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Treatment guidelines

Edentulous

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The Maxillo-mandibular relationship

The key to understanding maxillo-mandibular jaw relations from a patient-centered treatment point of view is to recognize the inseparable nature of the mandible’s two positions - vertical and horizontal. They can be discussed...

Patient assessment
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Treatment guidelines

Edentulous

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Vertical dimension

The recording of patient-specific vertical and horizontal jaw relations is a necessary starting point when planning for the occlusal rehabilitation. They are integral components of the mandible’s centric relation (CR)...

Diagnosis and treatment planning
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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Lip line

Optimal esthetic treatment outcomes require a harmonious reconciliation between lip morhology and teeth positioning. Lips provide a picture frame for the anterior teeth that support them; with mouth size and labial contours depending on genetically...

Diagnosis and treatment planning
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
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Treatment guidelines

Edentulous

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Drug abuse

The medical history should reveal if the patient takes any prescribed medication and especially whether in the correct dosage. Fear of oral surgery may induce a temporary overconsumption of drugs such as beta-blockers or...

Systemic factors
Patient assessment
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Treatment guidelines

Edentulous

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Smoking

Smoking and nicotine consumption have a constrictive effect on blood vessels thereby reducing blood supply. It increases the susceptibility to periodontal inflammatory diseases, dry extraction sockets and wound healing...

Peri-implantitis
Systemic factors
Patient assessment
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Treatment guidelines

Edentulous

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Compliance

Implant based treatment is a comprehensive long-term therapy with various treatment steps and ongoing need for adequate aftercare. It therefore requires considerable involvement, cooperation and dedication – compliance – from the patient. Therefore, during the...

Patient assessment
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Treatment guidelines

Edentulous

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Age

Edentulism as a consequence of (sub)total agenesis of deciduous and/or permanent teeth in children and adolescents is extremely rare. It is commonly a component of a generalized underlying condition such as ectodermal dysplasia. There are...

Fixed prosthetics
Removable prosthetics
Local factors
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Treatment guidelines

Edentulous

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Risk assessment & special high risk categories, overview

A thorough risk assessment forms the cornerstone of successful patient treatment. Four key sources of information permit the clinician to identify pertinent risks and to determine the seriousness of each risk...

Local factors
Systemic factors
Patient assessment
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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
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Treatment guidelines

Edentulous

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General patient history

It is helpful if a clinician is situated so that his/her eyes are at the level of the patient's eyes. For example, if the patient is seated, the clinician should also be seated. It is beneficial if the interview between clinician and...

Systemic factors
Patient assessment
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Treatment guidelines

Edentulous

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Patient Demand

In order to provide adequate treatment and meet patient satisfaction, it is crucial to evaluate patient expectations. These expectations normally fall into one or more of four categories: function, comfort, esthetics and...

Local factors
Patient assessment