Patient assessment and diagnosis in implant treatment

Abstract

As in any dental treatment procedure, a thorough patient assessment is a prerequisite for adequate treatment planning including dental implants. The literature was searched for references to patient assessment in implant treatment up to September 2007 in Medline via PubMed and an additional handsearch was performed. Patient assessment included the following aspects: (1) evaluation of patient's history, his ⁄ her complaints, desires and preferences; (2) extra-and intra-oral examination with periodontal and restorative status of the remaining dentition; (3) obligatory prerequisites were a panoramic radiograph and periapical radiographs (at least from the adjacent teeth) for diagnosis and treatment planning. Additional tomographs are required depending on the anatomic situation and the complexity of the planned restoration; (4) study casts are needed especially in more complex situations also requiring a diagnostic set-up, which can be tried-in and transferred into a provisional restoration as well as into a radiographic and surgical template. The current review clearly revealed the necessity for a thorough, structured patient assessment. Following an evaluation, a recommendation is given for implant therapy or, if not indicated, conventional treatment alternatives can be presented.

Endodontics or implants? A review of decisive criteria and guidelines for single tooth restorations and full arch reconstructions

“…Any further bone loss, particularly reaching ≥2.5 mm, is considered as disease manifestation (Berglundh et al. 2002), and affects at least 28% of subjects (Zitzmann & Berglundh 2008a, Zitzmann et al. 2008b).…”

“…In the implant literature, the majority of studies report implant survival rates defined as simple retention (Berglundh et al. 2002, Zitzmann & Berglundh 2008a, Zitzmann et al. 2008b).…”

“…If success criteria are applied, the absence of clinical symptoms, no signs of inflammation and a limited marginal bone loss (e.g., not exceeding 0.2 mm after the first year in function) (Smith & Zarb 1989) are frequently mentioned. In several studies, however, disease symptoms are not consistently investigated, i.e., probing is not applied, and bone level assessments are made from panoramic radiographs with limited accuracy (Zitzmann & Berglundh 2008a, Zitzmann et al. 2008b).…”

Nerve Damage Assessment Following Implant Placement in Human Cadaver Jaws: An Ex Vivo Comparative Study

“…1 In order to prevent this type of damage, adequate information is needed regarding jaw bone quality and quantity in the implant region. 5,6 In addition, anatomical knowledge regarding the location of mandibular canal, the course of inferior alveolar nerve and incisive nerve is essential. 1 Radiography combined with clinical examination is the only method available for the presurgical evaluation of implant sites in routine dental practice; however, while easily accessible, periapical and panoramic radiographs can provide only two-dimensional (2D) information on teeth and bone.…”

“…1 Radiography combined with clinical examination is the only method available for the presurgical evaluation of implant sites in routine dental practice; however, while easily accessible, periapical and panoramic radiographs can provide only two-dimensional (2D) information on teeth and bone. 5,6 The popularity of cone-beam computerized tomography (CBCT) in implant planning has increased in recent years, but its use prior to dental implant surgery is still not as common as it should be. In comparison to traditional medical CT systems, dental CBCT units offer reduced effective radiation doses, shorter acquisition scan times, easier imaging and lower costs.…”