-
0
Patient Assessment
- 0.1 Patient Demand
- 0.2 Anatomical location
-
0.3
Patient History
- 2.1 General patient history
- 2.2 Local history
-
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
-
1
Diagnostics
-
2
Treatment Options
-
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
-
2.1
Treatment planning
-
3
Treatment Procedures
-
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
-
3.1
Treatment procedures general considerations
-
4
Aftercare
Medication
Key points
- To provide patient comfort and reduce pain and swelling after a surgical intervention, analgetic medication is usually administered as a routine.
- In case of more extensive interventions and some predisposing health conditions (e.g. diabetes) consider preventive antibiosis.
- Consider possible interferences of some current analgetics and antibiotics with general medication (coagulation prevention, oral contraceptives).
- Consider possible side effects of medication (for example Reye syndrom associated with Acetylsalicylic acid in children, allergies).
Analgesics and anti-inflammatory drugs
Depending on type and size of surgical intervention the patient might need or appreciate adequate medication against pain and swelling, for example Paracetamol, Acetylsalicylic acid (ASA), or of the non-steroidal anti-inflammatory drug group (NSAID).
Side effects: In case of coagulation prevention with ASA or Coumarine type coagulants, pain relief with e.g. Paracetamol type analgesics is preferable, due to interference of Ibuprofen with ASA and Coumarine. (see article on Coagulation disorders and anticoagulants therapy)
Analgesics should be started before the local anesthesia wears off.
Pain relief should appear at latest the second day after surgery; if not, the patient should present for control.
Antibiotic therapy
If preventive antibiotic therapy has been started before surgical intervention, it needs to be continued after surgery for 1 to 4 days and completed according to antibiotic type used.
In case of grafting procedures preventive antibiotics are essential.
Penicillins (Penicillin V, Amoxicillin) and Cephalosporine type antibiotics can influence the effect of Coumarine and increase chance of bleeding. In case of coagulation prevention with Coumarine type coagulants Clindamycine type antibiotics should be preferred.
Sinus lift augmentation considerations
Since the patient should not blow through his nose for at least 2 weeks, nasal spray / decongestant should be prescribed
Ongoing medication
If some ongoing medication has been interrupted for the surgical intervention, resume medication after surgery. Consider possible interactions of this ongoing medication with any administered post-operative medication.
Mouth rinse
To reduce the amount of bacteria, prescribe an antiseptic mouth rinse (e.g. Chorhexidine), until first postoperative recall (day 7 -14). Assess and decide in the recall whether or not to continue mouth rinse administration.
