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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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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. -
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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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. -
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. -
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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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 -
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. -
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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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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Sofortbelastete Implantate und Herstellung einer Stegprothese
Drobig, FelixDie prothetische Versorgung auf Implantaten ist wirklich eine der erfolgreichsten zahnmedizinischen Therapien unserer Zeit. Die Verkaufszahlen für Implantate steigen kontinuierlich, trotzdem hat sich inzwischen auch ein Markt für sogenannte Generica-Implantate entwickelt, für die vergleichsweise günstige Preise genannt werden. Auch die schweizerische Dr. Ihde Dental GmbH bietet neben anderen sogenannte Generica Implantate an. Mit dem Allfit STO-Implantat von Dr. Ihde Dental haben wir in der Praxis von Dr. Drobig, Karlsruhe einen Fall aufgezeichnet, bei dem wegen ungünstiger Kieferverhältnisse eine untere Totalprothese auf sofort belasteten Implantaten verankert wird. -
Restoration of a Class IV defect in the anterior segment
Hugo, Burkard -
Bone Spreading, Bone Condensing
Streckbein, RolandChirurgie: Aufklappung und Lappenbildung, Festlegung der Implantatposition mittels Bohrschablone, Anlage der Implantatstollen, Gewindeschneiden, Knochenverdichtung, Insertion der Implantate, Abformung, Wundverschluss, spätere Eingliederung. Zahntechnik: Modellherstellung mit Laborimplantaten, Modellation des Steggerüstes, Adaption des lasergeschweißten Gerüstes auf dem Modell, Herstellung des Zahnersatzes, Einarbeiten der Stegreiter in den Zahnersatz, Fertigstellung.
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RIDGE AUGMENTATION BY APPLYING DEPROTEINISED BOVINE BONE MINERAL (DBBM) AND BIORESORBABLE MEMBRANE—A CASE REPORT
Objectives: Lateral ridge augmentations are traditionally performed using autogenous bone grafts, bone screws and titanium-reinforced ePTFE membrane; they are associated with considerable patient morbidity and a requirement for large flaps at second-stage surgery. The aim of this study was to determine whether the use of resorbable membranes and bone substitutes could lead to successful horizontal ridge augmentation, allowing the installation of implants in normal conditions, and thus minimising risks and morbidity to the patient. Methods: The patient presented with an anterior maxilla bone deficiency (canine–canine) preventing the placement of dental implants. The residual bone average was 2.5mm before bone augmentation surgery. Soft tissue flaps were carefully raised and particles of deproteinised bovine bone mineral (DBBM) (Bio-Oss[tm]) were placed in the defect area. A collagenous membrane (Bio-Gide[tm]) was applied to cover the DBBM and immobilised to the surrounding bone using only the soft tissue. The flaps were sutured to allow for healing by primary intention and to stabilise the DBBM and membrane. Results: Ten months after primary surgery, the average bone gain was 5mm and the bone crest was approximately 7mm after augmentation, allowing implant placement. When the flaps were raised for re-entry, the regenerated tissue appeared as mineralised bone tissue. Integration of deproteinised bovine bone particles into the newly formed bone was observed. Conclusion: Despite its limitations, this clinical case demonstrated that the combination of DBBM and collagen membrane may be used successfully for horizontal ridge augmentation. -
Full reconstruction of lower jaw inculding esthetic improvement
PD Dr. Ronald JungTo create optimal chewing efficiency the lower jaw was reconstructed with mixed implant- and tooth-supported bridges containing cantilevers. The abraded front teeth were crowned to improve the esthetics. -
REHABILITATION OF A PATIENT WITH NOSE MUTILATION RESULTING FROM CARCINOLOGIC SURGERY USING EXTRAORAL FIXTURES AND EPITHESIS
Objectives: Treatment of nose mutilation resulting from cancer treatment requires use of a technique that allows good aesthetic rehabilitation. Plastic surgery is an option, but involves several surgeries, which are time consuming and often have only partial aesthetic results. Using an extraoral fixture for bone anchorage of a removable nose prosthesis results in quicker and better aesthetic results. Methods: We present the case of a 60-year-old man who had undergone a total nasal resection for a large basal cell carcinoma of the nose. Anatomopathologic analysis of the resection showed free margins, and did not reveal any ganglionic metastasis. No radiotherapy was applied. One year later, two extraoral fixtures were inserted in the frontonasal bone, under general anaesthesia, and 4 months after insertion, the fixtures were denudated under local anaesthesia, and prosthetic abutments placed. After 2 weeks, prosthetic steps were realised, and the patient received a removable nasal prosthesis that was fixed by two magnetic devices on the implants. This report describes and illustrates the various surgical and prosthetic steps involved. Results: Patient satisfaction was achieved with this technique. Surgical reconstruction following a centrofacial mutilation is challenging because of the need to recreate a complex 3-D nasal form. Extraoral craniofacial fixtures have an average success rate of 95% in non-irradiated patients and have made it possible for the nasal epithesis to be considered as a forerunner in cosmetic rehabilitation strategies. Conclusions: The clinical case presented here shows that transcutaneous extraoral fixtures may be used as bone anchorage for nasal epitheses, in cases of nasal mutilation resulting from cancer treatment.





