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0
Patient Assessment
- 0.1 Patient Demand
- 0.2 Anatomical location
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0.3
Patient History
- 2.1 General patient history
- 2.2 Local history
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0.4
Risk Assessment
- 3.1 Risk Assessment Overview
- 3.2 Age
- 3.3 Patient Compliance
- 3.4 Smoking
- 3.5 Drug Abuse
- 3.6 Recreational Drug and Alcohol Abuse
- 3.7 Condition of Natural Teeth
- 3.8 Parafunctions
- 3.9 Diabetes
- 3.10 Anticoagulants
- 3.11 Osteoporosis
- 3.12 Bisphosphonates
- 3.13 MRONJ
- 3.14 Steroids
- 3.15 Radiotherapy
- 3.16 Risk factors
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1
Diagnostics
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2
Treatment Options
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2.1
Treatment planning
- 0.1 Non-implant based treatment options
- 0.2 Treatment planning conventional, model based, non-guided, semi-guided
- 0.3 Digital treatment planning
- 0.4 NobelClinician and digital workflow
- 0.5 Implant position considerations overview
- 0.6 Soft tissue condition and morphology
- 0.7 Site development, soft tissue management
- 0.8 Hard tissue and bone quality
- 0.9 Site development, hard tissue management
- 0.10 Time to function
- 0.11 Submerged vs non-submerged
- 0.12 Healed or fresh extraction socket
- 0.13 Screw-retained vs. cement-retained
- 0.14 Angulated Screw Channel system (ASC)
- 2.2 Treatment options esthetic zone
- 2.3 Treatment options posterior zone
- 2.4 Comprehensive treatment concepts
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2.1
Treatment planning
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3
Treatment Procedures
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3.1
Treatment procedures general considerations
- 0.1 Anesthesia
- 0.2 peri-operative care
- 0.3 Flap- or flapless
- 0.4 Non-guided protocol
- 0.5 Semi-guided protocol
- 0.6 Guided protocol overview
- 0.7 Guided protocol NobelGuide
- 0.8 Parallel implant placement considerations
- 0.9 Tapered implant placement considerations
- 0.10 3D implant position
- 0.11 Implant insertion torque
- 0.12 Intra-operative complications
- 0.13 Impression procedures, digital impressions, intraoral scanning
- 3.2 Treatment procedures esthetic zone surgical
- 3.3 Treatment procedures esthetic zone prosthetic
- 3.4 Treatment procedures posterior zone surgical
- 3.5 Treatment procedures posterior zone prosthetic
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3.1
Treatment procedures general considerations
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4
Aftercare
General patient history
Key points
- Review general health status of patient, medication and previous surgeries/treatments.
- Evaluate potential interferences with planned or likely treatment.
- In case of doubt seek general medical / internist’s advise.
Initial assessment - Patient interview
It is helpful if a clinician is situated so that his/her eyes are at the level of the patient's eyes. For example, if the patient is seated, the clinician should also be seated. It is beneficial if the interview between clinician and patient does not occur in a dental chair as this will not facilitate confidence. In this way, key aspects of the patient's personality, expectations, and medical conditions are more likely to be shared. It is vital that the patient's chief complaint be identified to be later matched with his treatment expectations. All patient interview procedures should ensure patient privacy.
General health assessment
A general health assessment should review the following biological systems:
- Cardio-vascular
- Blood
- Neural
- Gastro-intestinal
- Urogenital
- Metabolic diseases
- Previous surgeries and hospital visits
- Allergies, skin (especially allergies to substances found in dental (restoration) materials)
- Infections, specific infections (Hepatitis, HIV)
- Head and neck conditions including angiomata, nasal or sinus surgery and laryngeal or oro-pharyngeal complaints
In addition, one should inquire about a history of travel to tropical countries (latency of certain diseases). It may be necessary to procure medical reports if available. In case of doubt consider referring patient to the house doctor or internist for further evaluation or recommendations.
Absolute contraindications to treatment due to health problems are rare, if any, but acute stages of local/general diseases and certain medications may call for temporary attention and postponed treatment.
Also, consider inquiring/assessing about use of nicotine, alcohol, drugs (Refer also to chapter ‘risk assessment’).
Medication
Reviewing the medications that the patient is currently taking, or has taken in the past, may identify risks to surgical and prosthetic treatment. Furthermore, a patient may not always know the conditions for which they are being treated and their medication list may signal additional conditions of concern to be investigated by the clinician. For example, elderly patients consider medication a routine and might forget to mention them, if asked in a generic way. In case of doubt ask patients if they take any medication for the bone, for the heart and so on.
