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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

Salivary output

Physiological salivary output is 0.75 to 1.5 liters per day, with most originating from the submandibular glands. Saliva is a lubricant and has a complex set of protective and healing functions for the oral cavity. It adheres instantly to...

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

Probing

Radiographical check-ups to evaluate bone levels cannot be repeated too often to avoid unnecessary radiation. Monitoring the overlying soft tissues may help to identify eventual problems of the underlying bone, although the correlation...

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...

Edentulous

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Treatment guidelines

Radiotherapy

Radiotherapy

Rehabilitation of patients with oral cancers is usually done in a combined way with surgical, chemo- and radio-therapy. Radiotherapy predisposes to fibrotization, ischemia and xerostomia. The latter side-effect renders mucosally supported dentures even more difficult to...

Edentulous

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Treatment guidelines

Steroids

A steroid is an organic compound and a type of lipid substance. Steroids play a critical role in metabolism, for example, as the dietary fat Cholesterol, as bile acids or as steroid hormones (e.g. Cortisone/Glucocorticoids, Estrogens, Testosterone). The more complex...

Edentulous

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Treatment guidelines

BRONJ / ARONJ

A critical side effect in the oro-maxillo-facial region observed in patients undergoing administration over a long period of time and especially intravenously, bisphosphonate therapy may predispose to ‘bisphosphonate-related osteonecrosis of the...

Edentulous

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Treatment guidelines

Bisphosphonates

Bisphosphonates (BP) inhibit osteoclast activity and remain in the bone for a prolonged period. Bisphosphonates are the most commonly prescribed drugs to treat osteoporosis, bone fragility disorders, like Paget’s disease, osteogenesis imperfecta...

Edentulous

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Treatment guidelines

Coagulation disorders and anticoagulants therapy

Patients may have compromised blood coagulation due to inherited hemophilia or acquired disorders of coagulation resulting from preventive anticoagulant therapy in case of cardiovascular diseases. There are also states of heightened coagulation...