Friedrich Neukam, Stefan Holst: Optimal decision-making and treatment planning - a shared responsibility

The lecturers present their team approach for patient communication, diagnostics, treatment planning and treatment decisions, discuss the functional and esthetic consequences of edentulism, and review the different treatment phases. In addition to regular intro-and extra-oral examination, pretreatment assessment needs to take into account patient general medical condition, manual skills, and compliance for implant treatment. Dr Neukam reviews high risk factors and absolute contra-indications for implant treatment. The treatment planning is always prosthetically driven, the treatment phase is following strict treatment sequences and an aligned workflow for predictable outcomes. Invasive augmentation techniques can often be avoided by using short implants or osteodistraction techniques. Dr Holst reviews restoration material selection and prosthetic design options. For an increasing edentulous patient cohort maintenance aspects of the restoration design are crucial, and for hygiene and manipulation a removable solution might often be more practical for the patient. Rigid anchoring using milled bars requires less prosthodontic maintenance in comparison to resilient denture stabilisation with round bars. Offering high precision, passive fit and homogenous, biocompatible and highly polishable materials, CAD/CAM technology offers major advantages over cast restorations. Both lecturers highlight that simple, straightforward and low-invasive techniques and simple, easy to maintain restoration designs reduce complications and are key for long-term success.