Treatment Planning Completely Edentulous Ridges with Implants

The crucial factors in deciding whether a fixed or removable prosthesis should be planned will influence the entire treatment plan including implant positioning and flange considerations. Most factors precluding the use of a fixed implant–supported restoration are related to osseous and/or soft tissue deficiencies. The resorptive processes can cause prognathism the need for facial support speech disruption and/or esthetic problems. So any parameter that would rule out a fixed reconstruction should be assessed in the sagittal and vertical planes with the help of awax try-in. The first clinical diagnosis should be definitively verified within the reformatted CT scan. If bone and soft tissue deficiencies cannot be compensating for a removable reconstruction is the most desirable alternative solution. If a fixed prosthesis is feasible in patients with minimal resorption and limited intermaxillary space implants should be placed meticulously in the intended tooth position.