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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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Primary splinting

Implant supported overdentures are an evidence-based treatment option for edentulous patients leading to a significantly increased quality of life.
There are various retention elements available which connect the implants directly...

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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Number of implants maxilla and mandible

The tradition to insert 6 implants, and eventually more, in an arch-wide pattern dates back to the early days of osseointegration when implants with a machined surface were used and risk for early...

Implant prosthetics
Biomechanics and occlusion
Success & failure
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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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Soft tissue management

The aims of peri-implant soft tissue management in the edentulous mandible are the eventual reconstruction of attached gingiva or immobilizing the soft tissue at the implant-soft tissue interface. Vestibuloplasty means deepening of the...

Soft tissue management
Peri-implant therapy
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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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Occlusal schemes

A choice of occlusal schemes can be employed for the prosthodontic rehabilitation of the edentulous patient. Clinical outcomes with different schemes continue to be debated and no one scheme has emerged as clearly superior. However, although the...

Biomechanics and occlusion
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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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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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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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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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Overdenture retention devices, overview

Attachment selection

The relative merits of different prosthodontic treatment objectives - resilient versus rigid attachments - are controversial and empirical. A resilient retention mechanism is recommended on the assumption that this will protect implants from overload; while in...

Prosthetic materials
Implant prosthetics
Biomechanics and occlusion
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Treatment guidelines

Edentulous

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Implant overdenture placement

Placement of a removable prosthesis requires attention to detail to cover all important clinical items such prosthesis fit, denture base extensions, esthetics, occlusion, patient comfort and post-insertion instructions. Implant overdentures may or may not...

Implant prosthetics
Biomechanics and occlusion
Removable prosthetics