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Treatment guidelines

Edentulous

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Zygomatic implants

Indications

Zygomatic implants have been documented as a an alternative for the rehabilitation of the atrophic posterior maxilla with both the classical two stage and immediate loading protocols. Zygomatic implants avoid grafting and sinus lift procedures and therefore contribut

Posterior implants
Implants in compromised sites
Success & failure
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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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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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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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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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Closed versus open tray technique

The open tray technique for making a definitive impression is one of two choices (the other being a closed tray impression) in the fabrication of a fixed complete denture. The open tray technique is specifically indicated, when the implants are not...

Implant prosthetics
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Treatment guidelines

Edentulous

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Framework trial placement

At this appointment, the prosthesis framework is evaluated for accuracy of fit, appropriate contour to faciltate oral hygiene access and the necessary balance of structural morphology for rigidity/strength and sufficient space to...

Implant prosthetics
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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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Trial placement

The trial placement appointment is a significant one for successful edentulous patient care. It will be the first time that dentist and patient can see what has been created in the laboratory; and a decision will then be one...

CAD/CAM
Implant prosthetics
Diagnosis and treatment planning
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Treatment guidelines

Edentulous

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Maxillo-mandibular relations

One goal in the treatment of the fully edentulous patient is to re-establish the maxillo-mandibular relation in the transversal and sagittal dimensions comprising adequate facial height. The occlusal contact situation be...

Implant prosthetics
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Treatment guidelines

Edentulous

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Impression - parallel vs non-parallel implants

It is important to evaluate whether the implants are parallel to each other. If the implants are fairly parallel to each other (Fig 1) a closed tray impression technique can be employed. Since the implants are parallel to each other, the polymerized...

Implant prosthetics
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Treatment guidelines

Edentulous

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Splinted vs unsplinted impression copings

In vitro research studies have compared splinted versus unsplinted impression techniques and have, in general, shown that the splinted impression technique yields more accurate master casts when compared to a reference...

Implant prosthetics
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Treatment guidelines

Edentulous

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Impressions - overview

The goals of an impression are to accurately capture tissue contours necessary and relevant for fabrication of a prosthesis that adapts well to mucosa or a prosthesis that fits well and passively on implants...

 

Implant prosthetics
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Treatment guidelines

Edentulous

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Fixed Implant Prosthesis Clinical Protocol

A fixed implant prosthesis is completely anchored and supported by dental implants. There are different terms used to describe a fixed implant prosthesis, such as fixed complete denture, fixed detachable prosthesis, the hybrid prosthesis, or the...

Implant prosthetics