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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
Professional oral hygiene
Key points
- The regular recall control appointment comprises professional cleaning of tongue dorsum, prosthetic components and any supragingival parts of the implant.
- The routine hygiene appointment can and should be used for detection and management of any complications (e.g. inflammation, prosthetic malfunction etc.), and evaluation of oral tissue condition.
- To avoid scratching the implant surfaces, for cleaning use for example plastic or titanium scalers.
Professional oral hygiene recall
The regular recall control appointment, at least every 6 months, should comprise a hygiene check by the dental/oral hygienist or other auxiliary, and include professional cleaning of the restoration, prosthetic components, sulcus and any supragingival parts of the implant.
Check patient compliance and oral hygiene. Depending on motivation and hygiene situation the patient should be reinstructed and remotivated for optimal hygiene measures. If needed, consider adaptation and higher frequency of recall visits and professional oral hygiene.
In addition to the professional hygiene activities, the routine hygiene appointment can and should be used for detection and management of any complications.
Professional cleaning
Remove plaque, staining and calculus with plastic or titanium instruments/scalers suitable for use on implants. Do NOT use regular steel instruments on implants, as use of such instruments will scratch the implant surface and subsequently increase plaque retention and formation. Polish with rubber cups and adequate polishing paste suitable for implant (titanium) surfaces. For interdental areas and mucosal parts of restorations consider use of interdental brushes and fluffy, lintfree Superfloss-type floss.
Important: in case of patients with endocarditis history, administer adequate antibiotic prevention (such as Amoxicillin, or Clindamycin) one hour before treatment (Dose depends on patient weight and kidney function)
Prosthetic check
Check condition and function of prosthetic restoration and components, e.g. chipping of ceramic parts, loosening of abutments and retention screws etc. In case of such incidents perform adequate intervention or present patient to prosthetic clinician for adequate intervention (occlusion- and function check, screw-tightening, re-cementation, repair of restoration, consideration of protection guard etc.)
Soft tissue check
As a good routine, check all oral soft tissues for any pathology signs.
Check peri-implant mucosa for signs of inflammation or infection.
In case of inflammation signs, after professional cleaning rinse sulcus with suitable antimicrobial rinse (such as Chlorhexidine, 2% hydrogen peroxide etc.). Instruction of patient for home rinse with suitable antimicrobial rinse (Chlorhexidine), 3 times daily, recall and re-evaluation after 2 weeks. Consider increasing frequency of regular recall and hygiene re-instruction.
In case of signs of heavy inflammation/ infection like swelling, exsudation, pain, bleeding, present to clinician for adequate diagnostics, X-ray, and treatment decision (e.g. antimicrobial irrigation, antimicrobial medication, surgical intervention…)
Effectiveness and efficiency of Inflammation treatment with Antimicrobial Photodynamic Therapy is controversial.
After appointment make sure to schedule next recall visit.
