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0
Patient Assessment
- 0.1 Patient demand
- 0.2 Overarching considerations
- 0.3 Local history
- 0.4 Anatomical location
- 0.5 General patient history
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0.6
Risk assessment & special high risk categories
- 5.1 Risk assessment & special high risk categories
- 5.2 age
- 5.3 Compliance
- 5.4 Smoking
- 5.5 Drug abuse
- 5.6 Recreational drugs and alcohol abuse
- 5.7 Parafunctions
- 5.8 Diabetes
- 5.9 Osteoporosis
- 5.10 Coagulation disorders and anticoagulant therapy
- 5.11 Steroids
- 5.12 Bisphosphonates
- 5.13 BRONJ / ARONJ
- 5.14 Radiotherapy
- 5.15 Risk factors
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1
Diagnostics
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1.1
Clinical Assessment
- 0.1 Lip line
- 0.2 Mouth opening
- 0.3 Vertical dimension
- 0.4 Maxillo-mandibular relationship
- 0.5 TMD
- 0.6 Existing prosthesis
- 0.7 Muco-gingival junction
- 0.8 Hyposalivation and Xerostomia
- 1.2 Clinical findings
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1.3
Clinical diagnostic assessments
- 2.1 Microbiology
- 2.2 Salivary output
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1.4
Diagnostic imaging
- 3.1 Imaging overview
- 3.2 Intraoral radiographs
- 3.3 Panoramic
- 3.4 CBCT
- 3.5 CT
- 1.5 Diagnostic prosthodontic guides
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1.1
Clinical Assessment
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2
Treatment Options
- 2.1 Mucosally-supported
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2.2
Implant-retained/supported, general
- 1.1 Prosthodontic options overview
- 1.2 Number of implants maxilla and mandible
- 1.3 Time to function
- 1.4 Submerged or non-submerged
- 1.5 Soft tissue management
- 1.6 Hard tissue management, mandible
- 1.7 Hard tissue management, maxilla
- 1.8 Need for grafting
- 1.9 Healed vs fresh extraction socket
- 1.10 Digital treatment planning protocols
- 2.3 Implant prosthetics - removable
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2.4
Implant prosthetics - fixed
- 2.5 Comprehensive treatment concepts
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3
Treatment Procedures
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3.1
Surgical
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3.2
Removable prosthetics
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3.3
Fixed prosthetics
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3.1
Surgical
- 4 Aftercare
软组织和硬组织
Key points
- 如果患者配戴覆盖义齿,则应在夜间将其摘除
- 修复体不合体可能导致纤维瘤和溃疡
- 对于夜间磨牙症患者,如果固定全颌牙桥与天然齿系相对,则需要使用防磨牙托
活动修复构造下的软组织并发症
活动修复体在夜间一定要摘除。由于树脂义齿基托紧密覆盖角质化粘膜,往往会导致修复体下的牙龈出现真菌/念珠菌感染。附着的粘膜表现为红肿,有时甚至会出血。
使用咪康唑凝胶 1 周(每天两次),结合夜间摘除义齿,通常会实现快速而完全的愈合。
其他问题包括不合体修复体引起的刺激性纤维瘤或创伤性溃疡。对义齿进行调整会立即缓解,一段时间后会痊愈。如果刺激性纤维瘤导致附着体(球形附着体/定位器/杆卡)上出现增生,则需要进行牙龈修整。
固定修复构造下的软组织并发症
由于牙医实现美齿效果的努力或患者需求,牙桥和牙龈之间的空间经常出现堵塞,而在过去,基台往往完全可见。因此,对种植体穿龈部分周围进行适当的清洁是基本不可能的,从而导致食物嵌塞和感染,还会发生口臭。
有牙牙颌相反侧的硬组织并发症
仅一侧颌骨无牙的患者仍然必须注意保养相反侧牙颌中的天然齿系。剩余牙齿的牙周状况尤其重要,因为我们知道,细菌可以从牙周袋移位至之前原来的种植体/基台表面。仍有必要定期进行牙齿/牙周检查。尤其是有牙牙颌应保持最佳口腔卫生状况。
应仔细检查咬合情况,尤其是如果固定全颌牙桥与天然牙相对的患者出现夜间磨牙症。在后一种情况下,必须制作防磨牙托。