorption is a gradual medial or palatal shift of the crest of the maxilla. This...

Patient assessment
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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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Overarching considerations

The primary goal is a proper oral function. This implies not only chewing but also speaking, smiling. Patients’ adaptability varies enormously. Some are satisfied with removable dentures, others object to the esthetics of...

Local factors
Patient assessment
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Treatment guidelines

Edentulous

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Anesthesia

The choice of anesthesia depends on many variables including the complexity of treatment, duration of treatment, need for patient awareness and the response during treatment, only to name a few. In general, the clinician and patient should discuss the...

Patient assessment
Preoperative procedures
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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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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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Radiological Control

At the beginning of the recall control it is necessary to define the intention of a radiograhical control and if it is needed. Radiological controls are only justified in the presence of certain symptoms, anamnesis and/or clinical examination...

Radiology
Aftercare / follow up
Peri-implant therapy
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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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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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General health check

Patient health can change considerably over time - therefore at every recall visit, check and get updated information on general health of patient, and if needed adapt maintenance policy adequately. Information (for example a poster)...

Aftercare / follow up
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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
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Treatment guidelines

Edentulous

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Patient expectations

Addressing the patient’s chief complaints satisfactorily and meeting patient expectations lies at the core of all dental therapy. The best way to ensure that patient expectations are met or exceeded is by thoughtful listening during the diagnosis...

Diagnosis and treatment planning
Aftercare / follow up
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Treatment guidelines

Edentulous

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Patient compliance/recall

Patient compliance is a critical factor in promoting the long-term success of oral rehabilitation. The issue of patient compliance should be enthusiastically engaged by the clinician/dental practitioner. The practitioner may see a non-compliant...

Aftercare / follow up
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Treatment guidelines

Edentulous

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Occlusal guard

The use of acrylic or porcelain artificial teeth brings different challenges related to nocturnal paranormal function. High occlusal forces can be mitigated by wearing of a protective occlusal guard. Acrylic teeth may wear over time and/or become dislodged from...

Aftercare / follow up