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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. -
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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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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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. -
Esthetic and Restorative Dentistry - Ceramic Materials
Terry, Douglas A. -
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. -
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. -
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 -
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. -
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. -
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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Augmentation regio 16 mit SonicWeld Rx System
Iglhaut, Gerhard M. -
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Kommunikation der Zellen - Die entzündliche Reaktion (Trailer)
Stadlinger, Bernd / Terheyden, HendrikFilmpremiere zur Kongresseröffnung "Deutscher Zahnärztetag" am 09. November 2012. Das Unsichtbare sichtbar werden zu lassen und zugleich die Faszination Wissenschaft zu erleben, ist die große Herausforderung der neuen Filmreihe "Kommunikation der Zellen". In einer sehr aufwendig produzierten Computeranimation in HD Qualität werden die hoch komplexen zellulären Interaktionsprozesse einer entzündlichen parodontalen Reaktion mit ihren beteiligten Botenstoffen visualisiert. Die Zelltypen als Hauptdarsteller sowie die Proteine und Botenstoffe als Nebendarsteller nehmen den Kampf gegen die eindringenden Bakterien durch einen fein aufeinander abgestimmten Kommunikationsprozess auf. Ein dramaturgisch und didaktisch außergewöhnliches Filmerlebnis. Gliederung: - Biofilm - Gingivitis und das innate Immunsystem - Parodontitis und das adaptive Immunsystem - Reinigung und Regeneration
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New Osteology Research Scholarship Programme
Research drives advances in science, and promoting research in the field of oral tissue regeneration is one of the core activities of the Osteology Foundation. That is why the Foundation is continuously expanding its activities in this field. New in 2015: the Osteology Foundation is now offering one-year Research Scholarships for young investigators to develop their career in the field of oral tissue regeneration. The aim of the Osteology Foundation is to offer scholars an outstanding environment and expertise on clinical and basic research. Osteology Scholarship Centres The scholars will work on a research project teaming up with their mentors at one of the Osteology Scholarship Centres, which are among the worlds leading research institutes in oral regeneration. The Osteology Scholarship Centres are: University of Gothenburg (Prof. Christer Dahlin) University of Michigan School of Dentistry (Prof. William Giannobile) Medical University of Vienna School of Dentistry (Prof. Reinhard Gruber) University of Zurich (Prof. Christoph Hmmerle) Amount of funding and application details The Research Scholarships consist of 35000 Swiss Francs per scholar for a twelve month stay in one of the Osteology Scholarship Centres, and are offered annually. All young investigators with an academic affiliation can apply. The Research Scholarships are awarded based on the evaluation of a motivation letter, a curriculum vitae and a recommendation letter. Financial needs are also taken into account. Deadline for the submission of applications is May 15, 2015. Applicants will be notified about acceptance by July 15, 2015. Develop your research career in oral regeneration, andapply for an Osteology Research Scholarship now! -
Osteology Expert Meeting
Internationally renowned experts with great experience and interdisciplinary expertise in simulation gathered in Zurich for the 1-day Expert Meeting to discuss the topic and share their expertise in this field with theFoundation Boardand representatives of theExpert Councilof the Osteology Foundation attending the meeting. The Osteology Foundation organizes an Expert Meeting every year to discuss a topic either of high relevance for science and practice in oral regeneration or of importance for the future development of the Foundation and its activities or the dental field in general, as was the case at the 2015 meeting. The aim of the Expert Meeting on simulation in training and education was to evaluate the state of the art in other disciplines, to find out which new possibilities current developments and technologies allow, and the consequences for the Osteology Foundation on the one hand, but also for the whole field of professional training and education in dentistry, on the other. External speakers and experts invited to the 2015 meeting wereProfessor Amitai Ziv, Israel,Professor Margaret Cox, UK,Professor Gabor Szekely, Switzerland,Dr David Joseph, France, andArnaud Cosson, France. In addition,Dr Stefan Tuchschmid, Switzerland, joined for the discussions.Dr Franck Renouard, France, Board Member of the Osteology Foundation, gave an introduction to the subject area, emphasising the overall importance of training. To err is human Professor Amitai Ziv, Founder and Director of theIsrael Centre of Medical Simulation(MSR), and also a veteran combat pilot and trainer from the Israeli Air Force gave a truly eye-opening talk, demonstrating different applications of simulation in training and the impact they can have in the practice. As a medical professional, he demonstrated the crucial importance of medical simulation, but also being a pilot, he placed a special focus on lessons learned from the aviation field. In late 1999, the important report on patient safety To Err is Human was issued by the US National Institute of Medicine, Ziv told the audience. It indicated that health care is far less safe than it should be, and that deaths due to medical errors in the US number almost 100,000 annually. The report triggered a massive response, and simulation in health care has grown rapidly ever since. Today simulation is used to reproduce real patient experiences and encounters using guided and controlled simulation-based scenarios, Ziv continued. It offers a safe and mistake-forgiving environment where trainees can learn from their errors without risking harm to real patients. Simulation provides a hands-on empirical educational modality, enabling controlled proactive exposure of trainees to both regular and complex, uncommon clinical scenarios. It also provides an opportunity for team training, which is important for patient safety, but is seldom addressed in traditional medical education. Another important benefit is the reproducible, standardized, objective setting it provides for assessment purposes, Ziv added. He demonstrated the impact of the training by showing examples from his institute, the MSR, which operates as a national simulation centre conducting mandatory training and assessment programs in multiple clinical fields. At MSR they use actors, models and virtual techniques to simulate a huge variety of training situations. Rapid increase in computational power Professor Gabor Szekelyin his presentation provided an introduction into the technical aspects of simulation for medical training, what is possible now, and what may be possible in the future. Szekely is head of theMedical Image Analysis and Visualization Groupat the Swiss Federal Institute (ETH) in Zurich and is also Chairman of the Swiss Institute of Computer Aided Surgery. The rapid increase in computational power available, as well as current capabilities in computer graphics and virtual reality, enable the use of advanced, complex simulation systems, Szekely explained. As a result, simulation is set to become a useful tool in everyday clinical practice, efficiently assisting surgeons in dealing with difficulties in the operating room. Szekely presented examples for the development of surgical simulators, and the major of technological components necessary for their development. Medical simulation mainly concentrates on minimally invasive procedures, he explained, because there are still many obstacles towards creating realistic haptic training simulators for open surgery. Implementation in the dental field Professor Margaret Cox, Professor of Information Technology in Education at Kings College London, who has developed educational software for more than 40 years, presented a haptic device that she and her working group have developed for dental education. The aim of thehapTEL projectis to develop and evaluate a haptic environment for preparing cavities in a virtual tooth. The outcome of the project included setting up 14 fully functional hapTel curriculum workstations, which have been integrated into the dental undergraduate curriculum for six years, explained Cox. Educational evaluation results showed that the students who learn on the hapTEL workstations performed just as well as those learning in the traditional Phantom Head laboratory, with the added advantage of being able to review their progress at any time and seeing exactly how well they are doing. Cox also reported that since July 2011 the work of the project has been extended and modified hapTEL work-stations now enable students to learn how to give injections. Simulation of implant placement Another example where simulation is used, was presented byDr David Josephfrom the University of Nancy. He presented initial results obtained with a haptic simulator (VirTeaSy) that has been used to train and evaluate students in implantology. They observed improved performance in students who trained on the simulator with results close to those of experienced operators (Joseph et al. Biomed Res Int 2014). Implant placement simulators are now commercially available, said Arnaud Cosson, CEO ofHRV, the French company producing and marketing the simulators in combination with a 3D realistic immersive environment and the corresponding software that offers about 70 exercises in which realistic clinical situations are simulated. Experience with surgical simulators The participants of the meeting had the opportunity to try out an arthroscopy simulator used in orthopaedics. The highly realistic haptic simulator presented by the Zurich-based companyVirtaMed demonstrated the technical possibilities in the field of simulation. Drawbacks in current education During workshops in the afternoon, the Osteology Foundation Board and members of the Osteology Expert Council took the chance to discuss the topic in small groups with the invited experts. The discussions revealed drawbacks and deficiencies in current training at universities, but also in continuing education for practitioners in the dental field. Both recognition of the importance of simulation in dentistry, as well as the current technologies is still not common, the experts agreed. In discussions, the participants of the Osteology Expert Meeting came to the conclusion that various types of mistakes can be avoided through more extensive or better training. Three type of mistakes were identified: mistakes caused by lack of knowledge, mistakes arising from lack of experience, and mistakes relating to attitude. As general problems that exist in training students, the following points were listed: the availability and heterogeneity of cases, limited personal resources, and the impossibility of re-doing procedures from scratch in case of mistakes. In addition, the training of soft skills and reflection on mistakes is lacking in student education, and interdisciplinary education is often completely neglected. The participants of the Osteology Expert Meeting in Zurich agreed that there is a great need for simulation in dental education in two different areas of expertise: Firstly, for the training of processes, simulating stress, and using soft skills in different clinical situations. And secondly, realistic haptic training of different procedures and practical skills, where simulation is to be used in combination with existing and well-established techniques. Consequences for training in dentistry? After the presentations and discussions with the experts, the Osteology Board and Expert Council arrived at the conclusion that simulation in training is certainly something that should not be neglected. Deficiencies in current training and education in dentistry exist and current methodology can be improved. How these deficiencies can be eliminated and the role the Osteology Foundation could play, remains open and has to be discussed further. The Osteology Foundation thanks all experts, speakers and contributors to the Expert Meeting for sharing their knowledge and opening up new perspectives for training and education in dentistry. -
Knochenaugmentation im Frontzahnbereich für spätere Implantation
Grunder, UeliGliederung: - Schnittführung / Lappenmobilisation - Knochenentnahme mit Trepanfräse, 6mm - Knochenbettvorbereitung mit Trepanfräse, 5mm - Fixation des autologen Knochens - Membrananpassung - Einbringen des Ersatzmaterials - Befestigung der Membran mit Nägeln - Applikation einer Zweiten Membran - Lappenmobilisation - Lappenverschluss Materialliste: - Trepanfräsen (Biomet3i, Palm Beach Gardens, Florida, USA) - Fixationsschrauben (Biomet Microfi xation, Jacksonville, Florida, USA) - e-PTFE Membran ( Gore-Tex® reinforced, WL Gore, Flagstaff, AZ, USA ) - Mineralisiertes Kollagen-Knochen Ersatzmaterial (Bio-Oss® Collagen, Geistlich Pharma AG, 6110 Wolhusen, Schweiz) - Collagenmembran (Biogide,Geistlich Pharma AG, 6110 Wolhusen, Schweiz)