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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. -
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. -
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. -
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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. -
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. -
Fiberglass frameworks in removable prosthodontics
Bücking, Wolfram -
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 -
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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Frontzahnimplantat mit Alveolarkammextension, Bindegewebstransplantat und Rotationslappen
Wagner, WilfriedGliederung - Alveolarkammextension - Implantatinsertion - Freies Gingivatransplantat - Rotationslappen Inhalt: Im Bereich der Nichtanlage 12 wird der schmale Alveolarkamm im Sinne einer Alveolarkammextension nach Vorbohrung aufgedehnt und ein 3,5mm Astra-Implantat stabil inseriert. Mit einem freien Gingivatransplantat von der gleichen Seite lässt sich der bestehende Weichteildefekt ausgleichen. Dazu lagert man das Transplantat mit einem Vicrylfaden vestibulär in den Defekt ein. Zur Defektdeckung wird ein kleiner palatinaler Rotationslappen gegengeschwenkt, um eine zusätzliche Entlastungsinzision im ästhetisch sichtbaren, vestibulären Bereich zu vermeiden. -
Crestale Knochenelevation, ein Patientenfall
Streckbein, Roland -
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HISTOLOGICAL ANALYSIS OF DIFFERENT COLLAGEN MEMBRANES—PHYSIOLOGICAL OR FOREIGN BODY REACTION?
Objectives: Collagen membranes and matrices are known to be reliable barrier materials in guided tissue and guided bone regeneration, for regenerating lost hard and soft tissues in oral and implant surgery. This study presents results from histological investigations of different collagen-based membranes in order to outline the cellular reactions according to specific characteristics of the materials and their manufacturing processes. Methods: Collagen membranes and 3-D collagen matrices that vary in origin and manufacture were implanted subcutaneously in CD-1 mice and Wistar rats, as well as in humans, to determine the tissue reaction within the peri-implant tissue. Samples extracted up to 60 days after implantation were processed and evaluated histologically and histomorphometrically with a special focus on material stability, vascularisation and induction of a multinucleated giant cells triggered foreign-body reactions. Results: Histology revealed distinct differences in the cellular reactions to the various membranes depending on material-specific characteristics and processing techniques. Cellular reactions consisted mainly of mononuclear cells (e.g. macrophages) as sign of high biocompatibility, material integration and lack of a foreign-body reaction, as well as the presence of multinucleated giant cells that arise from macrophages and migrate into the implant bed. Complete volume stability and integrity was also observed in terms of continuous cell and tissue ingrowth and early vascularisation. Conclusions: Collagen-based membranes serve in periodontology and implantology as versatile barriers that separate different tissues and cells during the healing process. For clinical application of collagen membranes, it is very important to have a detailed knowledge of the cell reactions induced in the implant bed. Cellular reactions, volume stability and membrane permeability, as systematically analysed in this study, have a distinct influence on clinical success. -
Postoperative Care and Complications
Dr. Thomas G. Wilson, Jr.In this module, Dr. Thomas G. Wilson, Jr., presents a variety of post-operative complications, discusses their prevention as well as treatment. Dr. Wilson’s lessons covers the spectrum from the initial consultation through long-term follow up.