Soft Tissue Grafting Around Compromised Dental Implants in the Esthetic Zone
Dental implant esthetics can be challenging, but these challenges are magnified when a patient has had multiple failed implant and bone grafting surgeries. This video demonstrates the treatment of one such case. This is a surgical video demonstrating the VIP-CT (Vascularized Interpositional Connective Tissue) graft. While multiple treatment options exist, this start-to-finish video highlights the patient's initial presentation, the surgical technique, and the final outcome at 2 years.
The Diagnosis and Treatment of Inflammatory Peri-implant Disease: We Have a Problem
This detailed presentation will discuss the etiology, microbiology, histopathology and clinical manifestations of peri-implant disease, and will present evidence based in-office and at-home treatment regimens to stop mucositis from progressing to peri-implantitis. Additionally, "COAP", a new minimally invasive surgical technique for the treatment of peri-implantitis will be introduced.
Surgical Concepts to Treat Esthetic Implant Disaster Cases - Part 1 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.
Sinus Grafting and Minimal Risk Techniques
Sinus floor elevation represents today a predictable solution allowing implant placement in atrophic posterior maxilla with high implant success rate. Several techniques and different grafting biomaterials have been used clinically, depending on residual bone, patient’s needs and implantation protocols.
During this presentation, we will present latest advances in both lateral and crestal sinus floor elevation techniques. The importance of new advances and technologies, such as radiographic planning and the use of piezosurgery, will be exposed. These clinical advances will play a major in reducing risks and complications related to sinus grafting procedures while preserving maximum clinical efficiency.
Antimicrobial Effect of a Single Dose of Amoxicillin on the Oral Microbiota
Amoxicillin is commonly used in oral surgery for antimicrobial prophylaxis against surgical-site infection and
bacteremia because of its effect on oral streptococci. The aim of this study was to determine whether amoxicillin reaches
the break-point concentrations in saliva and has any effect on the salivary microbiota, colonizing bacteria on mucosal
membranes and on the gingival crevice after a single dose of amoxicillin. A single dose given as prophylaxis to prevent a surgical-site infection results in a significant reducing effect on
the oral streptococcal microflora in the gingival crevice and may have an impact on bacteria spreading into tissues and the
bacteria of streptococci.
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.
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.
Transcrestal Sinus Floor Elevation: Most Frequently Asked Questions
Over 20 years of clinical application and research on transcrestal sinus floor elevation (TSFE) procedures using a variety of implants, graft materials and instrumentation has proven its reliability, and versatility. While improving upon the original osteotome technique they have not yet eliminated the need for a more invasive lateral approach, especially at sites with very limited (1-2 mm) sub-antral bone. Extensive analysis of the existing research and long-term clinical experience will provide the answers to the most pertinent questions surrounding the transcrestal approach including but not limited to: patient selection, clinical limitations, instrumentation, graft selection/necessity and management of membrane perforations.
Modern Crown Lengthening: Classification and Clinical Application
Crown lengthening procedures are indicated to provide adequate tooth structure in case of subgingival tooth fracture or caries, uneven gingival level, un-esthetic short crowns due to the tooth wear, inadequate axial height, altered passive eruption ,forced eruption of a single or multiple teeth and finally in case of gingival smile.
The treatment modality for esthetic crown lengthening procedure should be based on detail diagnosis in each case because of the multifactorial etiology and because of the type of therapy selected by the clinician, will have a direct implication for the esthetic result.
Crowns and Bridges