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Edentulous

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Treatment guidelines

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...

Edentulous

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Treatment guidelines

Anatomical location

Oral implants are usually placed in the mandibular and maxillary bone and sometimes in additional bone structures such as the zygomatic, pterygoid or vomer bone. In order to identify relevant anatomical structures, diagnostic evaluation of the anatomy...

Edentulous

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Treatment guidelines

Digital treatment planning protocols, introduction

Spiral or Cone Beam CT (CBCT) data sets of the patient jaw bones and of the scan template are transcoded by a specific software to produce three-dimensional (3-D) images of the jaw bones and thickness of the mucosa. Software planning... 

Edentulous

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Treatment guidelines

Need for grafting

There are three main indications for grafting from an anatomical perspective...

Edentulous

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Treatment guidelines

Hard tissue management - mandible

The scientific literature shows that short implants with a length of ≥ 6 mm are able to support prosthetics in the edentulous mandible. After tooth removal the mandible displays different degrees of atrophy (Fig 1&2). Regarding hard tissue management...

Edentulous

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Treatment guidelines

Hard tissue management - maxilla

3-D imaging seems the best option unless clinical examination reveals an ample bone volume. The bone quality can be derived from density measurements if CT scan images are available or approximately from the trabecular pattern of 2-D images. Pano....

Edentulous

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Treatment guidelines

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...

Edentulous

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Treatment guidelines

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....

Edentulous

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Treatment guidelines

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...

Edentulous

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Treatment guidelines

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...

Edentulous

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Treatment guidelines

Splints for imaging and surgery

The primary goal of creating a preliminary teeth arrangement for a try-in diagnostic evaluation is the opportunity to visualize those specific morphological features that impact functional and esthetic considerations for each treated patient...

Edentulous

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Treatment guidelines

CT

Tomography represents 2-D images of a slice through an object. Computerized tomography (CT) can produce virtual slices and conventional CTs take slice by slice and the machine stops and moves in between slices. Spiral/helical CTs are continuous scans in a...

Edentulous

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Treatment guidelines

CBCT

Radiation source collimated at its source and then di­verges into a fan shape to reach detectors. This results in a cone beam.
Pixel (picture + element) is the smallest single component of a 2-D image, whereas a voxel is the small­est element...

Edentulous

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Treatment guidelines

Panoramic radiographs

When obtaining a panoramic film, one must be aware of the importance of following proper technique and carefully positioning the patient's skull between the X-ray generator and the film. Rotation of the film and radiation source often occurs along a...

Edentulous

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Treatment guidelines

Intra-oral radiographs

Intra-oral radiography can provide sufficiently diagnostic information regarding a dentition and also, in many instances, also yield the necessary pre-surgical planning information for implant surgery. If panoramic radiography is not available...