Implant Treatment Planning for the Edentulous Patient, A Graftless Approach to Immediate Loading

Implant Treatment Planning for the Edentulous Patient

A Graftless Approach to Immediate Loading

By Edmond Bedrossian, DDS, FACD, FACOMS, Diplomate, American Board of Oral and Maxillofacial Surgery Associate Professor, Department of Oral and Maxillofacial Surgery Director, Implant testing, University of the Pacific, Oral and Maxillofacial Residency Training Program Private Practice, San Francisco, California


1. Demographics of the edentulous patients

2. Osseointegration: rational for 2-stage vs. 1-stage protocols

3. Immediate loading

    1. 2-stage procedures
    2. Distance Osteogenesis
    3. Contact Osteogenesis
    4. Enhanced surfaces, Fluid retention index
    5. ISQ and immediate loading

4. Treatment limitation in treating the edentulous maxilla

    1. Literature review for treatment of the edentulous maxilla
    2. Lip support, VDO, phonetics, oral hygiene
    3. Surgical limitation for implant placement (posterior maxilla)
    4. Grafting approach: Surgical reconstruction of composite defects
    5. Prosthetic reconstruction of composite defect

5. Systematic pretreatment evaluation of the edentulous maxilla

    1. Composite defects
    2. Types of implant supported prosthesis
    3. Transition line
    4. Zones of the maxilla

6. Graftless approach for the treatment of the edentulous maxilla

a) Anterior tilted implant concept

7. Graftless approach for the treatment of the edentulous maxilla

a) Zygoma implant concept

8. Systematic pretreatment evaluation of the edentulous mandible

    1. All-on-4 concept

9. Conversion technique for immediate loading of the edentulous patient

10. Computer guided surgery (CGS)

    1. Treatment planning
    2. Guided templates
    3. Immediate loading

d) CGS: Maxillary tilted implants

e) CGS : Mandibular tilted implants

f) CGS : Zygoma concept

11. Case presentations: Alternatives for the final framework designs

    1. Hybrid vs. Profile prosthesis
    2. Titanium framework for the final profile prosthesis

c) Cal bar for the final profile prosthesis

12. Case presentations: Immediate loading tilted implants

    1. Tilted concept maxilla profile prosthesis
    2. Tilted concept mandible: profile prosthesis
    3. Tilted concept: PFM prosthesis

13. Case presentations: Immediate loading zygoma implant

    1. The zygoma protocol
    2. Combination of failing teeth and implants
    3. Guided zygoma

14. Case presentations: Advanced procedures

    1. Complete anodontia
    2. Ectodermal dysplasia
    3. Management of the patient with alveolar cleft
    4. Immediate replacement of existing failing implants
    5. Failing implant supported maxillary overdenture

15. Case presentations: Management of complications

    1. Failed zygomatic implant
    2. Failed tilted implant

16. Case presentations: The quad-zygoma concept