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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. -
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 -
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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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 -
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. -
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 -
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. -
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. -
Esthetic and Restorative Dentistry - Ceramic Materials
Terry, Douglas A. -
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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.
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Implant-supported crown at site 21
Weigl, Paul / Trimpou, Georgia -
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. -
The Carnevale Technique: Hemisection/Trisection of Molars with Furcation Involvement
Hürzeler, Markus B.Procedure: - Apical Flap Repositioning - Trisection of the Upper Molar - Extraction of the Distobuccal Root - Tangential Preparation of the Abutment Teeth - Temporary Relining Contents: Molars with furcation involvement have a shorter long-term prognosis for tooth retention than single-rooted teeth. Apart from replacing these teeth with implants, they can also be treated by hemisection or trisection with the goal of eliminating furcation and creating single-root conditions. Studies on the long-term stability of teeth treated by hemisection / trisection show mixed results. Some investigators have found failure rates of up to 40 percent. In Gianfranco Carnevale's group, on the other hand, success rates of more than 90 percent have been reported for a 10-year follow-up period. Pretreatment: Initial work on the abutment teeth, which had grade II-III furcation involvement, was done six to eight weeks after conservative periodontal therapy in preparation for placement of the long-term temporary. Preparation was done tangentially, up to the bone level, to spare as much dental hard tissue as possible while eliminating all recesses and root concavities. A metal-reinforced long-term temporary was used to splint the prepared teeth. Endodontic treatment of the affected teeth was subsequently performed. Surgical procedure: Apical displacement of the gingiva around the involved teeth was done before incision. A mucosal fl ap was created on the buccal and palatal sides. Trisection of the teeth was then performed. After dissecting and excising the distobuccal root, intraoperative preparation of the abutment teeth was carried out. Temporary relining was another important step, the objective of which was to splint the root and to prevent tilting. Further treatment: Impressions for the defi nitive restoration were made six months postoperative. The restoration margins of the tangential preparation were defined using a master model. The definitive reconstruction had fine metal margins.
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GUIDED BONE REGENERATION (GBR) IN THE AESTHETIC ZONE—RESTORATION OF HORIZONTAL BONE DEFECTS WITH MIXED BONE GRAFT AND TITANIUM MESH
Objectives: To report a case of a severe horizontal defect in a maxillary lateral incisor in which GBR was applied with adjunctive use of autologous (mandibular body cortical) bone and xenogeneic bone graft (BioOss[TM]), combined with titanium mesh, to improve clinical and aesthetic effectiveness, with a two-year follow-up. Methods: A 30-year-old non-smoking female patient with an uneventful medical history was referred to the Implantology Clinic at Paulista University, São Paulo, with a compromised maxillary lateral incisor, and complaining of masticatory parafunction and aesthetic issues. Despite satisfactory oral hygiene, intraoral examination showed advanced local tissue destruction with severe alveolar bone loss and dental mobility. A large buccal plate dehiscence was detected clinically and radiographically. A non-traumatic surgical approach under local anaesthesia consisted of simple manual tooth removal, requiring no forceps or elevators. After 30 days of healing, a cone beam CT showed lingual bone width of 3mm. An implant (3.25 x 13mm Biomet-3i) was installed in the basal bone adjunctively with a mixture of particulate autologous bone graft harvested from mandibular body cortical bone and BioOss[tm] xenogeneic bone graft (to reconstruct the horizontal defect). A preadapted titanium mesh (Neobiotech[TM]) and resorbable collagen barrier (BioGide[TM]) were placed over the grafted region to help maintain bone volume and prevent any exposures. During a six-month healing period, the patient used a provisional removable partial denture. Then the titanium mesh was removed and a provisional crown was fabricated to optimise the emergence profile. Results: No bone exposure was observed in the grafted area and no complications occurred in the donor site. Postoperative clinical and CT examinations at 6, 12 and 24 months showed sufficient and satisfactory bone formation. Besides the limited torque (15N/cm) during implant placement, the final prosthetic design was successful. At two-year follow-up, volumetric stability and satisfactory functional and aesthetic results were achieved. Conclusion: Mixed bone grafts combined with titanium mesh appear to be an effective and advantageous procedure for horizontal bone defects in aesthetic zones, providing volumetric stability and satisfactory functional and aesthetic results. -
Implant timing
PD Dr. Ronald JungIn every clinical situation, which is scheduled for an implant placement, a decision needs to be taken in regards to the right time after tooth extraction to insert the implant. In this module you are going to learn all the important decision-making factors (anatomical, esthetical, clinical, radiographical and patient centered) to chose the correct timing for implant placement after tooth extraction. -
Intraoral hergestellte glasfaserverstärkte Kompositbrücke zum Ersatz einzelner Frontzähne - Der komplette Fall
Hugo, BurkardGliederung: - Einleitung und Indikationsstellung - Brückenkonstruktion mit Glasfaserverstärkung - Vorstellung der Patientin mit Nichtanlage regio 12 und 22 - Klinischer Ablauf zur Herstellung der Brücke an Zahn 22 - Diskussion der Technik Inhalt: Vorgestellt wird eine direkte Applikationstechnik für adhäsiv verankerte Kompositbrücken. Das Verfahren soll zum Ersatz einzelner Frontzähne insbesondere bei jüngeren Patienten nach Zahnverlust infolge Trauma oder bei angeborenen Nichtanlagen dienen. Die Brückenherstellung erfolgt vollständig intraoral. Beim ein- oder zweiflügeligen Pfeilerdesign wird ein Gerüst aus parallel vorimprägnierten Glasfasern adhäsiv befestigt und das Zwischenglied mittels eines spezifischen Verfahrens frei aus Komposit aufgebaut. Das vorgestellte systematisierte Verfahren erlaubt eine kostengünstige Anfertigung von direktem Zahnersatz mit vorhersagbarem ästhetischem Ergebnis. Maximale Substanzschonung und Reversibilität durch den Verzicht auf präparative Maßnahmen schränken die Möglichkeiten zukünftiger Versorgungen (z.B. Implanatate) nicht ein.