Interpositional Bone Grafts to Treat the Posterior Atrophic Mandible
This presentation analyzes the interpositional bone graft or inlay technique, discussing the reconstructive surgical approach. Horizontal osteotomy with the interposition of bone in the form of a “sandwich” involves raising a coronal osteotomized segment of the mandible, which is still attached to the lingual periosteum, and interpositioning a block bone graft. This technique guarantees a dual vascular supply to the inlay graft from the lingual periosteum and from the residual bone; it also allows optimum use of the native basal bone, which should be less prone to resorption. The advantages and disadvantages of the inlay technique are compared with other commonly used augmentation techniques in the management of posterior mandibular atrophies.
A Defined Algorithm for Regenerative Success Part 2
These presentations will focus open the above concepts but prioritize the diagnostic phase and surgical common denominators required for a successful regenerative outcome. Flap design, space maintenance, bone and membrane selections and tension free closure provides the template for all the new age materials and technologies to be successful in clinical practice.
Bone Reconstruction: A New Algorithm for the Implantologist
Bone augmentation is often required to place an adequate number of dental implants in ideal positions for prosthetic support. In addition to biomechanical demands bone augmentation can also provide proper ridge contour for improved esthetic outcomes. Disadvantages of bone augmentation techniques include increase morbidity, surgical time, costs and treatment length. As such a trend has develop towards treatment approaches that avoid bone grafting including shorter and narrower implants, angled implants and/or fewer implants for prosthetic support. This presentation will look at various bone augmentation techniques, methods to minimize the morbidity of bone grafting and guide clinicians on implant rehabilitation with grafting versus non-grafting approaches.
Advances in Hard and Soft Tissue Management Using 3D Printing Technology
It is becoming rare today to come across simple cases in Periodontics; our specialty has come to face complex cases where hard and soft tissue deficiencies are quite common. These suggested protocols and schematic approaches were developed to help the surgical practitioner visualize and divide the problem into a predictable step-by-step workflow. The utilization of 3-D printed CBCT studies of the treatment planned surgical sites was shown to be integral in patient care and clinical outcomes. Every step is dictated by biology; all incision designs, flap management techniques, and biomaterials used have been selected to maximize the blood supply in the area and minimize trauma to the vascular network that nourishes our surgical site.
Reconstruction of a Single-Tooth Traumatic Defect in the Anterior Maxilla Using the Khoury Bone Plate Graft
Trauma to teeth and the dentoalveolar process may result in a ridge defect that precludes straightforward implant
therapy of the patient. Typically bone and soft tissue augmentation of the area would first be needed to adequately
prepare the tissues for the implant and its restoration..Grafting of the site is substantially more difficult in cases where
the ridge also lacks adequate height, and techniques to recreate a bony envelope to apply guided bone regeneration
may be required. Moreover, defects in the anterior aesthetic zone that require both bone and soft tissue grafting and
a restoration that harmonizes the adjacent pink and white aesthetics may be an even more significant challenge to
the restorative team. Hereafter a case of trauma to an anterior maxillary tooth that saw destruction of the ridge is
presented, with the defect reconstructed to accommodate a functional and aesthetically pleasing implant supported
Immediate Implant Placement into Extraction Sockets with Labial Plate Dehiscence Defects: A Clinical Case Series
To measure the buccal plate reconstruction of extraction sockets with labial plate dehiscence defects using a bone
allograft in combination with an absorbable collagen membrane and a custom-healing abutment at the time of tooth
removal. Implants placed into sockets with labial plate dehiscence defects demonstrated radiographic reformation of the labial plate dehiscence defect at 6 to 9 months post-treatment. The net gain in labial plate on CBCT in L1 and L2 was 3.0 mm, where 0 mm existed at pre-treatment. The minimum amount of labial plate thickness of 2.0 mm was achieved in all treated sites, evaluated radiographically at 6-9 months post-operatively, in a single
procedure, without flap elevation and maintaining the gingival architecture and satisfactory esthetics.
Subclassification and Clinical Management of Extraction Sockets with Labial Dentoalveolar Dehiscence Defects
Immediate implant therapy involving implants placed into intact Type 1 extraction sockets has become a consistent clinical technique. The classification of Type 2 extraction sockets, where the mucosal tissues are present but there is a midfacial osseous dehiscence defect, has been described according to the extent of the buccal bone plate absence. The literature has offered different techniques in the treatment of Type 2 sockets; however, the extent of the defect has never been defined or delineated.
Manejo Integral de Maloclusion Clase III en Adulto, con Requerimientos Periodontales y Protesicos; Reporte de un caso clinico
En nuestra clinica observamos un aumento de pacientes adultos con problemas esqueletales, compromiso periodontal y necesidades protesicas. Debemos recurrir a la interconsulta con el periodoncista, protesista y cirujano maxilofacial, para la correccion del caso, prestando especial atencion al componente dentario, esqueletal y los tejidos blandos faciales del paciente. La cirugia ortognatica, que generalmente la realizamos luego de una preparacion ortodoncica, permite corregir discrepancias en el adulto y restaurar la funcion y estetica en los tres planos del espacio. Realizada la correccion oclusal, procedemos a sustituir dientes ausentes, mediante implantes y protesis fijas. El Periodoncista, mantiene un control constante de la salud de los tejidos de soporte, durante todas las fases de la terapia multidisciplinaria.
Combined Augmentation Therapies in the Esthetic Zone
The esthetic zone presents a far bigger challenge than any other area of the mouth. It is the one area that a patient has the ability to really scrutinize the work that has been done and anything that does not pass muster will quickly create problems in our practices. Uncompromising treatment planning is therefore essential to ensure the long term aesthetic stability of our esthetic cases. Treatment planning involves both bone and soft tissue therapy as both are critical for the stability. This lecture will highlife the importance of different treatment options as well as show numerous new techniques that are possible to achieve the results that both our patients and practitioners are proud of.
Achieving Stable Esthetic Results with Implant Supported Restorations
We will discuss basic concept regarding immediate implant placement and guided bone regeneration procedure related to the esthetic zone before focusing on the soft tissue management. We will describe the prosthetic procedures which are performed before, during and after the surgical procedures. Provisional restorations, impression techniques, prosthetic profiles and restorative materials will be presented. The purpose of the presentation is to provide a check list that will guide the clinician developing a proper analysis and diagnosis for the successful esthetic result with implant supported restoration.
Crowns and Bridges