Management of Narrow and Short Ridge Dimensions in Implant Dentistry: New Minimally Invasive Concepts
The management of narrow and short ridge dimensions has posed a great concern for most implantologists.
Often large GBR or block augmentation procedures are suggested with high morbidity but this lecture presents more minimally invasive options to restore these ridge challenges. Ridge Expansion with motorized drills as well as the utilization of ultra-short and wider implants to avoid sinus and nerve proximity challenges will be discussed. The role of blood born bioactive modifiers, specifically PRGF (Plasma Rich in Growth Factors) to enhance wound healing will similarly be highlighted.
The Biomimetic Approach to Saving Teeth: Minimally Invasive Restorations and Periodontal Surgery
Stress reduced composite restorations now play a significant role in minimally invasive restorative dentistry. When combined with micro-periodontal surgical grafting techniques to alter gingival levels these procedures save teeth and warrant further consideration in our daily treatment. Our ability to minimize tooth reduction during tooth preparation and still maintain a strength of material and of bonding on previously exposed root surfaces as well as endodontically treated teeth is the future of a truly biomimetic approach.
This presentation highlights this biomimetic approach to treatment and showcases the clinicians ability to provide long term management of both function and esthetics. It should open our eyes to the potential of maintaining the dentition of our patients rather than crown or implant replacement.
The AGE Approach: A Combination Protocol for Hard and Soft Tissue Augmentation in Complex Cases
Although new restorative materials have improved predictability and outcomes, hard and soft tissue management plays a fundamental role when working in aesthetic areas. To achieve ideal results, preservation of the natural hard and soft tissue architecture is the primary clinical objective. This new proposed AGE protocol illustrates the importance of hard and soft tissue management when working in esthetic and highly compromised areas.
This protocol and schematic approach was developed to help the surgical practitioner visualize and divide the problem into a predictable step-by-step workflow.
"The Root Membrane Technique” / Socket Shield: Long-Term Results
Loss of blood supply derived from the periodontal ligament (PDL) has been identified as a major etiologic factor for ridge resorption. Animal studies and case reports provide proof-of-principle data on the feasibility of immediate implant placement in proximity to a retained root fragment for the strategic preservation of the natural tooth apparatus. This novel concept relies on the preservation of PDL, buccal bone and soft tissue esthetics via selective preservation of the buccal portion of the root and PDL which can lead to predictable and sustainable clinical stability of immediately placed and loaded implants.
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.
The BARI Technique: A New Approach To Immediate Loading
When dealing with full-arch rehabilitation,
the provisional phase is important
in order to define the correct occlusal,
intermaxillary, and esthetic relationships
for each individual patient. In
these cases, it is difficult to transfer this
information to the final restorations. Several
techniques have been developed
to transfer the information from tooth- or
implant-supported fixed provisionals to
the definitive rehabilitations. The present
article describes a technique proposed
by the authors to transfer the information
from a removable prosthesis to an
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 Socket-Shield Technique: First Histological, Clinical, and Volumetrical Observations after Separation of the Buccal Tooth Segment – A Pilot Study
The “socket-shield technique” has shown its potential in preserving buccal tissues. However, front teeth often
have to be extracted due to vertical fractures in buccolingual direction. It has not yet been investigated if the socket-shield
technique can only be used with intact roots or also works with a modified shield design referring to vertical fracture lines.
The aim of this study was to assess histologically, clinically, and volumetrically the effect of separating the
remaining buccal root segment in two pieces before immediate implant placement.
Zero Bone Loss Protocol - Part I: Influence of Vertical Soft Tissue Thickness on Crestal Bone Stability
It is suggested that thin tissues might be thickened during implant placement, thus reducing bone resorption. The role of soft tissue thickness is well established in aesthetic treatment. It is known that thin soft tissues present an unfavorable situation for implant placement, crestal bone stability and subsequent prosthetic treatment.
Hard and Soft Tissue Augmentation: Optimizing Esthetic Results for the Restorative Dentist
Contemporary patient expectations have made esthetics a major requisite of all treatment plans, especially in situations where there is a high smile line. Although new restorative materials have highly improved predictability and esthetic outcomes, soft and hard tissue management play a fundamental role when working in esthetic areas. To achieve ideal esthetics, preservation of the natural soft and hard tissue architecture is a primary clinical objective. These new proposed techniques illustrate the importance of pre-prosthetic soft and hard tissue management when working in highly esthetic compromised areas.
The Socket Shield Technique - Have the Rules of the Game Changed in Aesthetic Zone Implant Therapy?
Implant therapy is in the age of being increasingly aesthetically driven, not merely restorative. With the increasing popularity of immediate implants, particularly with anterior tooth extraction, the relevance of socket changes following extraction has come to the fore. Contrary to what was originally believed, the installation of an immediate implant does not arrest bone loss, and immediate implants in the aesthetic zone are prone to recession of bone and soft tissue as a result of bundle bone resorption which is obligatory with tooth extraction.
Crowns and Bridges