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Treatment guidelines

Edentulous

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Comprehensive treatment concepts, Zygomatic implants

Conventional dentures are a common treatment option, but, when bone is missing, they may not meet functional, psychological and social needs of the individual. Classical surgical approaches include different...

Radiology
Edentulous treatments
Implants in compromised sites
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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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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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Implant placement with open flap procedure - mandible

The surgeon should be standing or be seated behind the supine patient. Bilateral truncular anesthesia is needed. The incision can be crestal or at a distance in the labial fold. Presence of keratinized tissue both labially and palatally should...

Edentulous treatments
Soft tissue management
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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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Implant placement - maxilla

Incision can be made either on top of the crest or at some distance in the labial fold. The outcome for both approaches seems comparable. A sagittal release incision at the midline eases the reflection of the labial mucoperiosteum. It is logical to try to achieve...

Edentulous treatments
Soft tissue management
Implant prosthetics
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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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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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Placement of implants - Angulation

The primary goal of angulated implant placement concepts is the implant-based prosthodontic rehabilitation of the edentulous maxilla and mandible and avoiding grafting procedures and thereby offering a more simple and less invasive treatment...

Edentulous treatments
Implants in compromised sites
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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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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