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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. -
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. -
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. -
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. -
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. -
Fiberglass frameworks in removable prosthodontics
Bücking, Wolfram -
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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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. -
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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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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Multiple recession coverage using a modified tunnelling procedure
Zuhr, OttoOverview - Incision technique - Flap creation - Transplant fixation - Suture closure Contents: This video demonstrates the coverage of multiple recessions by means of a modified tunneling technique characterized by the use of a minimally invasive, atraumatic procedure without the creation of vertical incisions -
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Gaumenimplantat und Kortikalisschrauben als KFO-Verankerungselement
Kunkel, MartinGliederung: - Topographische Anatomie des Gaumens - Positionsbestimmung des Gaumenimplantats - Chirurgische Insertion des Gaumenimplantates - Chirurgische Insertion von Kortikalisschrauben - Beispiele kieferorthopädischer Apparaturen. Materialliste: Gaumenimplantat der Fa. Straumann (Straumann Orthosystem, palatal implant) und eine Schraube aus dem Aarhus System der Fa. Medicon.
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Immediate Implant Placement in the 12 and 22 Region
Diemer, JosefProcedure - Incision in region 22 - Flap Design - Preparation of the Implant Bed - Implant Placement - Suture - Extraction of tooth 12 - Curretage - Implant Placement Materials Implant System: 3I, Osseotite, Ø 4mm Region 12: 15mm length Region 22: 13mm length -
Clinical implant prosthodontics - step by step
Weigl, Paul / Trimpou, GeorgiaClinical steps for the fabrication of implant-supported restorations - Single-tooth restoration - Fixed partial denture - Electroplated cone-retained restoration - Conical copings using a pre-fabricated abutment matrix system -
ANTIBODY-MEDIATED OSSEOUS REGENERATION (AMOR) IN THE RECONSTRUCTION OF ALVEOLAR RIDGE DEFECTS
Objectives: The aim of this study was to examine the efficacy of antibody-mediated osseous regeneration (AMOR) in conjunction with two novel extraction devices, namely a SocketKAP™ (for obturation of socket orifices) and SocketKAGE™ (for providing space in sites with facial dehiscence for ridge preservation and augmentation procedures following tooth extraction). Methods: In this prospective controlled study, 8–12-year-old macaques (Macaca fascicularis; n = 6) underwent removal of both maxillary and mandibular second left and right premolars (ULPM2, URPM2, LLPM2, LRPM2), both maxillary and mandibular second left and right molars (ULM2, URM2, LLM2, and LRM2) on each side. This was followed by resection of the entire facial alveolar wall. They were randomly assigned to the following intervention groups: dehiscence socket unfilled and uncovered (group A; negative control); dehiscence socket reconstructed with SocketKAGE™ and covered with SocketKAP™ (group B); dehiscence socket reconstructed with SocketKAGE™ and ABBM and covered with SocketKAP™(group C); dehiscence socket reconstructed with SocketKAGE™ and chimeric anti-BMP-2 monoclonal antibody (mAb) and covered with SocketKAP™(group D); dehiscence socket reconstructed with SocketKAGE™ and iso-type-matched control mAb (Iso-mAb) and covered with SocketKAP™ (group E). At 6 and 12 weeks post-extraction, cone beam CT imaging was performed. All files were imported to Simplant TM/® software (for linear measurement of remaining bone width and height at 1mm, 2mm, 3mm and 5mm from alveolar crest) and to reverse engineering Geomagic ControlTM/®software (for volumetric analysis of alveolar bone). Histologic evaluation was also made of the dimensional changes in dehiscence defects after ridge preservation using different materials. Non-parametric analysis of variance was conducted using the methods of Brunnner and Langer. Results: The result from linear and volumetric analyses demonstrated that group D (chimeric mAb +SocketKAP™ + SocketKAGE™) was associated with significantly greater percentages of remaining bone width and height at the buccal point, and remaining bone volume at 6 and 12 weeks when compared to group A (negative control), group B (SocketKAP™ + SocketKAGE™) and group E (Iso-mAb); the latter lost approximately 70% of crestal bone width at the crestal 1 mm point, and ABBM failed to prove more effective in preserving alveolar bone width at crestal 1mm (36%). When anti-BMP-2 mAB was used, the percentage of bone width was as good as those with ABBM at crestal 2mm, 3mm and 5mm areas. However, the most important finding was that the data demonstrated that bone remodelling using chimeric mAb was not only limited to the crestal 2–5-mm zone, but also the crestal 1-mm area, with mean remaining bone widths of 52% and 68% at 6 weeks and 12 weeks, respectively. Both CB-CT and volumetric analysis revealed more active and extensive bone regeneration of marginal bone with chimeric mAb compared to other groups. Histologic analysis showed the knife-edge of alveolar crest following tooth extraction in groups A, B, C and E, as well as statistically significant more bone remodelling in chimeric mAb, including a higher percentage of bone formation within newly generated tissue together with signs of osteogenic cell activity. Conclusions: These results suggest that chimeric anti-BMP-2 mAb, in conjunction with SocketKAPTM/® and SocketKAGETM/® was effective in the reconstruction of the alveolar bone in extraction sockets with facial dehiscence defects. These favourable results may be attributed to advantageous nature of AMOR, such as using endogenous BMP-2 captured by chimeric mAb enhance osteogenesis, with higher biological activity of endogenous BMP and a longer half-life of captured BMP compared to ABBM (which only exhibits osteoconductivity).