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Short and narrow implants, how far can we go?
Christoph Hämmerle, José NartIn this webinar moderated by Prof Ronald Jung and Dr. Adrián Guerrero the expert presenters Prof. Christoph Hämmerle and Dr. José Nart discuss about the importance and benefits of using short and narrow implants. -
REAL-TIME NAVIGATION: THE BEGINNING OF A NEW ERA IN GUIDED IMPLANT SURGERY
Objectives: To demonstrate that dynamic guided surgery is as predictable as conventional surgery. Methods: Partially edentulous patients requiring a fixed rehabilitation were selected for this pilot study. No specific contraindications were established, and smokers were not excluded. An impression was taken pre-operatively using an irreversible hydrocolloid (Cavex CA37®) to fabricate a diagnostic cast for moulding the surgical stent (NaviStent®). Afterwards, a standard cone-beam CT (CBCT) scan was made with the NaviStent® in place using a Planmeca Promax 3-D Max®. Images were converted into DICOM files and transformed into a 3-D virtual model using the Navident® software. The potential implant locations were planned in a prosthesis-driven way. For preparing the osteotomy, the drilling axis of the handpiece and the twist drills were calibrated. The osteotomies were prepared at low speed using a high level of cooling. The navigation software guided the drilling procedure in real time. Before installing implants, an extra calibration procedure was performed for tracking the implant. The aim of this pilot study was to determine the clinical outcome up to 12 months post-operatively for implants installed using the Navident® guided surgery system. Results: Partially edentulous men (n = 6) and women (n = 7) were included in this pilot study (mean age 52.15 years; range 20–75). Out of these 13 patients, two were current smokers of more than 10 cigarettes per day. Twenty implants were inserted. No mechanical or biological complications occurred during the surgical procedure, and no major complaints were reported, such as hemorrhage, sinus pathology or severe post-operative pain. No implants were lost up to 1 year after insertion, resulting in 100% implant survival. Conclusions: Based on the results of this pilot study, real-time navigation is a promising technique. However, there is not yet enough evidence to show that the method is as safe and predictable as conventional implant surgery. -
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Covering a Recession with a Soft Tissue Transplant
Heinz, Bernd / Jepsen, SörenObjectives: Use of a soft tissue graft for recession coverage at tooth 23 and for gingival augmentation. Content: 1. Incision around tooth 23, intra-sulcular preparation, mobilization of coronal sliding flap, and pre-flap preparation. 2. Root smoothing, reduction of ground cavity with diamond burs from Perioset system. 3. Preparation and harvesting of connective tissue flap from palate, Emdogain application, and wound closure. 4. Placement of interrupted interdental sutures for fixation of connective tissue flap. -
Esthetic and Restorative Dentistry - Ceramic Materials
Terry, Douglas A. -
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Implantation with Simultaneous Augmentation
Grunder, UeliProcedure: - Case evaluation - Incision technique - Implant placement - Membrane adjustment and fixation - Introduction of replacement material - Flap mobilization - Suture technique Contents: Implantation was desired for replacement of a missing upper canine tooth and the adjacent lateral incisor tooth. The initial case evaluation revealed a relatively narrow gap between these two teeth in addition to extensive hard and soft-tissue defects. We selected an incision technique that made it possible to do the augmentation work yet subsequently achieve a tension-free flap closure. Since the bony defect was large while the available space was limited, we had to go for the best possible compromise in regard to implant insertion. After the implants had been inserted, augmentation was carried out using a non-absorbable, titanium-reinforced membrane, bone replacement material, and an absorbable membrane. Extreme flap mobilization was needed to achieve flap closure. An optimal suture technique was used to complete the surgery. -
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Aesthetic upper anterior implant placement case
Dr. Dominik BüchiDr. Dominik Büchi performed a ridge preservation to keep the soft tissue volume. He then placed an implant 8 weeks later with simultaneous GBR. The final emergence profile was created by a fixed provisional crown. -
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Soft Tissue Management in the Aesthetic Zone
Daniel ThomaExpert presenter PD Dr. Daniel Thoma is a Head of Academic Unit at the Clinic for Fixed and Removable Prosthodontics and Dental Material Sciences, University of Zurich, Switzerland. Long-term successful outcomes with implant therapy are based on a number of parameters. Among these, the critical assessment of the peri-implant soft tissues and subsequent therapeutical interventions are considered key factors. -
Periodontal Preserve Therapy (Examples)
Clotten, StefanContent: - Periodontal maintenance therapy for teeth 34 and 35, including the regeneration of a bone defect using bone replacement material, collagen membrane and sutures. - Curettage for treatment of periodontal pockets. - Treatment of gingival pressure sores caused by tight-fitting orthodontic apparatus. - Incision of buccal attachment to relieve gingival pressure for elimination of gingival recession. -
Live surgery Surgical treatment of bone necrosis
Schultze-Mosgau, StefanOutline: - Surgical wound debridement - Sequestrotomy - Preparation of the soft-tissue bed - Plastic, tension-free, saliva-proof wound closure List of materials Basic surgical tool set: - Surgical blade - Preparation scissors - Pair of tweezers - Suture materials -
Cell-to-Cell Communication - Inflammatory Reactions
Stadlinger, Bernd / Terheyden, HendrikVisualizing the invisible while experiencing a fascination with science is the great challenge that Cell-to-Cell Communication, representing an all-new genre, has set out to meet. A spectacularly sophisticated computer animation in HD quality depicts the highly complex processes of intercellular interaction during an inflammatory periodontal reaction complete with the messenger molecules implicated. The various cell types constitute the main cast of the film, using a finely tuned communication process in their quest to destroy the bacterial invaders, with messenger molecules as supporting cast. A stunning didactic and dramatic experience! Outline: - Biofilm - Gingivitis and the Innate Immune Defense - Periodontitis and the Adaptive Immune Defense - Cleaning and Regeneration -
Fiberglass frameworks in removable prosthodontics
Bücking, Wolfram -
Bone Spreading, Bone Condensing
Streckbein, RolandContent: Surgical flap creation and elevation; Use of drill template for exact determination of implant position; Implant site creation; Site preparation / tapping; Bone compaction; Insertion of the implants; Impression-taking; Wound closure; Later implant insertion; Dental lab work; Creating the model with laboratory implants; Shaping the bar frame; Adapting the laser welded frame to the model; Manufacturing the tooth replacement, Fitting the bar into the tooth replacement; Finishing work.
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Kommunikation der Zellen - Die Osseointegration
Stadlinger, Bernd / Terheyden, HendrikDas Unsichtbare sichtbar werden zu lassen - darin liegen die Faszination und die Herausforderung, die heute bekannten zellbiologischen Hintergründe der Osseointegration anhand der beteiligten Zelltypen und Botenstoffe zu visualisieren und diese komplexen biodynamischen Prozesse dramaturgisch und didaktisch so zu gestalten, dass sie in der Aus-, Fort- und Weiterbildung eine wertvolle Unterstützung in der Wissensvermittlung bieten. Mit dem Modul 1 "Kommunikation der Zellen - Die Osseointegration" startet die Exzellenzinitiative "Lehre - Lebendige Wissenschaft", in der sukzessiv alle relevanten biomedizinischen Prozesse in der ZMK als 3D-Computerfilmanimationen produziert und in einer 3D-Filmbibliothek der zahnmedizinischen Fachwelt zur Verfügung gestellt werden. Dieses neue Genre bietet interessante Perspektiven für die Lehre und ein Highlight für den Betrachter. Gliederung: - Die Hämostase - Die entzündliche Phase - Die proliferative Phase - Die Remodellierungsphase. Zum Film Hauptdarsteller: Thrombozyten, Fibroblasten, Endothelzellen, Granulozyten, Makrophagen, Perizyten, Osteoklasten, Osteoblasten, Osteozyten Nebendarsteller: PDGF, Thromboxan, TGF-a, TGF-ß, PDGF, VEGF, NO, ACE, TNF-a, IL-1, TNF-a, IL-6, FGF, MIP-1, RANKL, Sclerostin Das Projekt- und Expertenteam Wissenschaftliche Leitung: Dr. Dr. Bernd Stadlinger, Prof. Dr. Dr. Hendrik Terheyden Advisory Board: Prof. Dr. Christoph Hämmerle, Prof. Dr. Thomas Hoffmann Fachliche Beratung: Dr. Susanne Bierbaum, Prof. Dr. Dr. Uwe Eckelt, Dr. Ute Hempel, Prof. Dr. Lorenz Hofbauer, Prof. Dr. Dieter Scharnweber (Transregio 67) -
Implantation mit Sofortversorgung OK Regio 12
Wagner, WilfriedGliederung: - Extraktion - Vorbohrung und Einsetzen des Implantates - Einsetzen des T-Adapt Inhalt: Im vorliegenden Beitrag wir der traumatisch geschädigte und gelockerte Zahn 12 extrahiert. Eine Stiftfixierung ist nicht mehr möglich und es ist ein deutlicher Verlust der distalen Papille zu beobachten. Demnach ist ein 4,5 mm konisches Astra-Implantat geplant. Nach der Vorbohrung und dem Einsetzen des Implantates wird ein T-Adapt zur Ausformung und Stützung der Schleimhaut eingesetzt. Für die Dauer von 3 Monaten wird chairside eine provisorische Krone eingesetzt.
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BONE LID FOR CLOSING MAXILLARY SINUS WINDOW DURING SINUS GRAFTING WITH ANORGANIC BOVINE BONE MINERAL (ABBM) AND AMOXICILLIN—3-YEAR FOLLOW-UP OF 83 CASES
Objectives: The objective of this study was to use bone lid with particulate autogenous bone on BioOss ABBM (Bio-Oss) and insert implants just 3–4 months after the intervention, using amoxicillin in physiological saline to prepare the ABBM. Methods: In 2012, 83 cases of sinus lift were performed. Fifteen implants (XiVE) were simultaneously placed and 92 non-simultaneously 3–4 months later. The bone lid was taken during the opening of the buccal wall and preserved in physiological saline solution with amoxicillin (after checking first for allergy). It was repositioned on a bed of autogenous particulate bone placed on the ABBM (to allow stabilisation of the clot), which was also maintained in physiological saline solution with amoxicillin. Panoramic radiographs were carried out 3 years after implant insertion. Results: All 107 implants were osseointegrated at the second-stage surgery. One perforation of the membrane occurred during excision of the bone lid. Seven perforations were observed during the lifting of the membrane and were closed by sutures associated with collagen sponge. No infections were observed and good healing was seen on reopening. In cases of non-simultaneous implant placement, all were inserted 3–4 months after the first surgery. Radiograph images after 3 years showed good bone graft stability. Conclusion: Autogenous bone placed on ABBM allows repositioning of the bone lid and stabilises the blood clot. This seems to accelerate healing of the osseous buccal wall, thus allowing insertion of implants at 3–4 months instead of 6 months. The infection risk is smaller than when using membrane. The use of physiological saline solution associated with amoxicillin to prepare the BioOss seems to be associated with a lower failure rate than that reported in the literature (1.8% versus 14.5%). -
Pre- and peri-operative soft tissue management
Prof. Markus HürzelerSoft tissue management is an essential part of successful implant treatment. In this module, the aspects of soft tissue management previous to and simultaneous with implant placement are discussed. -
COX INHIBITORS SUPPRESS THE DIFFERENTIATION OF HUMAN OSTEOSARCOMA CELLS
Objectives: Recent reports of impaired bone healing associated with non-steroidal anti-inflammatory drugs (NSAIDs) have raised major concerns. This study was aimed to evaluate the effect of COX inhibitors in osteoblastic differentiation of osteoblast-like human osteosarcoma (HOS) cells and to evaluate whether selective COX-1 and COX-2 inhibitors have different effects on osteoblastic differentiation using HOS cells. Methods: HOS cells were cultured with selective COX-1 inhibitors (SC-560) and selective COX-2 inhibitors (NS-398). Cell numbers were counted and cell activity was measured using a WST-1 assay for 5 days of culture. Expression of alkaline phosphatase (ALP), bone morphogenetic protein (BMP)-2, bone sialoprotein (BSP) and osteocalcin (OCN) mRNA was evaluated by reverse transcriptase polymerase chain reaction (RT-PCR). Osteoblastic differentiation in cell cultures was also characterised by ALP activity. Results: SC-560 and NS-398 treatment did not inhibit cell activity below the concentration of 50nM and 1μM, respectively. Gene expression of BMP-2, BSP and OCN was not changed when HOS cells were treated with SC-560, whereas ALP mRNA expression was decreased when treated with 50nM and 100nM SC-560. ALP, BMP-2 and BSP gene expression was not changed in the HOS cells treated with NS-398, whereas OCN gene expression was prominently decreased when treated with NS-398 above concentrations of 100nM. A decrease in ALP activity after 5 days of culture was observed in SC-560- and NS-398-treated cells. Conclusions: These results suggest that COX inhibitors at higher concentrations suppress the osteoblastic differentiation of HOS cells and downregulate osteoblast-related genes. The mechanism of action of selective COX-2 inhibitors also differs from that of COX-1 inhibitors. The long-term use of high-dose NSAIDs for the control of pain and inflammation after dental surgery could have a negative effect on bone healing and on the outcome of bone management.





