Faculty of Dentistry
Removable Prosthodontics Division
Lecture : Dental implant treatment planning
[Link]. Dr.: Fatma Fouad Date : 27/2/2025
Implant treatment
Planning
Patient related Prosthesis related Implant related
factors factors factors
Patient related
factors
During diagnosis
Medical Patient force Patient esthetic, Cost of
Dental condition
condition factor functional needs treatment
Medical history Bone, soft tissue
Patient force factor
Parafunction
• Bruxism
• clenching
Masticatory power
• Sex (male force)
• Age( young force)
Crown height space (CHS)
• Load with increased CHS
Arch position
• Anterior region force
• Posterior region force
Opposing dentition
• Complete denture force
• Natural teeth (moderate ) force
• Implant fixed prosthesis force
Prosthesis
related factors
Anterior/ posterior Patient force factor
edentulous area
Bone density, esthetics
Maxillary/ Number of implant
mandibular
Bone density, esthetics
Single/multiple
implant Number, distribution
Partially or
completely
edentulous
Fixed/ removable
prosthesis
Implant related factors
Time of implant
Implant design Time of loading
placement
Surface treatment, body
Immediate or delayed Immediate / delayed
design
Bone density Bone density
Plan surgical site
Tissue level or bone level Surface treatment
Bone grafting
Tapered or conical Implant design
Steps of Treatment planning
Diagnosis Diagnostic Radiographs Prosthetic Implant
wax-up driven planning
approach
Patient related
factors
During diagnosis
Medical Patient force Patient esthetic, Cost of
Dental condition
condition factor functional needs treatment
Medical history Bone, soft tissue
Diagnosis
Medical Patient
Soft tissue Bone
history force factors
Non-
Keratinized
keratinized
Soft tissue
• Soft tissue around implant must be keratinized and attached to
underlying bone to provide 3-4 mm of tissue around implant forming
implant cuff.
• This cuff provides a seal around dental implant to prevent oral
microorganisms from leakage and cause bone resorption
Why keratinized mucosa????
• To withstand applied load during function.
• Can sustain oral hygiene measures around implant.
Non
Keratinized
keratinized
Less than More than
3-4 mm
3-4 mm 4 mm
Ideal Expect bone resorption Pocket formation
Free palatal graft
Apical
repositioning
Bone
• Width of bone at the crest of the ridge buccolingual.
• Length of bone mesiodistally.
• Presence of undercuts.
Steps of Treatment planning
Diagnosis Diagnostic Radiographs Prosthetic Implant
wax-up driven planning
approach
Diagnostic Diagnostic
Mounting
Impression. jaw
wax up casts .
relation.
Diagnostic Diagnostic
Mounting
Impression. jaw
wax up casts .
relation.
Diagnostic Diagnostic
Mounting
Impression. jaw
wax up casts .
relation.
Diagnostic Diagnostic
Mounting
Impression. jaw
wax up casts .
relation.
Importance of diagnostic wax up:
• The most esthetic placement of the restoration: lip support
Facial contour, lip line.
• This will decide the type of prosthesis removable or fixed.
• Analysis of crown height space available for restoration, mesiodistal space available for
crown.
• Fixed restorations require less space than removable.
• Screw retained and cement retained.
• Fabrication of radiographic stent.
• Fabrication of surgical guide.
Steps of Treatment planning
Diagnosis Diagnostic Radiographs Prosthetic Implant
wax-up driven planning
approach
Radiographic evaluation
• bone width.
• Bone height.
• Bone density.
• Bone angulation.
• M.D. length.
• Anatomical structures.
• Prosthetic space
assessment
Steps of Treatment planning
Diagnosis Diagnostic Radiographs Prosthetic Implant
wax-up driven planning
approach
prosthetic driven approach
• considers the final prosthetic outcome during the planning and placement phases of dental
implant treatment.
