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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
Occlusal guard
Key points
- An occlusal guard can protect dental prostheses and significantly enhance their longevity.
- Hard occlusal guards are often more effective than soft ones in bruxers.
- Soft occlusal guards are often more effective than hard ones in clenchers.
Occlusal guard
The use of porcelain artificial teeth brings different challenges related to nocturnal paranormal function. High occlusal forces can be mitigated by wearing of a protective occlusal guard. Chipping of porcelain is a frequent encountered complication of implant-supported restoration and is not easy to repair. Most of times a new restoration has to be made. However, clinicians feel that porcelain teeth offer an advantage in esthetics and texture.
If a patient is known to have paranormal function such as bruxing or clenching, this should be accommodated in the treatment plan. For these patients, an occlusal guard should be included in the original treatment plan.
An occlusal guard lies over the complete arch of teeth, including the implant-supported restoration and protects it by providing an intervening substance against which the opposing teeth apply force. The guard acts as an absorber and distributor of occlusal forces. In general, soft occlusal guards are better tolerated, and hence have greater patient compliance, than hard occlusal guards. Soft guards are particularly effective in clenchers, who exhibit an axial direction of occlusal force. Bruxers, who have a lateral motion to their paranormal activity, are best served by a hard occlusal guard that has good wear properties.
During the aftercare period, attention should be given to a number of items:
- does the patient still use the occlusal guard
- does the occlusal guard still fit
- are there signs of fracture or wear of the occlusal guard, requiring repair
