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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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Semi-guided surgery with prosthetic template

Hand-made templates are duplicates obtained from the denture/tooth arrangement with access holes or titanium tubes. These are located in the correct positions and axes of the planned prosthetic teeth according to the CBCT a...

Guided Surgery
Edentulous treatments
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Treatment guidelines

Edentulous

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Guided vs non-guided

Accurate implant planning is the first step to achieve an optimum prosthetic result. Well-fitting, well-designed dentures can directly be used for planning and pre-surgical analysis or a new tooth arrangement and mock-up have to be considered...

Guided Surgery
Edentulous treatments
Diagnosis and treatment planning
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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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Flap or flapless

Flapless implant surgery is a minimally invasive procedure that can be performed either using guided surgery or custom fabricated surgical guides made of casts taken at the first patient visit. Several clinical papers reported excellent short- and long...

Radiology
Guided Surgery
Edentulous treatments
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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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Splints for imaging and surgery

The primary goal of creating a preliminary teeth arrangement for a try-in diagnostic evaluation is the opportunity to visualize those specific morphological features that impact functional and esthetic considerations for each treated patient...

Radiology
Guided Surgery
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Treatment guidelines

Edentulous

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Salivary output

Physiological salivary output is 0.75 to 1.5 liters per day, with most originating from the submandibular glands. Saliva is a lubricant and has a complex set of protective and healing functions for the oral cavity. It adheres instantly to...

Local factors
Patient assessment
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Treatment guidelines

Edentulous

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Hyposalivation and Xerostomia

Saliva plays a significant role in the preservation and maintenance of oral health and function. It supports digestion by preparing food for mastication and swallowing, contributes to taste perception, facilitates speech communication and provides oral tissues...

Local 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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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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Recreational drugs and alcohol abuse

It is important to evaluate signs indicating if the patient abuses alcohol or takes recreational drugs and may have developed addictions. In general these drugs have a psychedelic,...

Systemic factors
Patient assessment