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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 -
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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. -
Fiberglass frameworks in removable prosthodontics
Bücking, Wolfram -
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. -
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. -
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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. -
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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 -
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. -
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.
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Die Anwendung von autogenem PRGF in der plastischen Parodontalchirurgie
Marggraf, ErwinGliederung: - Blutentnahme - Thrombozytenseparation und -aktivierung - Zugabe von Knochenersatzmaterial - Accessflap und Kürettage - Einbringen von PRGF und Knochenersatzmaterial - Plastischer Nahtverschluss Materialliste: Alle Materialien zur Herstellung von PRGF (BTI Deutschland) Knochenersatzmaterialien von Geistlich Biomaterials Operationsbesteck von AESCULAP Nahtmaterialien von ETHICON -
Operative Therapy for Retained Teeth in the Maxilla
Schultze-Mosgau, Stefan / Neukam, Friedrich Wilhelm / Basting, GerdContent: In adolescence, the exposure and orthodontic classification of retained teeth, especially canines and premolars, represents a useful therapy measure. Techniques for surgically exposing vestibularly and palatally retained teeth are demonstrated using the tubed pedicle flap technique. Because epithelialized mucous membrane is covered in the tubed pedicle flap technique, a renewed growth of the exposed tooth is prevented and a classification of the tooth with orthodontic appliances under sight control is enabled. Depending on the retention form, the extent of movement, and the patient's age, exposure may no longer be possible under some circumstances, indicating the need for operative removal of the retained canine or premolar. Preoperative localization methods, vestibular and palatal operative access paths, and surgical techniques for atraumatic removal are demonstrated. Operative techniques for the atraumatic removal of retained maxillary third molars also are shown. For the gentle removal of retained maxillary third molars, it is very important to record their topographic positional relationship to the maxillary sinus and to select the cutting direction and most suitable osteotomy technique. Outline: - Techniques for exposing maxillary canines or premolars for orthodontic classification - Operative removal of retained maxillary canines - Operative removal of retained maxillary third molars -
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)
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Implantatprothetische Arbeitsschritte am Patienten, Teil II
Weigl, Paul / Trimpou, Georgia -
REHABILITATION OF A FIBULA-RECONSTRUCTED MANDIBLE BY USING COMPUTER ASSISTED IMPLANT SURGERY. A CASE REPORT.
Objectives: Reconstruction of mandibular integrity following a block resection is complicated by the loss of function and integrity of the graft. We report on rehabilitation of a patient who underwent mandibular resection and fibular reconstruction. Methods: A 16-year-old girl was referred to the Oral Implantology Department Clinic at the Istanbul University Faculty of Dentistry, 2 years after mandibular construction via a fibular graft. The geometry and topography of the graft was inconsistent and challenging for a removable prosthesis. To avoid the risk of fracture and necrosis, computer-assisted planning and flapless implant surgery was chosen as the best course of action. After obtaining a cone beam computerised tomography (CBCT) scan of the mandible with a radiographic template, the images were transferred into dedicated software and three implants were planned for shortened fixed composite–hybrid prostheses. Following surgery, one implant was found to be mispositioned and removed the following day. Results: The mandible was successfully restored by two implant-supported hybrid prostheses, fabricated with the use of nano-filled composite following the osseointegration period. Conclusions: Rehabilitation of a pathologically reconstructed edentulous jaw may be successfully completed using computer-assisted planning and guided implant surgery. Clinicians should be cautious regarding deviations related to the use of sterolithographic guides. -
Study Protocols: Soft-Tissue Augmentation
based on the book chapter by Daniel S. Thoma and Ronald E. Jung Summary Soft tissue augmentation using autogenous grafts to restore keratinized tissue volume are described here. Synthetic and biological dermal substitutes, developed initially for treating burns, offer great potential as alternatives to these grafts which have certain limitations (particularly collagen-based products). Two protocols are presented, both for randomized controlled trials. The authors specify two research questions and two sets of defined eligibility criteria, study timelines with relevant clinical steps and time points for measuring clinical endpoints, protocol-specific measures and patient care regimens. Photos are provided of surgical sites before, during and after the procedures. The first study compares autogenous palate grafts (plus an apically positioned flap) with a soft tissue substitute in patients with an implant-supported prosthesis abutted by keratinized mucosa of less than 1 mm thick. Primary outcome measures include keratinized mucosal width, as determined by probing, and parameters relating to safety and effectiveness. There are phases for pre-baseline management, surgery, follow-up of 6 months, and a 5-year assessment of long-term safety, effectiveness and esthetics. The second protocol is for soft tissue volume augmentation in patients requiring volume increase in a single-tooth gap after implant placement. The positive control is a connective tissue graft, with endpoints including gain in mucosal thickness and esthetics, and a follow-up of 3 months. Open full-text PDF (1.9 MB)





