CASE SELECTION AND

TREATMENT PLANNING FOR

IMPLANT PLACEMENT
 Introduction
• The use of dental implants to provide support for
replacement of missing teeth is becoming an
important component of modern dentistry.
• Many individuals with edentulism can be treated
with partial or complete traditional removable
dentures or fixed bridges.However,these prostheses
are not satisfactory for a significant number of
individuals who have lost the tooth bearing portions
of the bone and simply cant manage removable
prosthesis, or medically compromised and cant
properly masticate food.In these cases dentists
suggests implant supported prosthesis.
 Patient risk factors
• Proper case selection is the most important aspect of implant
risk management.The following major risk and selection factors
should be considerd.

• SYSTEMIC FACTORS:Dibetes,bleeding disorder or

hypertension.Dentist should always begin by investigating
whether there are important systemic disease processes that
should be addresed before recommending dental implants.

• LOCAL FACTORS:Include adequacy of bone,oral

hygiene,occlusion,ridge morphology,bone quality,sinus or nerve
position,periodontal status.

• OTHER FACTORS:Include tobacco and alcohol use,patient

attitude,co-orporation,home care,ability to afford treatment
and reasonableness of expectations.If you sense that the
patients expectations are unrealistic ,don’t accept the case.
OVER VIEW OF TREATMENT
PLANNING
• Medical Evaluation

• Dental Evaluation

• Formulation of treatment plan

 MEDICAL EVALUATION
• Medical History

• Vital Signs

• Complete Blood Count

 DENTAL EVALUATION

• Clinical Evaluation and Charting

• Diagnostic Records

• Patient Expectations
 Clinical evaluation and charting
• ORAL PATHOLOGY
o Assessment of t.m.joint
• Periodontal Parameters
• Dental Caries
 Diagnostic records
• Photograph

• Study Models

• Radiograph

• Diagnostic Waxup
 BONE DENSITY
• Avalability of bone is particularly
important in implant dentistry and
is describes the external
architecture or volume of the
edentulas areas considered for
implants
• D1:-dense cortical bone
• D2: thick dense to porous cortical bone
on crest and course trabecular
bone within.
• D3: thin porous cortical bone on crest
and trabecular bone within.
• D4: fine trabecular bone .
 Available bone
• Available of bone describe the amount of
bone in the edentulas area considered for
implantation and is measured in

• HEIGHT
• WIDTH
• ANGULATION
• CROWN IMPLANT BODY RATIO
AVAILABLE BONE HEIGHT
 Available bone height
• The minimum bone height for a
predictable long term endosteal implant
survival is 10mm
• The height of implant also affect the
total surface area
• The advantage of increase height helps
in initial stability and long term
resistence to movment forces
Available bone width
 Available bone width
• 1mm:bone remaining after implant
placement to anatomical structure
• 2mm:tooth to implant
• 3mm:implant to implant
• 7mm:implant to implant in over denture
 Available bone length

• The length of available bone is

necessary for endosteal implant survival
it depends on the width of the bone
 Available bone angulation

• Idealy the bone angulation is alinged

with the forces of occlusion and is
parallel to the long axis of the
prosthodontic restoration
 Crown implant body ratio
• The crown height is measure from the occlusal or
incisal plane to the crest of the ridge and the endosteal
implant height from crest of the ridge to its apex.
• As the crown implant ratio
increases,the number of implants
and or wider implants should be
inserted to counteract the
increase in stress