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Aaron Fenton: The impact of osseointegration on the edentulous predicament - the fixed management option

Where would we be without the gift of dental implants today ? In light of a growing elderly population, Dr Fenton presents a journey through treatment of edentulous patients from the pre-implant times in dentistry till today's advanced options and future advances and opportunities...

Admin post op
Franck Renouard
Kenji Higuchi
Joseph Kan
Jaime Lozada
Göran Urde

Checklists

Administrative Post-Operative Steps

Primary responsibility: Nurse/Dental Assistant
Timing: After leaving OR
Location: Consultation room and/or front desk

Edentulous

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Treatment guidelines

Occlusal schemes

A choice of occlusal schemes can be employed for the prosthodontic rehabilitation of the edentulous patient. Clinical outcomes with different schemes continue to be debated and no one scheme has emerged as clearly superior. However, although the...

Edentulous

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Treatment guidelines

Soft tissue and hard tissue

Removable prostheses should always be removed over night. Since the acrylic denture base is tightly covering the keratinised mucosa, it often leads to fungal/candida infections of the ginigiva under the prosthesis....

Edentulous

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Treatment guidelines

Biologic complications

This is the reversible inflammatory process in the soft tissues around functioning implants. Peri-implant mucositis occurs in almost 60% of subjects (± 30% of sites), restored with implants. Diagnosis is stated by clinical examination: redness, ...

Edentulous

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Treatment guidelines

Radiological Control

At the beginning of the recall control it is necessary to define the intention of a radiograhical control and if it is needed. Radiological controls are only justified in the presence of certain symptoms, anamnesis and/or clinical examination...

Edentulous

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Treatment guidelines

Framework trial placement

At this appointment, the prosthesis framework is evaluated for accuracy of fit, appropriate contour to faciltate oral hygiene access and the necessary balance of structural morphology for rigidity/strength and sufficient space to...

Edentulous

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Treatment guidelines

Post operative soft tissue management

After treatment of edentulous patients, there is no need to schedule specific recalls for soft tissue control. Traditional post-operative controls at day 1 - 3, day 7 - 14 and week 4 - 6 after surgery involve soft tissue control and...

Edentulous

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Treatment guidelines

Post-placement

At this appointment, a careful evaluation of the patient's oral hygiene and soft tissue response is performed and adjustments made as needed. A daily home-care program must be customized to the individual's ability to clean the...

Edentulous

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Treatment guidelines

Implant overdenture maintenance

The objective of systematic periodic recalls for patients wearing overdentures are three-fold...

Edentulous

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Treatment guidelines

General health check

Patient health can change considerably over time - therefore at every recall visit, check and get updated information on general health of patient, and if needed adapt maintenance policy adequately. Information (for example a poster)...

Edentulous

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Treatment guidelines

Inflammation and infection

Inflammation can be limited to the soft tissue around the implant (mucositis) or involve the underlying bone tissue as well (peri-implantitis). Infection can be caused by various risk factors, such as inadequate hygiene and patient compliance...

Edentulous

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Treatment guidelines

Suture removal

Suture removal for mucoperiosteal wounds, depending on the age of the patient and the extent of the wound takes place after 8 to 12 days. Even resorbable sutures may benefit after such healing time from removal of remnants...

 

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...