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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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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. -
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. -
Fiberglass frameworks in removable prosthodontics
Bücking, Wolfram -
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. -
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. -
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. -
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 -
Esthetic and Restorative Dentistry - Ceramic Materials
Terry, Douglas A. -
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. -
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. -
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
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Operative Therapiekonzepte retinierter Oberkieferzähne
Schultze-Mosgau, Stefan / Neukam, Friedrich Wilhelm / Basting, GerdGliederung: - Freilegungstechniken oberer Eckzähne und Prämolaren - Operative Entfernung retinierter oberer Eckzähne - Operative Entfernung retinierter oberer Weisheitszähne. Inhalt Im Wachstumsalter stellt die Freilegung und kieferorthopädische Einordnung retinierter Zähne, insbesondere der Eckzähne und Prämolaren, eine sinnvolle Therapiemaßnahme dar. Demonstriert werden chirurgische Führungstechniken vestibulär und palatinal retinierter Zähne mit Hilfe der Rollappentechnik. Durch das Einschlagen von epithelisierter Schleinhaut bei der Rollappentechnik wird ein erneutes Einwachsen des freigelegten Zahnes verhindert und eine Einordnung des Zahnes mit kieferorthopädischen Apparaturen unter Sichtkontrolle ermöglicht. In Abhängigkeit von der Retentionsform, dem Ausmaß der Verlagerung und dem Patientenalter kann eine Freilegung unter Umständen nicht mehr möglich oder sinnvoll sein, so dass die operative Entfernung des retinierten Eckzahns oder Prämolaren angezeigt ist. Dargestellt werden präoperative Lokalisationsverfahren, vestibuläre und palatinale operative Zugangswege und chirurgische Techniken der atraumatischen Entfernung. Weiterhin werden Operationstechniken zur atraumatischen Entfernung retinierter, oberer Weisheitszähne gezeigt. Zur schonenden Entfernung retinierter, oberer Weisheitszähne ist die Erfassung der topographischen Lagebeziehung zur Kieferhöhle, die Wahl der Schnittführung und die geeignete Osteotomietechnik bedeutungsvoll. -
3D-Planung und schablonengeführte Implantation im zahnlosen Kiefer
Kirsch, Axel / Ackermann, Karl-Ludwig / Neuendorff, GerhardInhalt: - Chirurgische Maßnahmen für die Verankerung einer Planungsschablone - Inserieren von vier provisorischen Implantaten - Abformung und Bissnahme, Herstellung des Meistermodells - Zahnaufstellung für die Interimsprothese - Speicherung der Zahnaufstellung in einem Silikonschlüssel - Kopie der Zahnaufstellung in röntgensichtbarem Kunststoff für die CT-Aufnahmen - Implantatplanung mit Hilfe eines 3D-Datensatzes aus der CT-Aufnahme - Herstellung einer Übertragungsschablone mit dem CAMLOG® Guide System auf Basis der CAD-Planung - Einfügen der Führungshülsen in die Schablone - Anfertigung der definitiven Versorgung vor dem Inserieren der Implantate - Verwendung Vario SR Abutments mit Vario SR Titankappen für die Erzeugung eines Passive Fit - Herstellung eines gegossenen Gerüstes aus Titan zur Verstärkung der Versorgung - Chirurgische Maßnahmen für die definitive Implantation - Inserieren von sechs Implantaten zur Sofortbelastung - Gezielte Erzeugung eines Passungsspiels zwischen Implantat und Prothesenbasis
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SURGICAL AND PROSTHETIC RESTORATION OF HORIZONTAL RESORBED EDENTULOUS MANDIBLE—A CASE REPORT
Objectives: Few treatment methods are capable of improving quality of life for patients as well, and as predictably, as restoration of edentulous jaw using implant-supported dental replacements. Adequate bone volume is essential for inserting dental implants, so developing prosthetic and surgical approaches with high success rates for patients with bone in poor condition is important reread. This case report focused on surgical and prosthetic restoration of horizontal resorbed edentulous mandible. Methods: The patient was treated with a mixture of bovine hydroxyapatite (Bio-OssTM Biomaterials) and particulate autologous bone, with absorbable pins (Inion Tacks) and collagen membranes (Bio-GideTM). XiVE-SsTM implants were placed under full guidance in a separate surgery four months later (EXPERTeases). For wider support of the central-milled titanium bar (Atlantis-Isuss), the distal implants were inserted at an angel of 30 degrees. A vestibuloplasty was performed using a Mucogarft MatrixTM? And multi-unit abutments (MP-AbutmentssTM were applied to the implants at 0 degrees mesial and 30 degrees distal, to optimise conditions for taking impressions with parallel impression posts. Lohmann’s method was used for the reconstruction. Results: This relative easy and predictable procedure allowed successful reconstruction of strongly horizontal-resorbed mandible, with little loss of the reconstructed bone. Conclusion: We used allogeneic bone blocks, autologous bone blocks and mainly mixtures of bovine hydroxyapatite and particulate autologous bone adapted with absorbable pins and collagen membranes. It was easy and quick to adapt and shape the bone material, resulting in a shorter operation time. Particulated mixtures of bovine hydroxyapatite and autologous bone seem to be the material of the first choice. Use of central-milled titanium bar ensures a tension-free fit of reconstruction which reduces loss of the reconstructed bone. -
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EVALUATION OF A DOUBLE-LAYER TECHNIQUE (DLT) FOR ENHANCING BONE FORMATION IN ATROPHIC MAXILLARY ALVEOLAR RIDGES
Objectives: Different combinations of graft materials have the potential to enhance bone formation in atrophic edentulous or partially edentulous maxilla using guided bone regeneration (GBR) techniques. We aimed to evaluate histologically and radiographically the effect of grafts comprising allogenic bone and deproteinised bovine bone (DBB) in layers, covered with a resorbable membrane. Methods: Five partially edentulous patients with up to 4mm residual bone width in the maxilla underwent GBR. The sites were grafted using a double-layer technique (DLT), with allogenic bone as the first layer and DBB as the second. All sites were then covered by resorbable membrane, tucked into place with two titanium pins. Five months later, cone-beam CT scans were made and trephine biopsies were obtained during preparation of implant sites. These were processed for decalcified histological and histomorphometric evaluation. All implants (with diameters of 3.80–4.1mm) were successfully placed and primary stability was established. Results: The biopsy samples varied in length (4.5– 9mm). Histology showed new bone formation with fragmented medium-sized bone trabeculae within dense fibrous connective tissue and frequent osteoblastic reaction. There were no inflammatory infiltrates. Conclusion: These preliminary results suggest that the double-layer GBR technique gives good, reproducible clinical, radiographic and histological results when used for atrophic maxillary alveolar ridges before placing dental implants.





