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Edentulous

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Treatment guidelines

Skeletal consequences of edentulism

Teeth loss in the maxilla initiates residual ridge/alveolar resorption, especially in the anterior region, which is flared labially. The consequences of this resorption is a gradual medial or palatal shift of the crest of the maxilla. This...

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

Comprehensive treatment concepts, Pterygoid implants

In the edentulous upper jaw the placement of implants can be challenging due to limited bone quantity and the presence of the maxillary sinus. Pterygoid implants have high success rates, similar bone loss levels to those of ...

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

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...

Edentulous

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Treatment guidelines

Secondary splinting

Implant overdentures are an excellent treatment option for edentulous patients and lead to significant improvement of quality of life. There are various options for their retention mechanism...

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Edentulous

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Treatment guidelines

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

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Treatment guidelines

Problems and complications in maxillary implant surgery

In the edentulous upper jaw the proximity of adjacent anatomical structures and bone density of residual bone can compromise implant insertion and may lead to complications such as lacking primary implant stability, perforation, dislocation of implants or augmentat...

Edentulous

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Treatment guidelines

Pterygoid implants

In the edentulous upper jaw the placement of implants can be challenging due to limited bone quantity and the presence of the maxillary sinus. Pterygoid implants present an alternative option to use residual bone for implant anchorage and to overcome the need for...

Edentulous

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Treatment guidelines

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

Edentulous

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Treatment guidelines

Sinus lifting

Less than 4-6 mm of vertical residual bone height in the posterior segment of the maxilla is an indication for a sinus augmentation procedure [Esposito]. The external access to the maxillary sinus is carried out at a lateral buccal alveolar...

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

Implant placement with open flap procedure - mandible

The surgeon should be standing or be seated behind the supine patient. Bilateral truncular anesthesia is needed. The incision can be crestal or at a distance in the labial fold. Presence of keratinized tissue both labially and palatally should...

Edentulous

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Treatment guidelines

Semi-guided surgery with prosthetic template

Hand-made templates are duplicates obtained from the denture/tooth arrangement with access holes or titanium tubes. These are located in the correct positions and axes of the planned prosthetic teeth according to the CBCT a...