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Edentulous

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Treatment guidelines

Existing prosthesis

Examination of existing dentures provides invaluable information on patients’ perceptions of teeth and soft tissue esthetics, including facial vertical dimension support. It also informs clinicians regarding their patients’ overall...

Edentulous

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Treatment guidelines

Temporo-mandibular disorders (TMD)

Routine evaluation of a patient’s temporo-mandibular joint function is an integral part of any oral examination.
Moreover, good muscular control and painless coordination of jaw movements are desirable in the management of edentulism...

Edentulous

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Treatment guidelines

The Maxillo-mandibular relationship

The key to understanding maxillo-mandibular jaw relations from a patient-centered treatment point of view is to recognize the inseparable nature of the mandible’s two positions - vertical and horizontal. They can be discussed...

Edentulous

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Treatment guidelines

Vertical dimension

The recording of patient-specific vertical and horizontal jaw relations is a necessary starting point when planning for the occlusal rehabilitation. They are integral components of the mandible’s centric relation (CR)...

Edentulous

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Treatment guidelines

Overdenture Clinical Protocol

Successful oral rehabilitation of edentulous patients with removable prostheses demands careful adherence to a clinical protocol.
Clinical objectives are met by using a routine clinical protocol that includes most or all of the following steps...

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...

Edentulous

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Treatment guidelines

Osteoporosis

Osteoporosis is a frequent disease affecting predominantly postmenopausal women. The prevalence is 7% in women aged 55 and raises to 19% in women aged 80. Osteoporosis is diagnosed by a decreased radiologic bone density (DXA-score). Primary osteoporosis is more...

Edentulous

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Treatment guidelines

Diabetes

Diabetes refers to metabolic diseases where blood sugar levels are too high, a condition termed hyperglycemia, and where symptoms as increased hunger, weight loss, more frequent urination, weakness and fatigue and excessive thirst are observed. High...