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Free content
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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. -
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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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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. -
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. -
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 -
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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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. -
Fiberglass frameworks in removable prosthodontics
Bücking, Wolfram -
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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. -
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.
Most Popular
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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. -
Cell-to-Cell Communication - Osseointegration
Stadlinger, Bernd / Terheyden, HendrikThe invisible becomes visible and holds both challenge and fascination. The cellular-level biological processes that underlie osseointegration are visualized based on the cell types and messengers implicated, representing the current state of our knowledge. Complex biodynamic processes are showcased dramatically and didactically to support the transfer of knowledge in training and education. Module 1, Cell-To-Cell Communication - Osseointegration, ushers in an Initiative for Excellence entitled Education - Science Comes Alive. It will eventually present all the relevant biomedical processes in dentistry and oral and maxillofacial surgery in the form of 3D animations, to be made available to a professional public as a 3D film library. This innovative genre - with special highlights for every viewer - will open up interesting teaching and training perspectives. Outline: - Hemostasis - Inflammatory Phase - Proliferative Phase - Remodeling Phase. On This Film Main Cast: Platelets, Fibroblasts, Endothelial Cells, Granulocytes, Macrophages, Pericytes, Osteoclasts, Osteoblasts, Osteocytes Also Starring: PDGF, Thromboxane, TGF - a, TGF - ß, VEGF, NO, ACE, TNF - a, IL - 1, IL - 6, FGF, MIP - 1, RANKL, Sclerostin Length: 12 minutes Project/Expert Team Authors and Scientific Management: Bernd Stadlinger, PD Dr. Dr. | Hendrik Terheyden, Prof. Dr. Dr. Advisory Board: Lyndon F. Cooper, DDS, PhD | Christoph Hämmerle, Prof. Dr. Thomas Hoffmann, Prof. Dr. | Myron Nevins, DDS Technical Advisors: Susanne Bierbaum, Dr. | Uwe Eckelt, Prof. Dr. Dr. Ute Hempel, Dr. | Lorenz Hofbauer, Prof. Dr. Dieter Scharnweber, Prof. Dr. (Transregio 67) -
Preparation of Crowns and Bridges
Neumeyer, Stefan
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Old reconstructions and missing teeth - a comprehensive case
Dr. Christian LeutertMissing posterior teeth and old unesthetic reconstructions - see how this case was solved by Dr. Christian Leutert at the University of Zurich. -
THE EFFECT OF BIOENGINEERED MUSSEL GLUE AS A bone morphogenetic protein (BMP)-2 CARRIER FOR BONE REGENERATION
Objectives: Recombinant human (rh)BMP-2 is known to induce bone formation by stimulating osteoblast differentiation. Mussel adhesive proteins (MAPs) secreted from mussels have been suggested as suitable adhesives for tissue engineering and medicine. In this study, rMAP was used to immobilise rhBMP-2 on a titanium mesh (Ti-mesh) surface, and the osteoinductivity of the BMP-2/rMAP on Ti-mesh surfaces was investigated in vitro and in vivo. Methods: (i) Expression and purification of rMAP: Hybrid rMAP was expressed in Escherichia coli and the proteins were harvested for purification after centrifugation. The rMAP was extracted using 25% (vol/vol) acetic acid, and endotoxin was removed by sequential purification. The purity of rMAP was assessed by 12% (wt/vol) sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE). (ii) BMP-2 immobilisation using rMAP on Ti-mesh surfaces: For in vitro analysis, surfaces were coated with 50µg/cm2 of rMAP solution after removing all organic molecules from the Ti-mesh surface. To immobilise BMP-2 on Ti-mesh surfaces, rMAP solution was mixed with 50µg/mL of rhBMP-2 in sodium bicarbonate (pH 0.8), and coated on the mesh surfaces as described previously. (iii) Animal surgery for in vivo bone regeneration ability assays: Each kind of Ti-mesh surface was tested on male Sprague-Dawley rats (n = 6) weighing 250–300g. The rat calvaria were exposed through skin and periosteum incisions using a #15 surgical blade, and circular bone defects were punched using a 8-mm diameter trephine drill under saline irrigation. Two short screws were used to fix each Ti-mesh (prepared just before surgery) over the defect. (iv) Radiographic and histological assessment was made of in vivo bone regeneration. (v) In vitro cell attachment and proliferation assays were performed. (vi) In vitro osteoblast differentiation assays included phenotypic differentiation assays and osteogenic gene expression analysis. Results: Through micro-CT analysis and histological evaluation, the BMP-2/rMAP-coated titanium surfaces displayed improved new bone formation in the rat calvarial defect model compared to rMAP-coated and uncoated surfaces. In addition, cellular behaviours (e.g. adhesion and proliferation) of mouse pre-osteoblast MC3T3-E1 cells were significantly increased on Ti-mesh surfaces coated with BMP-2/rMAP and rMAP. The BMP-2/rMAP-coated surface showed the highest degree of osteogenic differentiation. Messenger RNA expression of osteogenic differentiation marker genes was upregulated in MC3T-E1 cells on BMP-2/rMAP-coated Ti-mesh surfaces. Conclusions: Recombinant MAP is a promising biomaterial for BMP-2 immobilisation on titanium surfaces and guided bone regeneration with enhanced osteoinductivity