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Treatment Planning Complex Implant Cases

All on 4 / Teeth in a day

Immediate Load vs Delayed approach

Fixed Hybrid Prosthesis vs Bar Retained Removeable Prosthesis

Benjamin Franklin said “If you Fail to Plan then you must Plan to Fail”, has never rung truer especially when talking about complex implant cases.

Complete and Comprehensive treatment planning is essential for every patient. But when it involves complex implant cases or even planning for a single implant, it becomes even more critical.

 Three things must be addressed and they are as follows.

  • A thorough evaluation of the patient’s medical history, proper dental diagnosis, and appropriate treatment planning.
  • Knowledge, Experience and Training together with some of todays technology (CBCT, X Rays, Panoramics, Intra-oral Scans) and of course a thorough Clinical examination of the patient.
  • In order to successfully begin to plan a case it is paramount to have this information to properly diagnose your patients as well as assess bone quality, quantity, and enough space for the desired restoration, whether it is a single crown or Full Arch Bridge.

Planning = Success

When Treatment planning, I am a firm believer in Planning from the Top Down. I like to know where we want and need to end up, so we can plot a plan that will get us there.

Digital Smile Simulation/Design

A patient does not walk into your office asking for Implants, they come in asking for new teeth and a new smile.

  • One of the tools we use is to be able to Digitally Design the Patients New Smile before any work begins. This gives both the Patient and the Doctor a starting point as well as a goal to aim for.

Prevu Smile Simulation.

It is up to us to be able to guide them as to what is the Best Treatment for them. Afterall we are the professionals.

A clear, concise and understandable treatment plan should be given to the patient, and the patient must be informed of all the different treatment options and the risks and benefits of those treatments.

Fixed Hybrid Implant Bridge

Removable Bar Retained Overdenture

 The most difficult aspect to manage in these cases is the patient’s expectations, these must be managed throughout as these expectations can change a treatment plan and/or add steps to get the result the patient desires.

Most patients are unaware of how the whole process works.

  • They think that once an implant is completed no additional treatment will be needed. They must be informed and have the proper expectations and realize that certain maintenance is required.
  • Patients also have to understand that they have to take responsibility for their treatment. Patients that had bad oral hygiene practices before, are not suddenly going to change, unless they are made to understand that we can only do what we can do, the rest is up to them.

Homecare for Patients

  • A Waterpik device used twice a day is the number 1 way to start the cleaning process. Patients can access both the Buccal and Lingual as well as access points that will help dislodge any trapped debris. It is safest to use on the Low or Medium settings but not on high.
  • Floss or Super-floss tied to a floss threader is another way to access hard to reach spots.
  • To clean the transition area between the prosthesis and the soft tissue a sulcus brush can also be helpful.
  • A daily regime of rinsing with a medicated oral rinse is also recommended. Be aware that depending the type of prosthesis, some rinses may cause staining.

Furthermore, depending on the case, a patient will need to have regular restorative maintenance from time to time due to normal wear and tear, and that that will be charged accordingly and is part of standard maintenance.

  • The same way as you service a car and change its tyres and brakes etc, so a restoration also needs to be “serviced”.

Large Complex Cases are Definitely a TEAM SPORT.

Surround yourself with experienced and passionate people that have done these cases successfully, and work closely with our team at Dental Laboratory Associates that will be by your side every step of the way.

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