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Edentulous

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Treatment guidelines

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...

Edentulous

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Treatment guidelines

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, ...

Edentulous

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Treatment guidelines

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...

Edentulous

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Treatment guidelines

Microbiology

Epithelial desquamation in the oropharynx limits bacterial accumulation, except on the tongue dorsum and in the tonsillar crypts. Loss of teeth dramatically reduces the load of periodontal pathogens except for Aggregatibacter actinomycetemcomitans and to a...

Edentulous

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Treatment guidelines

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...

Edentulous

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Treatment guidelines

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...

Edentulous

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Treatment guidelines

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...

Edentulous

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Treatment guidelines

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...

Edentulous

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Treatment guidelines

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...

Edentulous

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Treatment guidelines

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...

Edentulous

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Treatment guidelines

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...