Implant Planning Considerations

Aesthetic

• Lip Coverage: Assess the coverage of lips during normal function and smiling, especially for anterior teeth and gingiva.
• Anterior Restorations: Ensure they provide adequate lip support.
• Restoration Appearance: Evaluate planned restorations using diagnostic setups or provisional restorations. These can also be used to create surgical stents or guides for optimal implant placement and serve as transitional restorations during treatment.
• Patient Evaluation: Assess patients with and without their current or provisional prosthesis to evaluate facial contours, lip support, tooth position, and prosthesis visibility during function.
• Pink Aesthetics: Consider soft and hard tissue grafting to achieve the most aesthetic outcomes.
• Tissue Condition: Evaluate the presence of keratinised tissue and the position of the frenulum.
• Ridge Shape and Volume: Assess the shape and volume of the ridge.
• Occlusal Analysis: Conduct a thorough analysis of occlusion.

 

Functional

• Function: Reduced function is commonly reported by patients missing molars.
• Shortened Dental Arch: Consider the implications of a shortened dental arch.
• Occlusion Assessment: Ensure a comprehensive assessment of occlusion.

 

Planning

• Visual and Palpation Assessment: Evaluate the ridge’s height, width, and contour visually and through palpation. Detect concavities or depressions, particularly on labial aspects. Consider the ridge's angulation and its relationship to the opposing dentition.
• Clinical Techniques for Assessment:
  • Ridge Mapping: Utilise ridge mapping for accurate assessment.
  • Soft Tissue Measurement: Measure soft tissue thickness by probing to the bone with a graduated periodontal probe after local anaesthesia (bone sounding).
  • Distance Measurement: Measure the distance between the edentulous ridge and the opposing dentition to ensure sufficient space for restorative components.
  • Ridge Form Considerations: Proclined ridge forms may necessitate Proclined implant placement, affecting aesthetics and loading.
  • Jaw Discrepancies: Large horizontal discrepancies between jaws, such as pseudo class III relationships following extensive maxillary resorption, may not be suitable for fixed bridges.
• Soft Tissue Assessment:
  • Thickness and Type: Assess soft tissue thickness for aesthetic considerations. Keratinised tissue attached to the ridge provides better peri-implant soft tissue support than non-keratinised mobile mucosa.
  • Implant Placement Considerations: Measure the length of the edentulous ridge to estimate the possible number of implants. Evaluate available space, influenced by adjacent tooth root angulation, either palpably or via radiographic assessment.

 

We would like to acknowledge Dr. Manraj Kalsi for his insights and contributions to this page