Transition from a hopeless dentition to a fixed implant-supported full-arch reconstruction can be difficult for patients, if wearing a transitional removable denture is involved. In addition, an increased risk of trauma to bone-augmented areas and to the implant-bone interface exists when using a removable transitional complete denture during the implant healing period; such risk can compromise implant success or increase crestal bone loss around implants before the final restoration. This lecture describes a treatment approach that allows replacement of the hopeless dentition with an osseointegrated fixed prosthesis, without rendering the patient totally edentulous before the delivery of the final implant-supported prosthesis. A staged approach using a few hopeless teeth to support a provisional fixed restoration during the healing process can help avoid discomfort and improve implants’ outcome.  Clinical cases and treatment plan strategies, some of them innovative, are used to illustrate the staged approach protocol. This protocol addresses patients’ psychological need to remain dentate during full-mouth rehabilitation while providing good esthetics and function during the restorative process of a dental arch.

Lecture Objectives:

• Cover common treatment modalities for fixed full arch implant candidates
• Understand the factors involved in treatment planning for the “Staged Approach” technique
• Understand the rationale and protocol of the “Staged Extraction Approach”