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Saturday 8:35 - 9:10am

The Total Face Approach (TFA) in Modern Implantology: A Novel Diagnostic/Therapeutic Algorithm

The Total Face Approach is a diagnostic/therapeutic algorithm that helps the clinician plan the most appropriate prosthetic design for complex cases.

Even though computer technology facilitates the accuracy of the surgical steps, the selection of the appropriate treatment plan is complex and the predictability of the esthetic result is sometimes uncertain.

The Total Face Approach allows the clinician to rationally choose between a fixed implant-supported prosthesis without pink material, a fixed implant-supported prosthesis with artificial gingiva (hybrid design), and removable implant supported prosthesis with labial flanges based on the anatomical and esthetic conditions of the patient.

The main advantage of this approach is that after the diagnostic phase, the most appropriate prosthetic design is automatically generated in accordance with the specific anatomical, esthetic, and prosthetic parameters of the patient.

However, if the clinician or the patient are not satisfied with the proposed prosthetic design, the therapeutic algorithm shows the surgical steps of hard and soft tissue reconstruction needed to switch from one type of prosthesis to the other in order to fulfill the main 3 prerequisites of an oral reconstruction: function (chewing ability, phonetics, free lip movements when smiling, and the absence of food entrapment in the transition zone ), esthetics in harmony with the entire face, and ease of maintenance with normal homecare hygiene procedures.

The prosthetic design should not be selected randomly or just on the basis of patient or operator preference. It should be chosen after a comprehensive evaluation that takes into consideration different parameters, while avoiding misunderstandings with the patient, whose desire is nearly always a fixed implant-supported restoration with a crown design. This design is not always achievable without a reconstructive phase and the patient should be informed of this limitation in advance.

At the conclusion of this lecture participants will have gained an understanding of:

  1. The rational steps to evaluate the patients' esthetics and function
  2. How to select the most appropriate implant prosthesis for each patient
  3. Which surgical steps are needed to switch from one type of prosthesis to the other (post-and crowns, hybrid prosthesis, overdenture)


Tiziano Testori, MD, DDS, FICD

Dr. Testori is head of the Section of Implant Dentistry and Oral Rehabilitation, IRCCS Galeazzi Institute, Milan. He was an assistant clinical professor, Department of Biomedical, Surgical and Dental Science, University of Milan, Italy and an adjunct Clinical Associate Professor, Department of Periodontics and Oral Medicine, The University of Michigan, School of Dentistry, Ann Arbor, Michigan.

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AAED 43rd Annual Meeting

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