Prof. Dr. Önjen Tak

FACIALLY DRIVEN PROSTHETIC PLANNING AND AESTHETIC RISK ANALYSIS IN IMPLANT-SUPPORTED FULL-ARCH PROSTHESES

It is complicated to achieve the ideal aesthetic and functional outcomes in every edentulous case, depending on the amount of soft and hard tissue lost in patients whose aesthetic expectations have increased exponentially in recent years. Additionally, considering that patients prefer fixed prostheses rather than removable prostheses, it is critical to select the proper prosthesis type in order to achieve aesthetic success. At this point; although hybrid prostheses have been preferred for aesthetic reasons in recent years, it should not be forgotten that they don’t fully meet the aesthetic expectations in every case. Therefore, making an extensive pretreatment evaluation and systematic treatment plan, including the evaluation of the relation between hard and soft tissues, and the determination of the individual optimum aesthetic values is mandatory for the rehabilitation of edentulous arches using implant-supported prostheses.

Evaluation of edentulous arches and visual perception of facial harmony are challenging because of the lack of anatomical references and teeth. Thus, a facially driven treatment planning with the help of diagnostic prostheses, which improves the aesthetic outcome and surgical accuracy is mandatory for edentulous patients. Furthermore, instead of following fixed paradigms to define aesthetic landmarks like the smile line, buccal corridor and tooth shape/size, an individual facial profile analysis with diagnostic prosthesis is helpful to determine the individual aesthetic values, taking into consideration the harmony among teeth, gingiva, lips, and face to design an attractive smile and fulfill patients’ expectations. Diagnostic prostheses also facilitate not only the determination of implant locations, the tooth arrangement, proper prosthesis type and pleasant smile, but also the simulation of the expected outcome of definitive restorations before treatment.

The main purpose of this lecture is to present how facially driven prosthetic planning can be integrated into the daily routine clinical workflow with its clinical steps.