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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. -
Fiberglass frameworks in removable prosthodontics
Bücking, Wolfram -
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. -
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 - 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 -
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 -
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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. -
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. -
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. -
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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Sofortimplantation 21 mit Kombitransplantatverschluss (Live-OP)
Iglhaut, Gerhard M. -
Minimalinvasive Parodontitistherapie (Chirurgische Rezidivbehandlung)
Beck, FrankDie chirurgische Rezidivbehandlung stellt die Forderung, im ästhetisch relevanten Gebieten möglichst wenig Weichgewebe zu opfern. Dieser Operationsfall beschreibt die Technik bei engen Approximalräumen. -
Computer-guided implant insertion at site 25
Hürzeler, Markus B.
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Surgical Techniques for Closure of Oro-Antral Communications
Schultze-Mosgau, Stefan / Neukam, Friedrich Wilhelm / Basting, GerdContent: With a maxillary sinus recess reaching far into the alveolar process of the maxilla, the maxillary sinus can sometimes be opened when maxillary incisors are extracted. An oro-antral communication is determined by a nose-blowing test or by sounding out of the alveolus with blunt probes. After an inflamed, cystic, or tumorous maxillary sinus illness has been excluded, an oro-antral communication should be closed immediately with plastic surgery within the first 24 hours after extraction to prevent the germ-free maxillary sinus from being contaminated. Plastic covering by plastic surgery using a cheek flap with vestibular stem is demonstrated. After a mucoperiosteal flap with vestibular stem has been formed, the flap is lengthened by slitting the periosteum so that a tension-free sealing of the opened maxillary sinus will be possible without endangering the flap's blood flow at the same time. Outline: - Diagnostics of an oro-antral communication - Exclusion of inflammatory, cystic, or tumorous maxillary sinus illnesses - Cheek flap plastic surgery for plastic covering of an oro-antral communication: - Cutting direction for the formation of a mucoperiosteal flap with vestibular stem; - De-epithelalization of wound margins; - Mobilization of the flap by slitting the periosteum; - Periosteal holding stitches for tension; - free closure of the oro-antral communication; - Stitching technique for saliva-proof wound closure. - Demonstration of buccal flap plastic surgery - Demonstration of bridge flap plastic surgery - Demonstration of palatal flap plastic surgery - Postoperative reaction measures -
Regenerative Measures for Osseous Defect Repair and Optimal Esthetics
Sculean, AntonProcedure: Theoretical Part: - Adult male with a deep and broad intraosseous bone defect located on tooth #13 - The indication for modified papilla preservation in the scope of regenerative therapy was established based on the width of the diastema - Regenerative periodontal therapy with Emdogain and a Bio-Oss® cancellous bone graft - Emdogain is applied to the root surface to stimulate regeneration of periodontal structures - To prevent graft collapse and to minimize the risk of development of too large a recession in this esthetically important region, the defect was filled with Bio-Oss® cancellous bone material Practical Part: - The papilla preservation technique was performed using microsurgical instruments - The root surface area was conditioned with 24% EDTA for ca. 2 minutes - Emdogain was applied to the root surface - The defect was filled with the Emdogain/Bio-Oss® mixture - The wound was closed with two mattress sutures one horizontal mattress suture to secure the graft in place, and a second modified vertical mattress suture to tightly close the papilla - A 5-0 suture was used for the horizontal mattress suture, and a 6-0 monofilament was used for the vertical mattress suture - Postoperative care entailed rinsing the wound twice daily for 4 weeks with 0.2% chlorhexidine and ibuprofen analgesia on the first few days after surgery Contents: The patient's jaw displayed a generalized loss of clinical attachment and alveolar bone. His general history was unremarkable; the patient was a non-smoker. Microbiological tests showed large numbers of Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis. The diagnosis was "generalized aggressive periodontitis". After four months of initial therapy consisting of antibiotic combination therapy (amoxicillin + metronidazole), intraoral radiographs showed a deep and wide intraosseous bone defect located mesial and palatal to tooth #13. To preserve this strategically important tooth we opted to perform regenerative therapy with Emdogain and Bio-Oss cancellous bone material. Ten months after regenerative periodontal therapy, the probing depth had decreased by 7 mm, and 5-6 mm of clinical attachment had been gained. At this time, the probing depth was 2-3 mm and intraoral radiographs showed near-complete filling of the osseous defect. -
Joint Symposium with AAP/AAP Foundation - great partnership for success
Nothing but positive feedback could be heard after the very successful symposium jointly organized by the Osteology Foundation, the AAP, and the AAP Foundation. It took place as part of the pre-programme of the AAP Annual Meeting, which was held in Orlando, Florida in November this year. With an audience of more than 500, the Symposium exceed all expectations. All seats were taken, and some late-comers even had to stand. Joan Otomo-Corgell, President of the AAP, opened the symposium, and particular welcomed over 130 third-year periodontics residents who had received scholarships from the AAP Foundation to attend the symposium. Theprogrammecovered a broad range of topics in periodontal treatment and research, exploring the current concepts and alternatives in bone regeneration, outlining the use of scaffolds and biological mediators to improve the outcomes of bone regenerative therapies, and explaining the clinical guidelines associated with current concepts and alternatives in soft tissue augmentation and periodontal regeneration. The symposium with national and international speakers also included discussion of using soft tissue substitutes to improve the outlines of soft tissue regenerative therapies. Mariano Sanzfrom Spain, current President of the Osteology Foundation (OF), andWilliam V. Giannobile(USA), Board Member of the OF, were among the presenters, as well asPamela K. McClain(USA), also Board Member of the OF and past-president of the AAP.David M. Kim(USA) andRodrigo Neiva(USA), both members of theOF Expert Council, gave presentations as well. A great addition to the programme was the presentation byMartha Somerman, Director of the National Institute of Dental and Craniofacial Research (NIDCR), who spoke about research opportunities in regenerative medicine. The organizers and everybody involved were extremely excited about the success of the symposium, and representatives of the two Foundations as well as the AAP announced to continue the collaboration, since it is a great partnership for success. More than 500 participants attended the joint symposium by the Osteology Foundation, the AAP and the AAP Foundation in Orlando, Florida, on 14 November 2015. The outstanding programme with national and international speakers focused on current technologies for hard and soft tissue oral regeneration.