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Edentulous

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Treatment guidelines

Bleeding

Damage of sublingual arteries can lead to intense hemorrhage. Subsequent elevation of floor of the mouth can lead to (fatal) airway obstruction ! An early symptom of sublingual swelling may be a muffled speech. In such situation ensure free airways (intubation, tracheotomy),...

Edentulous

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Treatment guidelines

Post-surgical recommendations

Inform patient about adequate actions after surgery. Leave around the clock emergency contact numbers in case of urgent complications. Plan or delegate to the referring dentist postoperative recall visits, at day 1 or 2, day 8 - 14 and 4 – 6 weeks...

Edentulous

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Treatment guidelines

Medication

the patient might need or appreciate adequate medication against pain and swelling, for example Paracetamol, Acetylsalicylicacid (ASA), or of the non-steroidal anti-inflammatory drug...

Edentulous

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Treatment guidelines

Infection - microbiological diagnostics

Presence/number of implants influences aerobe and anaerobe species in saliva and on tongue in edentulism. Subgingival microbiota in periimplantitis vary according to studies. Less periodontal pathogens than in partial edentulism. Prevotella nigrescens,...

Edentulous

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Treatment guidelines

Patient compliance/recall

Patient compliance is a critical factor in promoting the long-term success of oral rehabilitation. The issue of patient compliance should be enthusiastically engaged by the clinician/dental practitioner. The practitioner may see a non-compliant...

Edentulous

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Treatment guidelines

Overdenture retention devices, overview

Attachment selection

The relative merits of different prosthodontic treatment objectives - resilient versus rigid attachments - are controversial and empirical. A resilient retention mechanism is recommended on the assumption that this will protect implants from overload; while in...

Vorschaubild

Videos

Ann Wennerberg: On macro-, micro- and nanoscopic aspects of osseointegration

Implant design and implant surface structures have evolved over time and today various versions are available. Dr Wennerberg reviews the evolution of implant surface structures from the orignal Branemark machined Titanium designs to recent nanostructured surfaces, and discusses...

Edentulous

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Treatment guidelines

Recall visits - overview

To achieve good long term results, regular recall control appointments should be scheduled. Ideally, recall appointments take place at least every 6 months for a systemic review of the general health...

Edentulous

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Treatment guidelines

Post-operative care

The main objectives of post-operative care include control of the healing of the surgical site and identifying risks which could affect healing and, where pertinent, osseointegration. In addition, post-operative visits provide the opportunity to evaluate the... 

Edentulous

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Treatment guidelines

Placement of implants - Angulation

The primary goal of angulated implant placement concepts is the implant-based prosthodontic rehabilitation of the edentulous maxilla and mandible and avoiding grafting procedures and thereby offering a more simple and less invasive treatment...

Edentulous

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Treatment guidelines

Placement of implants - Height

The overall aim after implant placement concerning the periimplant bone height is to minimize marginal bone loss. However, several bone remodelling processes that occur after implant placement lead to periimplant bone loss and the establishment of...

Edentulous

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Treatment guidelines

Intra-operative complications

In the atrophic mandible soft tissues become prominent and the inferior alveolar nerve is located more superficially.
Fractures of the atrophic edentulous mandible can occur during implant insertion. Especially in hard bone...

Edentulous

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Treatment guidelines

Wound closure

Wound closure ensures and accelerates wound healing by protecting the site and influencing migration of keratinocytes over the granulation tissue. Some wound eversion maximizes epidermal approximation. Square knots, with two ties in one direction and a reverse...

Edentulous

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Treatment guidelines

Flap or flapless

Flapless implant surgery is a minimally invasive procedure that can be performed either using guided surgery or custom fabricated surgical guides made of casts taken at the first patient visit. Several clinical papers reported excellent short- and long...

Edentulous

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Treatment guidelines

Peri-operative care

As described in Patient Assessment, a thorough evaluation of patient factors influencing whether to proceed with surgical therapy is relevant.
Depending on the tpe of surgery prescribe pre-operative medication (for example antibiotic coverage), if...