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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. -
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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 -
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. -
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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. -
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. -
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 -
Esthetic and Restorative Dentistry - Ceramic Materials
Terry, Douglas A. -
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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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. -
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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YAG Laser Applications
Schwarz, FrankContents - Laser - Basic Concepts - Principles of Fluorescence Measurement - Nonsurgical Periodontal Therapy - Surgical Periodontal Therapy - Treatment of Cervical Dentin Hypersensitivity Synopsis The primary goal of periodontal therapy is to remove bacteria-laden dental plaque otherwise that will lead to progressive decay. In addition to the classic forms of periodontal therapy, laser modalities have also been proposed in recent years. The Er:YAG laser appears to be the most promising laser system for the treatment of marginal periodontitis. Several studies have demonstrated this laser's excellent ability to remove subgingival calculus without producing thermal effects in adjacent tissues. In addition, controlled clinical studies have shown that the Er:YAG laser leads to a signifi cant increase in clinical attachment in both nonsurgical and surgical periodontal therapy. Preliminary clinical results indicate that this minimally invasive tool permits instrumentation of very deep and fl at pockets (eg, when removing root cement or in patients with increased gingival recession) without injuring hard and soft dental tissues. This live operation video demonstrates use of the Er:YAG laser for both nonsurgical and surgical periodontal therapy. -
Operative Therapiekonzepte zur Entfernung retinierter unterer Weisheitszähne
Schultze-Mosgau, Stefan / Neukam, Friedrich Wilhelm / Basting, GerdGliederung: - Schematische und röntgenologische Demonstration unterschiedlicher Retentionsformen unterer, retinierter Weisheitszähne, Darstellung der Indikation zur Entfernung - Erstellung der Behandlungsunterlagen, Aufklärungsgespräche mit Darstellung der Komplikationen - Demonstration des operativen Vorgehens: Lokalanästhesie, Schnittführung, Schutz des N. lingualis, Osteotomie, Nahttechnik. Die Entfernung unterer, retinierter Weisheitszähne gehört zu den häufigsten dento-alveolär-chirurgischen Eingriffen. Durch die enge anatomische Lagebeziehung zu den benachbarten Zähnen und dem N. alveolaris inferior besteht bei der operativen Entfernung die Gefahr einer Schädigung der umgebenden Strukturen. Die Kenntnis der verschiedenen Retentionsformen und eine geeignete, atraumatische Operationstechnik ist für eine komplikationslose Entfernung von Bedeutung. Nach der Leitungsanästhesie des N. alveolaris inferior und des N. buccalis wird die Schnittführung so gewählt, dass ein vestibulär gestielter Mukoperiostlappen gehoben werden kann. Nach dem lingualen, subperiostalen Einführen eines Raspatoriums zum Schutz des N. lingualis wird durch die bukkale Osteomie mit kugelförmigen Hartmetallfräsen der Weisheitszahn bis zu seiner größten Zirkumferenz freigelegt und durch vorsichtige Luxationsbewegungen entfernt. -
Implant-borne restorations (3rd edition)
Speicher, Josef
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A NOVEL APPROACH FOR REGENERATIVE TREATMENT OF PERI-IMPLANTITIS: A CASE REPORT AND PROPOSAL OF A PROTOCOL
Objectives: The aim of this report was to propose guidelines for managing peri-implantitis including a three-step decontamination protocol and regeneration of a bone defect using autologous leukocyte and platelet-rich fibrin (L-PRF)-enriched composite graft, and to evaluate the radiographic defect fill and various clinical parameters. Methods: A 57-year-old woman was diagnosed with advanced peri-implantitis around two right molar implants that were placed and restored 4 years ago. Clinical examination revealed probing depth (PDs) of up to 12 mm, with bleeding and suppuration. After initial conservative non-surgical treatment, surgery was performed. The approach consisted of flap reflection, one-step mechanical debridement, three-step surface decontamination and fill of the intrabony defect with composite L-PRF, demineralised freeze-dried bone allograft (DFDBA), and gentamicin graft. Coverage was with a double-layer of autologous L-PRF membrane. Results: At 24-month follow-up there was a considerable reduction in probing depth and radiographic bone defect fill. Conclusions: The main treatment goals for peri-implantitis (peri-implant mucosa health and regeneration of peri-implant bone) were achieved using a novel complex management and maintenance (CMM) protocol for treatment of peri-implantitis. Long-term, randomised, controlled clinical trials are needed to produce robust data on the effectiveness of this treatment modality for treatment of peri-implant defects. -





