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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 -
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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. -
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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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. -
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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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 -
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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. -
Fiberglass frameworks in removable prosthodontics
Bücking, Wolfram -
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.
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Split Control System, Spreading am Modell und am Patienten
Streckbein, Roland -
Ãsthetische Versorgung von Frontzähnen mit keramischen Laminate Veneers
Bastek, Siegfried / Fiechter, PaulPräparation der Zähne, Kompositaufbauten starker Läsionen, Glättung der Präparationsflächen, Applizieren von Retraktionsfäden, Abformung mit ASilikon, Provisorische Versorgung, Modellherstellung, Anfertigung der Laminate Veneers, definitive Befestigung der Laminate Veneers mittels Adhäsivtechnik. -
Clinical implant prosthodontics - Part III
Weigl, Paul / Trimpou, Georgia
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Soft Tissue Management in Immediate Implantation in Region 21
Grunder, UeliProcedure: - Sounding - Extraction of the tooth 21 - Drilling and implantation - Soft tissue preparation (split flap technique / tunnelling technique) - Harvesting of the soft tissue graft from the palatal region and immediate closure of the site - Fixation of the transplant - Application of the healing abutments - Fixation of the transplant coronally Materials: Thommen Medical Implant System: SPI Element 4,2x14, 4,5 Implant shoulder Goretex 5,0, Premilene 7,0 Sutures Thommen gingiva former -
BONE AUGMENTATION WITH XENOGRAFT ASSOCIATED WITH BONE MARROW ASPIRATE CONCENTRATE (BMAC)
Objectives: To evaluate bony reconstruction of atrophic anterior maxilla using particulate grafts with or without autologous BMAC obtained via the BMAC method. Methods: Patients with atrophic anterior maxillae due to tooth loss (n = 8) were selected and split into groups according to the type of material used: the control group (n=4) received particulate xenograft only, the test group (n= 4) received a combination of particulate xenograft and bone marrow aspirate concentrate obtained via the BMAC method. Both groups received a collagen membrane to cover the xenograft. After 4 months, during implant placement, a bony sample was removed from the graft area using a trephine bur with a 2-mm internal diameter. The specimens were fixed and preserved for histomorphometric assessment of the following tissues: vital mineralised tissue (VMT), non-vital mineralised tissue (NVMT) and non-mineralised tissue (NMT). Cone-beam CT (CBCT) was performed three times to measure bony thickness: (i) prior to graft insertion, (ii) 4 months after grafting, and (iii) 8 months after grafting. The parameter used was local bone gain in millimetres. Results: Tomographic analysis revealed an increase in bony tissue in the CG of 3.78+1.35mm and 4.34+1.58mm at 4 months and 8 months, respectively. The TG showed an increase of 3.79+0.52mm and 4.09+1.33mm after 4 months and 8 months, respectively. Histomorphometric analysis revealed CG values for VMT, NMT and NVMT of 11.34±5.23%, 44.45±5.5% and 40.96±12.40%, respectively, and 64.31±9.12%, 32.41±10.38% and 0.73±0.56% for the TG. Conclusions: The use of a bone marrow aspirate concentrate obtained via BMAC increased bone formation in the graft area in the anterior maxilla. -
Study Protocols: Osseointegration Of Dental Implants
based on the book chapter by Giovanni E. Salvi, Dieter D.Bosshardt, and Niklaus P. Lang Summary The authors explain the rationale behind these techniques and how more in vivo studies of wound healing and tissue formation in humans are needed because most of the existing evidence relates to in vitro animal studies. The protocol has four phases: planning, surgery, laboratory processing and data analysis. It offers an opportunity to obtain standardized, reproducible evidence on the dynamic osseointegration process and allows comparisons to be made between implants with different designs, features and placement sites, for example, and preoperative and postoperative care regimens. It covers enrolment and selection of patients with third molar extractions and good bone volume for undergoing the split-mouth procedure, with details of the healing time points and patient care, and clear images of the procedure. The relevance of implant composition and surface properties (e.g. roughness and wettability) is explained, and the creation of a U-shaped wound compartment in the implant is described, with landmarks that can be identified after explantation. The interface that forms between the implant and bone is evaluated in terms of the bone-to-implant contact (BIC), with endpoints being determined by histology and histomorphometry to reveal immune responses and morphological changes. Microarray gene profiling is used to correlate clinical and molecular events with inflammation, angiogenesis and neurogenesis. The authors remind investigators to engage a biostatistician at an early stage. Open full-text PDF (1.3 MB)





