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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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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 -
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 -
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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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. -
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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. -
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. -
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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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 -
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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Management Of A Clinical Study
based on the book chapter by Jeanie Suvan Summary The focus of this chapter is on the appointment of a study manager to maximize the success of a clinical investigation. It explains the role of study managers (as distinct from principal investigators) in clinical trials, from initiation to study closure, applying project management principles from chairside to site facility. They use tailored planning strategies and tools including checklists, agendas, schedules, databases and spreadsheets, to deal with administrative and financial matters, standard operating procedures, timelines, logistics and auditing. Their involvement begins with translation of the protocol into reality and meeting regulatory requirements, through to data collection, adverse event recording and collation of documents in site files. The authors point out how good study managers identify limiting factors and barriers, prevent serious errors from occurring, and ensure all phases of the study flow smoothly. Their invaluable contributions include budgeting and tracking systems, devising formulae for calculating resources and clinic time, and contingency plans for coping with equipment failures and sickness absence. They contribute to team training, motivation and communication, and collaborate externally with ethics committee, funders, sponsors and report writers. They also help with patient recruitment, gaining informed consent, monitoring and retaining patients, and ensuring compliance. This information provides a compelling case for engaging a study manager. Open full-text PDF (1.1 MB) -
Compromised Bone Healing
The bone healing process in people can be affected by diseases such as Crohn’s disease, diabetes and colitis. It can also be affected by drugs such as bisphosphonates, which are used to treat weak bones in people with osteoporosis, Paget's disease and certain cancers. The role of animal models is enormous for investigating these disease conditions as well as other “risk factors” for compromised healing, such as radiotherapy, which is being increasingly used as early treatment of cancer in the community rises. Diabetes and intestinal disorders can be induced in rats, often using chemicals with toxic effects, but the diseases can take some time to develop. This chapter gives guidance on various timeframes for evaluating inflammatory processes, osseointegration and collagen cross-linking, and gives details on mechanical strength testing of dental implants and other candidate therapies. Different aspects of the compromised bone healing response can be observed using both the long bones (tibia and femur) and the maxilla of rats. This chapter also describes an adaptable study protocol for new investigators, with suitable endpoints such as bone to tissue ratio and bone to implant contact, to contribute to the body of knowledge on patients with compromised bone healing who are increasingly encountered in dental practice. -
Abnehmbarer Zahnersatz auf Implantaten - implantatgestützte Versorgungsformen im zahnlosen Kiefer
Wolfart, Stefan / Weber, VolkerGliederung: - Vorstellung der Patientin, Abformung, Kieferrelationsbestimmung - Wachsaufstellung, Herstellung der Interimsversorgung - Herstellung einer DVT basierten Planungs- und Bohrschablone - Chirurgische Maßnahmen für das Inserieren von vier 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® Systems, 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