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Lambert Stumpel

Patient cases

Fully edentulous maxilla - a "different" treatment approach

A 65-year-old female patient came for a complete-arch treatment.  The aim was to re-position the old removable denture in its original position to be able to transfer it into a cement-retained provisional denture. 

Edentulous

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Treatment guidelines

Provisionals

Conceptually, a provisional prosthesis for an edentulous patient is a convenient tool that offers the patient a satisfactory level of function and esthetic appearance while definitive treatment is undertaken...

Edentulous

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Treatment guidelines

Wax-up, arrangement, mock-up

Treatment planning for the edentulous patient requires a diagnostic tooth arrangement which provides valuable information for pre-surgical planning (surgical guide fabrication), facilitates discussion regarding...

Edentulous

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Treatment guidelines

Splints for imaging and surgery

The primary goal of creating a preliminary teeth arrangement for a try-in diagnostic evaluation is the opportunity to visualize those specific morphological features that impact functional and esthetic considerations for each treated patient...

Edentulous

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Treatment guidelines

CT

Tomography represents 2-D images of a slice through an object. Computerized tomography (CT) can produce virtual slices and conventional CTs take slice by slice and the machine stops and moves in between slices. Spiral/helical CTs are continuous scans in a...

Edentulous

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Treatment guidelines

CBCT

Radiation source collimated at its source and then di­verges into a fan shape to reach detectors. This results in a cone beam.
Pixel (picture + element) is the smallest single component of a 2-D image, whereas a voxel is the small­est element...

Edentulous

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Treatment guidelines

Panoramic radiographs

When obtaining a panoramic film, one must be aware of the importance of following proper technique and carefully positioning the patient's skull between the X-ray generator and the film. Rotation of the film and radiation source often occurs along a...

Edentulous

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Treatment guidelines

Intra-oral radiographs

Intra-oral radiography can provide sufficiently diagnostic information regarding a dentition and also, in many instances, also yield the necessary pre-surgical planning information for implant surgery. If panoramic radiography is not available...

Edentulous

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Treatment guidelines

Imaging tools overview

Because any form or radiation can impose a risk, patient history and clinical examination should be performed first to ensure that the right kind of imaging is sought and unhelpful imaging is avoided.
The four main types of imaging tools utilized, and...

Edentulous

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Treatment guidelines

Microbiology

Epithelial desquamation in the oropharynx limits bacterial accumulation, except on the tongue dorsum and in the tonsillar crypts. Loss of teeth dramatically reduces the load of periodontal pathogens except for Aggregatibacter actinomycetemcomitans and to a...

Edentulous

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Treatment guidelines

Hyposalivation and Xerostomia

Saliva plays a significant role in the preservation and maintenance of oral health and function. It supports digestion by preparing food for mastication and swallowing, contributes to taste perception, facilitates speech communication and provides oral tissues...

Edentulous

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Treatment guidelines

Muco-gingival junction

The gingiva is tightly connected to the underlying periosteum. It is globally keratinized and has a stippled surface. Its color varies from pink to brown or even black, depending on race and/or melanin deposits. It can be distinguished from alveolar mucosa, which...

Edentulous

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Treatment guidelines

Mouth opening

Most patients’ mouth opening readily permits access for routine prosthodontic and surgical treatment interventions. Limited mouth opening or microstomia is encountered in patients exposed to sclerodermia, diffuse systemic...

Edentulous

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Treatment guidelines

Lip line

Optimal esthetic treatment outcomes require a harmonious reconciliation between lip morhology and teeth positioning. Lips provide a picture frame for the anterior teeth that support them; with mouth size and labial contours depending on genetically...

Edentulous

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Treatment guidelines

Risk factors

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 Mellit...