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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 -
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. -
Esthetic and Restorative Dentistry - Ceramic Materials
Terry, Douglas A. -
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. -
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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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. -
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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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. -
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. -
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Fiberglass frameworks in removable prosthodontics
Bücking, Wolfram -
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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.
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3D planning and template-guided implant insertion in the edentulous jaw
Kirsch, Axel / Ackermann, Karl-Ludwig / Neuendorff, GerhardContents: - Surgical procedures for anchoring a diagnostic guide - Inserting four provisional implants - Impression and bite registration, fabrication of the master cast - Tooth-setup for the temporary restoration - Registering the setup in a silicone index - Duplicating the setup in radiopaque resin for CT imaging - Implant planning using a 3D record of the CT image - Fabricating a transfer template based on the CAD treatment plan using the CAMLOG® Guide System - Inserting the guiding sleeves into the template - Fabricating the final restoration prior to inserting the implants - Vario SR abutments with Vario SR titanium copings for a passive fit - Fabricating a cast titanium framework to reinforce the restoration - Surgical procedures demonstrating the definitive implant insertion - Insertion of six implants for immediate loading - Providing a controlled-clearance fit between the implants and the denture base -
Regenerative Therapy for Multiple Recessions
Heinz, BerndContents - History - Emdogain Application - Incision - Periosteal Incision - Root Smoothing - Suture Technique - PrefGel Application Synopsis: Regenerative periodontal surgery with Emdogain enamel matrix protein: The goal of regenerative periodontal surgery is to rebuild destroyed periodontal structures. Bone transplants, bone replacement materials, and nonresorbable and resorbable membranes have been and still are being used. In a new therapeutic approach to periodontal regeneration, the root surface is conditioned using an enamel matrix protein derivative (Emdogain, Biora). The protein complex stimulates the regeneration of root cement, which in turn leads to the regeneration of bone and collagen fibers. Since the early 1980's, Professor Lars Hammerström's Swedish research team has performed extensive research and studies on this method and its mode of action. Emdogain is now used for treatment of vertical bone defects and furcation defects. The exposed root surface is first carefully scaled using handheld instruments or a rotating, fine-grain diamond drill. PrefGel EDTA suspension (Biora) is then applied for 2 minutes, then thoroughly rinsed with physiological saline solution. The EDTA suspension serves to remove the smear layer and opens the dentinal tubules, leading to improved binding of Emdogain to the root surface. Emdogain is applied to the blood- and saliva-free root surface immediately after rinsing. Finally, the wound is sutured closed. -
Abnehmbarer Zahnersatz auf Implantaten - implantatgestützte Versorgungsformen im zahnlosen Kiefer
Wolfart, Stefan / Weber, VolkerInhalt: - Vorstellung der Patientin, Abformung, Kieferrelationsbestimmung - Wachsaufstellung, Herstellung der Interimsversorgung - Herstellung einer DVT basierten Planungs- und Bohrschablone - Chirurgische Maßnahmen für das Inserieren von 4 Implantaten im Unterkiefer - Nahtlegung und Umarbeitung der vorhandenen Prothese als Interimsversorgung - Nach 12 Wochen: Wiedereröffnung, Einsetzen von Gingivaformern - Freies Schleimhauttransplantat zur Verbreiterung der angewachsenen Gingiva - Prüfen der Implantatstabilität mit Periotest - Unterfütterung der Interimsprothese auf den Gingivaformern - Implantatabformung mit individuellem Löffel (Pick-up Technik) - Verwendung des Linefinders zur Übertragung der Gesichtsachse - Anfertigung der drei Prothesen mit verschiedenen Verankerungen: Locator®, Galvano-Doppelkrone, gefräster Steg - Umgang mit den Matrizen und Retentionseinsätzen des Locator® System, Übertragen der Locator® Aufbauten auf die Implantate - Herstellung der Galvanosekundärteile, intraorale Verklebung des Modellgussgerüstes (passive Fit), Fertigstellen und Eingliedern - Herausnehmbare Versorgung auf gefrästem Steg, zahnärztliche und zahntechnische Arbeitsschritte, Eingliederung - Hinweise zur Pflege der implantatgetragenen Versorgung
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MOLECULAR DISCRIMINATION AND ANGIOGENESIS PROPERTIES OF HUMAN OSTEOBLASTS FROM DIFFERENT BONE ENTITIES
Objectives: Autologous grafts from the iliac crest remain the gold standard for alveolar ridge reconstruction. This study aimed to compare the osteogenic potential of human osteoblasts from alveolar and iliac crest bone. Methods: We compared primary human alveolar osteoblasts (aHOBs) and human iliac osteoblasts (iHOBs) derived from patients undergoing routine intraoral bone grafting. Their proliferation potential was evaluated using real-time impedance monitoring. The relative gene expression of bone-specific biomarkers was determined by quantitative polymerase chain reaction (qPCR). Immunohistochemistry, phase-contrast microscopy, alkaline phosphatase (ALP) assay and alizarin red staining were used to visualise cell morphology and mineralisation capacity. In a second part of the experiment, the angiogenesis potential of OPN (osteopontin) derived from aHOBs and iHOBs was investigated using human umbilical vein endothelial cells (HUVECs) in terms of migration and tube formation. Results: The proliferation rate of aHOBs was nearly twice as fast as that of iHOBs (130 hours versus 80 hours). ALP activity and alizarin staining in both aHOBs and iHOBs indicated similar mineralisation capacities. Expression of seven genes (BMP-1, CSF-1, TGF-BR1, ICAM-1, VCAM-1, OPN and DLX-5) was significantly higher in iHOBs than aHOBs. In line with its gene expression, secretion of OPN was greater in iHOB supernatant than aHOB supernatant. OPN was found to stimulate migration of HUVECs (but not tube formation), confirming its role in angiogenesis. Conclusion: These data suggest that osteoblasts derived from iliac crest have higher osteogenic potential than primary osteoblasts from alveolar bone. This may enhance our understanding of the molecular impact of bone cells from different bone sources on bone regeneration in alveolar ridge reconstruction.Secreted OPN was found to have a role in angiogenesis by stimulating migration of HUVECs. -
Anterior Implant Placement using in a Combined Roll Flap and Connective Tissue Graft Technique
Schultze-Mosgau, StefanProcedure: - Incision Technique and Roll Flap Creation - Excision and Transplantation of Connective Tissue Graft Material from the Palate - Implant Placement and Fixation Procedure Contents: This video describes the preparation of an implant insertion site for placement of an individual implant at site 11 using a roll flap and free connective tissue graft technique. The procedure is designed to shape the implant insertion site and to create a secure, keratinized gingival base. Step-by-step, the operator demonstrates the incision technique, the roll flap creation procedure and the techniques used for excision, transplantation and fixation of the free connective tissue graft within the scope of implant placement. -
Innovative CAD/CAM treatment approaches for implant-supported fixed restorations
Beuer, Florian / Stimmelmayr, Michael / Schweiger, JosefContents: - Patient presentation - Preparing the implant bed, implant placement, checking implant positions - Securing the insertion posts to the index for fabrication of the cast - Suturing details - Delivery of the adapted long-term provisional - Fabricating the cast and the gingival mask, transferring the pontic emergence profiles to the gingival mask, mask adaptation - The master cast under the strip scanner with scan bodies on the laboratory analogs - CAD crown design and virtual anatomic shaping - CAM fabrication of a zirconia abutment - Adhesively connecting the zirconia abutment to the titanium base - Reentry, split-thickness flap, vestibuloplasty, connecting the zirconia abutments to the implants - Mucosal graft to restore a soft-tissue defect - Intraoral impression of the abutments - Fabricating the definitive lithium disilicate crowns: virtual crown design; CAM milling, characterization of the crowns - Delivery, final adjustments, presentation of the treatment outcome





