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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

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

Cement-retained restorations, overview

Cement-retained restorations are a traditional design to attach a restoration (crown, bridge) to an implant-retained abutment, similar to cementing a crown or bridge restoration on a natural tooth. With the traditional, relatively...

Edentulous

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Treatment guidelines

Veneering with Acrylic

Frameworks are veneered with veneering materials, to design the esthetics and shape of the definitive restoration. Framework material options for acrylic veneering include titanium, (CrCo) Cobalt - Chrome and precious alloys...

Edentulous

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Treatment guidelines

Veneering with Ceramic

Frameworks can be made from titanium, zirconia, precious alloys and Co-Cr base alloys and can be cement-retained or screw-retained. With minimal bone resorption, a ceramo-metal restoration is preferable to accommodate interarch...

Edentulous

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Treatment guidelines

Abutment materials

Implant-based prostheses can be cement-retained, screw-retained or a combination of both (Fig 1). By definition, an abutment is a component that is intermediate between the implant and the restoration and it is usually screw...

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

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

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

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

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...

Edentulous

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Treatment guidelines

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...