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0
Patient Assessment
- 0.1 Patient demand
- 0.2 Overarching considerations
- 0.3 Local history
- 0.4 Anatomical location
- 0.5 General patient history
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0.6
Risk assessment & special high risk categories
- 5.1 Risk assessment & special high risk categories
- 5.2 age
- 5.3 Compliance
- 5.4 Smoking
- 5.5 Drug abuse
- 5.6 Recreational drugs and alcohol abuse
- 5.7 Parafunctions
- 5.8 Diabetes
- 5.9 Osteoporosis
- 5.10 Coagulation disorders and anticoagulant therapy
- 5.11 Steroids
- 5.12 Bisphosphonates
- 5.13 BRONJ / ARONJ
- 5.14 Radiotherapy
- 5.15 Risk factors
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1
Diagnostics
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1.1
Clinical Assessment
- 0.1 Lip line
- 0.2 Mouth opening
- 0.3 Vertical dimension
- 0.4 Maxillo-mandibular relationship
- 0.5 TMD
- 0.6 Existing prosthesis
- 0.7 Muco-gingival junction
- 0.8 Hyposalivation and Xerostomia
- 1.2 Clinical findings
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1.3
Clinical diagnostic assessments
- 2.1 Microbiology
- 2.2 Salivary output
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1.4
Diagnostic imaging
- 3.1 Imaging overview
- 3.2 Intraoral radiographs
- 3.3 Panoramic
- 3.4 CBCT
- 3.5 CT
- 1.5 Diagnostic prosthodontic guides
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1.1
Clinical Assessment
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2
Treatment Options
- 2.1 Mucosally-supported
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2.2
Implant-retained/supported, general
- 1.1 Prosthodontic options overview
- 1.2 Number of implants maxilla and mandible
- 1.3 Time to function
- 1.4 Submerged or non-submerged
- 1.5 Soft tissue management
- 1.6 Hard tissue management, mandible
- 1.7 Hard tissue management, maxilla
- 1.8 Need for grafting
- 1.9 Healed vs fresh extraction socket
- 1.10 Digital treatment planning protocols
- 2.3 Implant prosthetics - removable
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2.4
Implant prosthetics - fixed
- 2.5 Comprehensive treatment concepts
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3
Treatment Procedures
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3.1
Surgical
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3.2
Removable prosthetics
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3.3
Fixed prosthetics
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3.1
Surgical
- 4 Aftercare
Complete Denture post-placement
Key points
- Post-placement visits should include evaluation of denture base fit, extension, occlusion, esthetics, function and comfort
- When appropriate, healing of soft and hard tissues should be evaluated
- Resilient relining material should be replaced if necessary
Post-placement visits - considerations
At post-placement visits, the same factors evaluated carefully at the insertion appointment should be reviewed again and adjustments made where necessary. Denture base fit, extensions, occlusion, esthetics, function, comfort and overall patient satisfaction need to be checked. Also, if these visits are post-surgery as might be the case for an immediate denture, the clinician should assess soft tissue healing and any residual swelling. If a resilient liner was placed, healing and shrinkage of soft tissues may result in poor denture base fit necessitating replacement of the liner. For most resilient liners, the mechanical properties are such that replacement every 2-4 weeks is indicated. Over the long-term, when denture base fit worsens with ongoing resorptive and morphological changes, a defintive reline of the denture base is indicated.
Patient response
Post-placement visits are of great importance for assessing the patient response to the esthetic outcome along with reviewing the patient's adaptability to the new prostheses and to determine if a removable prosthesis will satisfy the patient. Some patients choose a removable option initially only to find that they wish to switch to an implant overdenture or a fixed prosthesis once they experience daily living with a removable prosthesis. In these instances, implants and prosthetic re-design are likely indicated. Regardless of whether the patient likes or dislikes the complete denture, the prosthesis has served a valuable purpose in directing additional care to increase the probability of a satisfied patient.
