0 Patient Assessment
- 0.1 Patient Demand
- 0.2 Anatomical location
  - 1.1 Anterior and posterior location considerations
  - 1.2 Dentogingival complex and biologic width
- 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
- 1.1 Clinical assessment and clinical findings
  - 0.1 Lip line, smile line
  - 0.2 Mouth opening
  - 0.3 Condition of natural teeth
  - 0.4 Occlusion and functional aspects
  - 0.5 Soft tissue condition
  - 0.6 Periodontitis
  - 0.7 Bone volume and interdental space
  - 0.8 Temporo-mandibular disorders (TMD)
- 1.2 Diagnostic imaging
  - 1.1 Diagnostic imaging overview
  - 1.2 Intra-oral radiographs
  - 1.3 Panoramic
  - 1.4 Cone Beam Computer Tomography (CBCT)
  - 1.5 Computed Tomography (CT)
  - 1.6 Intra-oral imaging and scanning
- 1.3 Prosthodontic tools
2 Treatment Options
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
  - 2.1 Provisionalization procedures esthetic zone
  - 2.2 Impression options and procedures
  - 2.3 Placement of restoration
  - 2.4 Screw-retained restorations
  - 2.5 Cement retained restorations
- 3.4 Treatment procedures posterior zone surgical
- 3.5 Treatment procedures posterior zone prosthetic
  - 4.1 Provisionalization procedures posterior zone
  - 4.2 Impression options and protocols
  - 4.3 Placement of restoration
  - 4.4 Screw-retained restorations
  - 4.5 Cement-retained restorations
4 Aftercare
- 4.1 Surgical Aftercare
  - 0.1 Medication
  - 0.2 Post-operative soft tissue management
  - 0.3 Suture removal
  - 0.4 Post-surgical recommendations
- 4.2 Prosthetic Aftercare
  - 1.1 Esthetic and functional check
  - 1.2 Provisional restoration
  - 1.3 Oral hygiene instructions
  - 1.4 Occlusal guard
- 4.3 Post treatment complications and management
  - 2.1 Bleeding
  - 2.2 Soft tissue, hard tissue, adjacent teeth
  - 2.3 Patient compliance/recall
  - 2.4 Biologic complications
  - 2.5 Esthetic complications
- 4.4 Recall visits and logistics
  - 3.1 Systematic recall/review
  - 3.2 Patient expectations
  - 3.3 General health check
  - 3.4 Professional oral hygiene
  - 3.5 Check of prosthetic restoration
  - 3.6 Probing
  - 3.7 Inflammation, infection
  - 3.8 Microbiology diagnostics
  - 3.9 Radiographic control
  - 3.10 Natural teeth

Treatment guidelines

Risk factors

Key points

In most cases contraindications are not absolute and are subject to the individual patient situation and risk assessment.
Some serious medical risk factors remain. However always consider patient motivation and compliance as well.
In case of doubt consider non-implant based treatments.

Relevant risk factors for implant treatment:

Children and adolescents (during ongoing bone/skeletal development), unless in selected anodontia patients. However, implant placement for orthodontic treatment purposes is indicated.
Uncontrolled metabolic diseases such as Diabetes Mellitus Type 2
Uncontrolled HIV or tuberculosis infection
Blood disorders (such as Advanced chronic Lymphocytic Leukemia, chronic myelodysplasia)
Within 1 year of a heart infarction or cerebro-vascular insult
Currently administered chemotherapy and/or radiotherapy
Significant malfunction of a patient's immune system such as immune-suppression after transplantation
Systemic bone diseases (for example Paget's disease ...)
Psychiatric conditions such as dysmorphophobia or ones affecting a patient's ability to reason and make appropriate treatment decisions
Significant abuse of recreational drugs and/or alcohol which interfere with proper social behavior
Non compliance of patient
Untreated oral diseases (such as jaw osteonecrosis)
Therapy resistant periodontitis
Pregnancy

Additional external resources

ADA recommendations

Digital Textbooks

eBook: Single Implants and their Restoration

Single implants and their restoration

Chapter 2: Evidence Regarding Treatment Outcomes and Complications

An osseointegrated implant with its restored crown has become routinely recommended for replacing a single tooth. In fact, placement of an implant and crown is widely regarded as the preferred treatment modality rather than a fixed partial denture or a removable partial denture. This treatment planning choice is due, in part, to the high survival rate of single implants and their associated crowns and patient preference. When faced with the choice to involve two otherwise healthy teeth adjacent to an edentulous area or fabricate removable prosthesis, patients are more likely to select an implant supported single crown.

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