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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. -
Esthetic and Restorative Dentistry - Ceramic Materials
Terry, Douglas A. -
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Fiberglass frameworks in removable prosthodontics
Bücking, Wolfram -
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. -
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. -
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. -
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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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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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. -
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. -
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.
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Guided Bone Regeneration in Posterior Maxilla with Membrane Technique. Insertion of an Implant - The entire case
Mengel, Reiner / Foitzik, ChristianOverview: Part 1 - Incision and mobilization of the mucoperiosteal flap - Cleaning the bony defect - Screw insertion for support, membrane application and fixation - Suture closure Part 2 - Opening of the mucosa above the region of augmented bone - Preparation of tunnel and bone bed for an open screw-type endosteal implant (Straumann® implant) - Use of single button sutures for tension-free wound closure Contents: This female patient presented with bone loss due to a radicular cyst at tooth 27 and peri-implantitis at tooth 26. Four months after extraction of the respective tooth and implant, guided bone regeneration (GBR) was carried out using supporting screws and an e-PTFE membrane for augmentation of the posterior tooth region of the maxilla. Four months after GBR the insertion of an implant took place. -
Composite Restoration in Anterior Teeth
Hugo, BurkardProcedure: - Introduction with control of the Gap Width and Colour Selection - Preparation of the Dental Surface (application of the Matrix) - Gap Closure, Final Polish Contents The present case shows the gap closure at tooth 22 with a direct adhesive technique. The gap closure is done here after the orthodontic treatment of a central diastema. A special matrix technique is used to allow a perfect design of the aproximal surfaces and the creation of the aproximal contact points. During the colour selection the dentin and enamel colours are chosen very carefully, to allow a good esthetic result and different composites are used to achieve a natural aspect of the tooth. -
Bone Transplantation with Systemized Armamentarium
Streckbein, Roland
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ALVEOLAR DIMENSIONAL VARIATIONS IN ALVEOLAR PRESERVATION AND POST-EXTRACTION IMMEDIATE MAXILLARY IMPLANTS—A 3-D MULTILEVEL MULTIVARIATE PROSPECTIVE STUDY
Objectives: The aim of the study was to evaluate the bone dimensional alterations that occur following tooth extraction and immediate or secondary implant installation in the maxillary arch, and the factors that may influence it, through assessment of early healing events and dimensional changes of the buccal and lingual walls of fresh extraction sockets following immediate implant installation compared to alveolar preservation and secondary implant placement. Methods: Thirty-five patients (mean age 49.58 ± 11.09 years) treated with 37 single-tooth implants in the maxillary area (from 15 to 25) were included in this study. Before surgery, patients were randomly assigned to two groups to ensure balanced distribution. In group A, fresh extraction sockets were filled with Bio-OssTMdeproteinised bovine bone material (DBBM) and sealed with a resorbable collagen membrane (Mucograf SealTM). Implants were inserted 16 weeks after alveolar preservation. In group B, implants were placed over immediate extraction sites with no compromise of the buccal bone plate and left to heal for a period of 16 weeks, following a two-stage protocol. The implant surface–alveolar buccal wall gap was filled with the same DBBM material. Cone-beam CT was performed after extraction and implant placement (baseline), and at 4 weeks (T1), 16 weeks (T2) and 1 year (T3) after surgery, to assess buccal plate height (BH), palatal plate height (PH), buccal–palatal coronal distance (BPD) and buccal plate thickness (BPT). Mean values of each groups were compared using a t-test and ANOVA for comparison of multiple variables. A Pearson correlation analysis assessed the influence of the alveolar anatomy and extension of bone resorption in at different time sets. Statistical significance was set at 0.05. Results: Thirty-one patients (mean age 43.6 ± 11.4 years; range 30–66) treated with thirteen alveolar bone preservation procedures (Group A) and twenty single-tooth immediate implants (Group B) were examined. Of the initial thirty-five patients, one was excluded due to implant failure and three failed did not finish the recall program (all were in group B). At baseline, group A had BPT at the incisive/canine sites of 0.48 ± 0, 36mm, and 0.93 ± 0.36mm at premolar locations. Group B had BPT of 0.91 ± 0.47mm and 1.22 ± 0.98mm for the incisive/canine and premolar sites, respectively. A normal distribution was found for both groups regarding BPT. At T2, there was a reduction in bone dimensions. No significant changes were found in BH between baseline and T2 in either group. Significant differences were found in BPD from baseline to T1 and from baseline to T2, with a statistically significant reduction in buccal–palatal volume in both groups. A positive correlation was found between BPT and the reduction in buccal–palatal volume, described by the BPD measurements, in both groups. Conclusion: Both treatments failed to prevent bone resorption. Immediate implant installation in fresh sockets with DBBM particles was no better than alveolar bone preservation in terms of bone preservation of fresh extraction sockets, but both treatments reduced bone loss after extraction compared to non-grafted sites (described in the literature), and may help clinicians to make decisions about immediate implant placement into sockets. Future studies might compare this type of placement with other treatments in the anterior maxillary region, and consider different timings of placement and related surgical procedures. -
New Large Clinical Grants Programme
The Osteology Foundation calls for applications for the new Large Clinical Grants. Theprogram aims to support hypothesis driven clinical research by well-established research groups with demonstrated clinical research expertise. There are two stages in the application process: Stage 1 Applicants can submit an abstract of their proposed project by15 November. The Osteology Science Committee selects projects which then progress to the next stage. Stage 2 Applicants are invited to submit their full application. The submissions are then evaluated for potential funding by the Osteology Science Committee. Study types Research types falling within the scope of the Osteology Foundation are for example: RCT (also small multi centres) and quasi RCT Case controlled studies Prospective cohort studies Surgical techniques (also in combination with biologics, drugs and devices) e.g.: Biologics Dugs (also e.g. phase I / phase II - pilot studies, proof of principle) Devices (also e.g. phase I / phase II - pilot studies, proof of principle) Combination products Who can apply? Well-established research groups that demonstrated clinical research expertise. Amount of funding Grants are limited to 350000 Swiss Francs with a maximum project duration of three years. Awarding criteria Hypothesis answering a clinical research question relevant to the field of oral and maxillofacial regeneration Methodology Facilities and expertise to conduct a GCP study Sound and transparent budget Application guidelines Apply now!