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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. -
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. -
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. -
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. -
Fiberglass frameworks in removable prosthodontics
Bücking, Wolfram -
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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. -
Esthetic and Restorative Dentistry - Ceramic Materials
Terry, Douglas A. -
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 -
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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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 -
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. -
Most Popular
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Piezo Surgery Technique for Alveolar Ridge Augmentation with Sinus Lift
Schlee, MarkusOverview: - Periodontal and implant planning - Treatment of a horizontal and vertical bone defect - discussion of the literature - Clinical implementation of bone augmentation using a bone block and treatment of a vertical pocket with Emdogain - Sinus lift in combination with alveolar ridge augmentation and horizontal expansion of the alveolar process; orthodontic straightening of a molar tooth Contents: This contribution illustrates a complex periodontal-implantological case, from treatment planning to clinical implementation. It details the transplantation of two bone blocks from the linea obliqua of the angle of the jaw to the anterior front tooth region, the treatment of a vertical bone pocket with Emdogain, the straightening of a molar tooth using orthodontic mini-implants, and a sinus lift together with alveolar ridge augmentation in the maxillary region using a piezo surgical technique. -
Immediate placement and all-ceramic restoration in the anterior maxilla - a customized interdisciplinary treatment approach
Happe, Arndt / Nolte, AndreasContents: - Patient presentation and esthetic analysis - Careful extraction of a non-salvageable tooth - Miniplast splint as a surgical template - Harvesting bone from the implant bed - Placing a CONELOG® implant at site 11 - Obtaining a corticospongeous bone cylinder at site 48 - Alveolar augmentation and reconstruction of the buccal bone lamella - Harvesting a connective-tissue graft - Tunneling the vestibular mucosa, various suturing techniques - Insertion of the provisional restorations - 3 months later: Preparing, impression and arbitrary transfer with a bite fork and facebow, temporary restoration - Master cast, new wax-up, determine the emergence profile - Fabricating a hybrid abutment, Scanning the custom abutment, on-screen crown design - Fabricating a zirconia abutment and a feldspathic ceramic veneer - Conditioning and adhesive attachment of the components, final intraoral check - Try in and adhesive cementation -
Interim Control System, Fixierung einer Interimsprothese auf Implantaten
Streckbein, Roland
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Compromised Bone Healing
The bone healing process in people can be affected by diseases such as Crohn’s disease, diabetes and colitis. It can also be affected by drugs such as bisphosphonates, which are used to treat weak bones in people with osteoporosis, Paget's disease and certain cancers. The role of animal models is enormous for investigating these disease conditions as well as other “risk factors” for compromised healing, such as radiotherapy, which is being increasingly used as early treatment of cancer in the community rises. Diabetes and intestinal disorders can be induced in rats, often using chemicals with toxic effects, but the diseases can take some time to develop. This chapter gives guidance on various timeframes for evaluating inflammatory processes, osseointegration and collagen cross-linking, and gives details on mechanical strength testing of dental implants and other candidate therapies. Different aspects of the compromised bone healing response can be observed using both the long bones (tibia and femur) and the maxilla of rats. This chapter also describes an adaptable study protocol for new investigators, with suitable endpoints such as bone to tissue ratio and bone to implant contact, to contribute to the body of knowledge on patients with compromised bone healing who are increasingly encountered in dental practice. -
Pectin nanocoating of titanium implant surfaces - an experimental study in rabbits
Objectives: The aim of the study was to evaluate the effect of nanocoating titanium implants with plant cell wall-derived rhamnogalacturonan-I, on bone healing and osseointegration. A new strategy to improve osseointegration and bone healing is biochemical stimulation by surface nanocoatings that may increase adhesion of bone proteins, and bone cells at the implant surface. Nanocoating with pectins, plant cell wall-derived polysaccharides, is frequently done using rhamnogalacturonan-I (RG-I). Methods: Machined titanium implants were coated with three modifications of rhamnogalacturonan-I (RG-I). Chemical and physical surface properties were examined before insertion of nanocoated implants (n = 96) into the left and right tibia of rabbits. Machined titanium implants without RG-I nanocoating were used as controls (n = 32). Total number of 128 implants was placed in tibias of 16 rabbits. Fluorochrome bone labels, calcein green and alizarin red S were given intravenously after 9 and 12 days, respectively. The bone response to the nanocoated implants was analyzed qualitatively and quantitatively after 2, 4, 6, and 8 weeks of healing using light microscopy and histomorphometric methods. Results: The RG-I coating influenced the surface chemical composition; wettability and roughness, making the surface more hydrophilic without any major effect on surface micro roughness compared to control implant surfaces.The different modifications of pectin RG-I did not significantly enhance bone healing and osseointegration analyzed after 2, 4, 6, and 8 weeks of healing compared to control implants. Although the qualitative analyses of the fluorochromes indicated a higher activity of bone formation in the mineralization front at the early stage, after 9 and 12 days at the RG-I nanocoated implants compared to the control implants although no significant quantitative difference was demonstrated. Conclusion: The present study showed that nanocoating of titanium implants with pectin RG-Is did not significantly enhance bone healing and osseointegration when placed in rabbit tibia bone. -
Periodontal Screening Index PSI
Belz, DieterMit diesem Beitrag wollen wir die Einführung des PSI, "Parodontal Screening Index", unterstützen. PSI ist ein Blutungsindex, der in vielen Ländern offiziell empfohlen und angewendet wird. Auch in Deutschland haben sich die Standesorganisationen sehr erfolgreich dieser Aufgabe gewidmet, so daß die WHO-Sonde wochenlang ausverkauft war. Bei der starken Verbreitung von Parodontitis in allen Schichten und Alterstufen der Bevölkerung erscheint die Einführung eines Index als Bestandteil der zahnärztlichen Diagnostiknatürlich als sehr hilfreich. Schließlich ist die Parodontitis die am weitesten verbreitete Krankheit überhaupt. Soll sich ein Index in der Alltagspraxis durchsetzen, so muß er einfach und schnell zu erheben ein. Dies ist hier nach übereinstimmender Beurteilung der Fall. Unser Bericht macht sie mit dem PSI und seiner Anwendung vertraut.