LECTURE NO.

lecture no I TUT courses - Dr. Walid El Aaser

lecture no I TUT courses - Dr. Walid El Aaser
Aim:

To know all information about

patient, implant & surgical
protocole
That enables you to perform
treatment planning

lecture no I TUT courses - Dr. Walid El Aaser

 Diagnosis & treatment planning

Patient Implant
selection selection

Using diagnostic aids

lecture no I TUT courses - Dr. Walid El Aaser

lecture no I TUT courses - Dr. Walid El Aaser
 Patient selection
 To decide weather patient is:
indicated or contraindicated
for: -implant surgery & -treatment of
complication
 If contraindicated patient :
we must know if he is ::
absolutely contraindicated
relatively contraindicated
if relatively contraindicated patient:
how to make him indicated patient
-Implant is not a life saving procedure
=Absolute and relative contraindication are relative
lecture no I TUT courses - Dr. Walid El Aaser
 ASA classification
1-Non contraindications

2- Relative contraindications

3- absolute contraindications

-philosophy of contraindication
lecture no I TUT courses - Dr. Walid El Aaser
 Category I:
Diseases / conditions / local or systemic
which are not contraindications for
implant

Example:
- simple caries far away to implant site
- gastritis -broken leg…

lecture no I TUT courses - Dr. Walid El Aaser

 Category II:
Diseases / conditions / local or systemic
which are relative contraindications for implant
Example:
- Implant field disease
- unfavorable local anatomy
- diabetes
- osteoporosis
- bad oral hygiene due to local factor
(ex:malocclusion)

lecture no I TUT courses - Dr. Walid El Aaser

 Category III:
Diseases / conditions / local or systemic
which are absolute contraindications for
implant
Example:
- Jaws, bone cancers
- Habitual bad oral hygiene
- Autoimmune disease
- Renal failure - liver failure
- Chemical therapy - Rheumatic heart disease

lecture no I TUT courses - Dr. Walid El Aaser

 Implant field
Maximum:
- 2 teeth or expected teeth mesial
- 2 teeth or expected teeth distal
- Implant site opposing
- one tooth or expected tooth mesial to opposing
- one tooth or expected tooth distal to opposing
Less than maximum:
according to type of disease and severity

lecture no I TUT courses - Dr. Walid El Aaser

Unfavorable local anatomy

- Orthodontic treatment needed

- Malocclusion
- No enough bone from real crest to vital structure

solution : addition (augmentation)

removing vital structure

lecture no I TUT courses - Dr. Walid El Aaser

 Anatomical landmarks
of importance for implantologist
Upper jaw :
floor of nose
floor of maxillary sinus

sinus lifting :----closed

--opened

lecture no I TUT courses - Dr. Walid El Aaser

 Anatomical landmarks
of importance for implantologist
Lower Jaw :
inferior border of mandible
mental foramen
inferior dental nerve

-inferior dental nerve

repositioning

lecture no I TUT courses - Dr. Walid El Aaser

 Diabetes and Implantation

lecture no I TUT courses - Dr. Walid El Aaser

 Osteoporosis and Implantation

lecture no I TUT courses - Dr. Walid El Aaser

 Bad Oral Hygiene

lecture no I TUT courses - Dr. Walid El Aaser

Diagnostic aids for patient selection
 By dentist :
- history - inspection
- palpation - caliperation
- periapical x-ray - lateral view x-ray
- panoramic x-ray - C.T scanning
- investigation
 By referral :
for diabetes
for osteoporosis

lecture no I TUT courses - Dr. Walid El Aaser

 Panoramic x-ray

lecture no I TUT courses - Dr. Walid El Aaser