Visualizing 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

Objectives: 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.

Procedure: - 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.

Expert 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.

Content: 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.

Outline: - 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

Dr. 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.

In 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.

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.

Content: - 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.

Gliederung: - 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

Gliederung: Theoretischer Teil: - Männlicher Patient: tiefer und breiter intraossärer Knochendefekt am Zahn 13 - Indikation für die Modified Papilla Preservation Technique im Rahmen der regenerativen Therapie durch die Breite des Diastema gegeben - Regenerative Parodontaltherapie mit: Emdogain (Regeneration parodontaler Strukturen); Bio-Oss Spongiosa (Verhinderung Lappenkollaps und Minimierung der Entstehung einer zu starken Rezession) Praktischer Teil: - Durchführung der Papilla Preservation Technique mit mikrochirurgischem Intrumentarium - Konditionierung der Wurzeloberfläche mit 24% igem EDTA für ca. 2 min - Entferung der EDTA Reste durch Spülung mit steriler Kochsalzlösung - Applikation von Emdogain auf die Wurzeloberfläche - Auffüllung des Defektes mit einem Gemisch aus Emdogain und Bio-Oss - Nahtverschluss mit zwei Matratzennähten (horizontal gekreuzte sowie vertikal modifizierte Matratzennaht) - Nahtmaterial: - 5-0 für die horizontale Matratzennaht; - 6-0 Monofilament für die vertikale Matratzennaht - Die postoperative Nachsorge umfasste Spülungen mit 0,2% Chlorhexidin (2 x Tägl. für 4 Wochen) und Gabe von Ibuprofen in den ersten Tagen post operationem. Inhalt: Der männliche Patient zeigte einen generalisierten Verlust von klinischem Attachment und Alveolarknochen. Die allgemeine Anamnese war unauffälig, der Patient war Nichtraucher. Die mikrobiologische Untersuchung zeigte hohe Zahlen von Actinobacillus actinomycetemcomitans und Porphyromonas gingivalis. Die Diagnose lautete: "generalisierte aggressive Parodontitis". Vier Monate nach Durchführung der Initialtherapie unter gleichzeitiger Gabe von Antibiotika (Amoxicillin + Metronidazol), zeigte die intraorale Röntgenaufnahme einen tiefen und breiten intraossären Knochendefekt, lokalisiert mesial und palatinal am Zahn 13. Um den Erhalt dieses strategisch wichtigen Zahnes zu gewährleisten, wurde eine regenerative Therapie mit Emdogain und Bio-Oss Spongiosa durchgeführt. Zehn Monate nach Durchführung der regenerativen Parodontaltherapie zeigte sich eine Reduktion der Sondierungstiefe um 7 mm und einen Gewinn an klinischem Attachment von 5-6 mm. Die Sondierungsiefe zu diesem Zeitpunkt war 2-3 mm und das intraorale Röntgenbild zeigte eine fast vollständige Auffüllung des Knochendefekts.

In diesem Beitrag mit Dr. Dr. Karlheinz Heuckmann, Chieming am Chiemsee, geht es um eine einfach und zeitsparende Methode für eine Sinusbodenelevation. Dr. Heuckmann hat zusammen mit dem Professor für Anatomie der Universität München, Dr. Klaus-Ulrich Benner, das von Meisinger vertriebene Balloon-Lift Control-System entwickelt. Mit der Balloon-Technik sind Sinuselevationen erstmals minimal-invasiv möglich und darüber hinaus in einem Bruchteil der bisher benötigten Zeit. Die Anwendung des Balloon-Lift Control-Systems ist leicht erlernbar und die Patienten sind überrascht, wie schnell der Sinuslift und die Augmentation erledigt sind.