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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
Esthetic and functional check
Key points
- A perfect outcome for both white and pink esthetics is important to most patients in single tooth implant restoration.
- Phonetic and masticatory outcomes are the two most important functional demands.
- To avoid disappointments, if needed, proper preparation and recalibration of the patient’s expectations during the treatment is critical.
Managing patient expectations
Because many patients are anticipating an ideal esthetic and functional outcome, proper preparation of the patient’s expectations during the treatment planning phase is imperative. Afterwards, during treatment and follow-up, occasionally recalibrating the patient to these pre-treatment preparations and prospects is helpful in ensuring that the patient is satisfied with treatment result.
Most often, a patient becomes dissatisfied due to esthetic concerns. The clinician and patient must openly discuss the possibilities for improvement in shade, form, texture, position and angulation of teeth in order to determine which deficiencies can be addressed within the limitations of the restoration design and materials used.
Phonetics and mastication
Both functional and phonetic performance should be carefully addressed by evaluating a patient’s speech and masticatory ability.
Occlusion and functional movements need to be carefully evaluated, to ensure chewing comfort and avoid overload of the implant restoration.
The palatal contours of teeth and restorations and resultant available tongue space are important determinants of many sounds. In particular, proper positioning and relationship of the anterior teeth, especially for fricatives and sibilants, is critical.
As with any new restoration, a certain period of adaptation is to be expected and patients should be informed that for both speech and mastication, some days or at times weeks might be necessary before the true phonetic and masticatory outcome can be determined. To guide patient expections adequately, ideally patients have already have been informed during the treatment planning phase, that a certain adaptation period might be necessary.
