The Evolution of Guided Surgery and Case Management
The innovation in assisted implant surgery is constantly increasing. This success is due to the fact that guided surgery provides a reliable therapeutic solution. The use of these techniques is not only interesting for implant-supported rehabilitation by immediate loading but also for tissues supporting implants by insuring the best emergence profile.
Surgical Concepts to Treat Esthetic Implant Disaster Cases - Part 2 of 2
The utilization of dental implants in the esthetic zone is a challenge for involved clinicians. With the increasing application of dental implants by non-experienced colleagues, the occurrence of esthetic failures with implant supported restorations is raising. This lecture will address the causes for such esthetic failures and the surgical approach for therapy. In most cases, implant removal is necessary, which must be done with a low-trauma technique to avoid additional bone loss. Today, this is done with special implant removal instruments using the Reverse Torque Technique. In addition, these failures are often characterized by a lack of keratinized mucosa.
The current strategies for the reestablishment of keratinized mucosa and for the augmentation of missing bone, mainly on the facial aspects are presented and documented with case reports. This includes aspects of timing, surgical techniques, and the selection of appropriate biomaterials.
Partial Extraction Therapy (PET) in Everyday Practice: Part 1
This presentation outlines the evidence-based, biological, esthetic and technical aspects of utilizing Partial Extraction Therapy (PET), such as Socket Shield technique, in everyday practice. Combining PET with Endoret® Graft, on immediate post extraction implant placement, seems to be an effective way to maintain anatomy, minimizing bone level's change after the bone remodeling period, and maximizing the aesthetic outcome, due to adequate soft tissue's levels and contour.
Partial Extraction Therapy (PET) in Everyday Practice: Part 2
This presentation describes new tools, including burs and new trans-mucosal abutments, which may enhance the clinician's ability to incorporate the Socket Shield technique into their practice. In addition, incorporating in-office CAD CAM technology, such as Zirkonzahn, makes it possible to design and fabricate same-day custom restorations including the ability, under special circumstances, to go directly to the final restoration.
Surgical Veneer Grafting - Compensation for Natural Labial Plate Remodeling After Immediate Implant Placement
Contemporary implant therapy aims to provide highly
esthetic and predictable treatment outcomes while decreasing
treatment duration and complexity. The clinician
must therefore be cognizant of circumstances with a predisposition
toward esthetic outcomes and treatment plan
accordingly. Preservation of the surrounding hard and
soft tissues associated with an immediate postextraction
socket implant to replace a nonrestorable tooth in the
esthetic zone is one of the greatest challenges facing the
dental team. A case report of a hopeless maxillary left central incisor in a patient with a thin periodontal phenotype illustrates this new surgical and prosthetic approach. Clinical, radiological,
and esthetic parameters were recorded to evaluate primary
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
The Pontic-Shield: Partial Extraction Therapy for Implant Dentistry
Augmentive ridge preservation techniques aim to manage the postextraction ridge. The partial extraction of teeth may better preserve the ridge form by maintaining the bundle bone-periodontal tissues and preserve the ridge beneath dentures or fixed prostheses. The socket-shield technique entails preparing a tooth root section simultaneous to immediate implant placement and has demonstrated histologic and clinical results contributory to esthetic implant treatment. A retrospective 10-patient case series treating 14 partial extraction sites demonstrates how a modification of the socket-shield technique can successfully develop pontic sites and preserve the ridge.
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.
The Evolution of Site Management for Implant Placement
During the last 20 years we have experience in Periodontics and Implantology a large amount of research and clinical cases that have aloud us to better understand how the Extraction and Implant Site behave. The Evolution of Site Management for Implant Placement goes to what we consider the most critical factors that influence our results in todays practice. The presentation goes through the evidence based alternatives and how this have changed with time. We also go through the Socket Shield alternative and present some of what we consider the future on this area will be.
Managing Esthetic Implant Complications
Dental implant success today is judged not only by osseointegration but also by bone, tissue stability and of course long term esthetic results. Cosmetic predictability can often be difficult to attain, and esthetic implant failures can be multifactorial and patient management issues. Once esthetic implant failures occur, many cannot be fully corrected. Some complications must be addressed by an interdisciplinary dental team. In this summary of case reports, surgical considerations are provided, including cases of facial asymmetry/recession due to facial implant placement or bone loss resulting from technique/treatment failures, as well as papillary deficiencies. Restorative considerations for correcting failures are also discussed.
The Role of Digital Technologies & Materials for Full-Arch Implant Reconstruction
In prosthetic rehabilitations, we used for many years codified and widely described protocols in literature, with results that met our expectations and well above those of our patients. It is true that the advent of new technologies has enabled the dental team to use new material and new equipment that facilitated the production of an adaptation and an accuracy of the prosthetic rehabilitation that has, up to now, been difficult to obtain.
In this presentation, we will analyze different cases, highlighting the operational differences that they have developed over time, with the increasing knowledge of the new materials and the daily developing of the new software's. It is also described how traditional materials and techniques have been replaced with other innovative new technologies, and how the results obtained with these are systematic and significantly better in updated generations prior.
Immediate Implants: Partial / Full Arch Rehabilitation & GBR - Part 2
By scientific studies produced in recent years has been confirmed, in selected cases, the validity of the post-extraction implants. The use of this method implies a lower emotional impact, a single surgery and a healing often better for the patient. We will be discussed traumatic extraction methods, perfect insertion of the implants with or without bone regeneration with bone substitutes and membranes and the opportunity to combine an advanced method as immediate implant with the execution of an immediate loading to restore aesthetics in more complex cases.
Crowns and Bridges