Gratis Inhalte
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Live surgery Surgical treatment of bone necrosis
Schultze-Mosgau, Stefan -
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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. -
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. -
Fiberglass frameworks in removable prosthodontics
Bücking, Wolfram -
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: - Incision around tooth 23, intra-sulcular preparation, mobilization of coronal sliding flap, and pre-flap preparation. - Root smoothing, reduction of ground cavity with diamond burs from Perioset system. - Preparation and harvesting of connective tissue flap from palate, Emdogain application, and wound closure. - Placement of interrupted interdental sutures for fixation of connective tissue flap. -
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. -
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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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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. -
Esthetic and Restorative Dentistry - Ceramic Materials
Terry, Douglas A.
Am beliebtesten
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Piezo Surgery Technique for Alveolar Ridge Augmentation with Sinus Lift
Schlee, MarkusOverview: - Periodontal and implant planning - Treatment of a horizontal and vertical bone defect - discussion of the literature - Clinical implementation of bone augmentation using a bone block and treatment of a vertical pocket with Emdogain - Sinus lift in combination with alveolar ridge augmentation and horizontal expansion of the alveolar process; orthodontic straightening of a molar tooth Contents: This contribution illustrates a complex periodontal-implantological case, from treatment planning to clinical implementation. It details the transplantation of two bone blocks from the linea obliqua of the angle of the jaw to the anterior front tooth region, the treatment of a vertical bone pocket with Emdogain, the straightening of a molar tooth using orthodontic mini-implants, and a sinus lift together with alveolar ridge augmentation in the maxillary region using a piezo surgical technique. -
Bone Spreading, Bone Condensing (Interim Control System)
Streckbein, Roland -
Restoration of Anterior Teeth with Porcelain laminate Veneers
Bastek, Siegfried / Fiechter, PaulContent Preparation of teeth; Composite build-up for larger lesions; Smoothing of preparation surfaces; Placement of retraction cords; Impression-taking with A-silicone; Placement of temporary; Preparation of model; Preparation of laminate veneers; Final adhesive bonding of laminate veneers.
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UNRAVELLING THE PROGRESSION TOWARDS PERI-IMPLANTITIS MICROCOSM AND DISINFECTION DYNAMICS ON TITANIUM IMPLANT SURFACES
Objectives: Biofilms contamination of implant surfaces are part of the aetiology of peri-implantitis, and different surface decontamination techniques have been proposed as anti-infective therapy. However, no single intervention has been found to be superior. The focus of the present study was to explore the microbial ecology of the peri-implantitis microcosm, and to develop novel surface decontamination methods. Methods: Microcosm biofilms were grown for 30 days in a constant depth film fermenter (CDFF) on SLA andmTi discs, under standardised parameters associated with peri-implantitis. The discs were randomly allocated to three test groups (T1, T2, T3), and two control groups, one consisting of discs with undisturbed peri-implantitis microcosm biofilms (MC) and one with sterile discs (SC). The test group T1 underwent mechanical cleaning with a TiBrushTM (TiB); T2 underwent a combination of TiB and photodynamic therapy (PDT); and T3 underwent a combination of TiB and 0.2% chlorhexidine gluconate/1% sodium hypochlorate (CA). The biofilms were visualised under confocal laser scanning microscopy and surface chemistry was evaluated by scanning electron microscopy with energy dispersive x-ray analysis (SEM/EDX) and X-ray photoelectron spectroscopy (XPS). The bacterial composition of the biofilms was studied before and after disinfection by next-generation sequencing (NGS) of 16S rRNA gene amplicons (MiSeq). Cytocompatibility testing was carried out using AdB Serotech and endotoxin testing bacterial by Kinetic-QCL. Image J and CasaXPS were used for image analysis. Results: The CDFF peri-implantitis model presented here favoured the growth of higher proportions of Klebsiella, Prevotella, Parvimonas, Porphyromonadaceae (family), Actinomyces, Fusobacterium, Enterobacteriaceae (family), Lachno anaerobaculum and Corynebacterium in in vitro peri-implantitis conditions. ISO-surface-volume rendering and analysis of the confocal biofilm stacks revealed the complex microstructure of the undisturbed MC. The physicochemical composition of titanium surfaces before and after decontamination was also investigated, as well as the biocompatibility effect when cultured with MG-63 cells. Elemental analysis disclosed surface alterations of the discs undergoing different treatments. Endotoxin was found in MC and all test groups. The highest levels were found in M surfaces (MC: 12,000 UI/mL). The core microbiome differed between M and SLA surfaces. Bacteria were observed in all groups after disinfection. Streptococcus were present in all SLA- and M-treated samples. Overall, M surfaces were contaminated by Prevotella, Parvimonas, Klebsiella and Neisseria in the highest proportions. Conclusion: The CDFF is useful for modelling microbial shifts associated with peri-implantitis pathogen communities. It seems that the titanium substrata plays only a minor role in the development of mature biofilms. Our data suggest that no treatment modality hindered biocompatibility of the titanium surface. The bacteria were mainly composed of gram-negative species and Streptococcus, which prevailed after chemical and mechanical therapy and LPS was found in all experimental groups. Collectively, these results suggest that a successful treatment for peri-implantitis should be holistic, eliminating live bacteria and bacterial virulence factors, and take account of alterations in the titanium surface. The state of the titanium oxide layer following disinfection and host interactions biofilms warrant further investigation. -
Periodontal Regeneration
Animals with defects of the gum can be used to investigate the effectiveness and safety of scaffold materials, devices and biologics for bone and soft tissue repair, before they are tested in people. Living models are essential for observing changes in structure and function over time, sometimes long periods, during the remodeling and healing phases. This chapter recommends which animals are best suited for studying agents such as growth factors and barrier membranes. They include both small and large animals, such as rats, dogs and primates, with both natural defects and surgically or ligature-induced defects. The design of the studies is addressed specifically, with instructions on the creation of various standardized defects, and how to care for the animals before and after surgery, including management of biohazardous materials such as viral vectors. The roles of institutional guidelines and the requirements of regulatory bodies and animal housing authorities are also covered. Investigators who are studying the healing process sometimes need guidance on selecting suitable endpoints that can be adapted to humans in clinical settings; several measurable outcomes are specified here, based on histologic, morphometric and imaging findings, which aim to provide relevant and reproducible data on molecular and cellular responses, and entire gum tissue reactions to the intervention. -
SINUS FLOOR AUGMENTATION AFTER ENDOSCOPIC SINUS SURGERY (ESS) FOR THE TREATMENT OF CHRONIC MAXILLARY SINUSITIS—A CASE SERIES
Objectives: The aim of this study was to evaluate maxillary sinus health in patients who underwent sinus floor augmentation for implant placement after endoscopic sinus surgery (ESS) for the treatment of chronic maxillary sinusitis. Methods: In this series, ESS was performed on four patients with chronic maxillary sinusitis before sinus floor augmentation. A two-stage sinus floor augmentation was performed using deproteinised bovine bone graft and non-cross-linked collagen membrane, 3 months later. Root-form dental implants were placed after 5 months of healing. Cone-beam CT (CBCT) images were taken before ESS, before and after sinus augmentation, and 3 years postoperatively. Sinus membrane thickness and ostium patency were evaluated during the observation period. Marginal bone loss for each dental implant was analysed by CBCT scanning and implant success was evaluated. All patients were rehabilitated with implant-supported fixed restorations. Results: All dental implants were placed in the grafted sinuses and the success rate was 100%. Sinusitis did not recur during the 3-year follow-up period. The ostiomeatal complex was not stenosed after ESS throughout the observation period, however the sinus membranes of two patients were thick and almost filled the sinus cavity before sinus floor augmentation. Corticosteroids were administered for 3 weeks to decrease the membrane thickness. Additive CBCT images confirmed membrane changes in these patients. On completion of medical therapy, sinus floor augmentations could be performed. Conclusion: ESS therapy before sinus augmentation is a reliable and predictable technique for achieving and maintaining the normal physiological environment of the maxillary sinus, after which dental implants can be safely placed in augmented sinus floor sites. CBCT scanning at regular intervals is recommended after ESS treatment for monitoring sinus membrane inflammation and ostium patency.