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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 -
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Fiberglass frameworks in removable prosthodontics
Bücking, Wolfram -
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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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. -
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. -
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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 -
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. -
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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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. -
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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Sandwich osteotomy in the posterior mandible
Bormann, Kai-Hendrik -
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3D-Planung und schablonengeführte Implantation im zahnlosen Kiefer
Kirsch, Axel / Ackermann, Karl-Ludwig / Neuendorff, GerhardGliederung: - Chirurgische Maßnahmen für die Verankerung einer Planungsschablone - Inserieren von vier provisorischen Implantaten - Abformung und Bissnahme, Herstellung des Meistermodells - Zahnaufstellung für die Interimsprothese - Speicherung der Zahnaufstellung in einem Silikonschlüssel - Kopie der Zahnaufstellung in röntgensichtbarem Kunststoff für die CT-Aufnahmen - Implantatplanung mit Hilfe eines 3D-Datensatzes aus der CT-Aufnahme - Herstellung einer Übertragungsschablone mit dem CAMLOG® Guide System auf Basis der CAD-Planung - Einfügen der Führungshülsen in die Schablone - Anfertigung der definitiven Versorgung vor dem Inserieren der Implantate - Verwendung Vario SR Abutments mit Vario SR Titankappen für die Erzeugung eines Passive Fit - Herstellung eines gegossenen Gerüstes aus Titan zur Verstärkung der Versorgung - Chirurgische Maßnahmen für die definitive Implantation - Inserieren von sechs Implantaten zur Sofortbelastung - Gezielte Erzeugung eines Passungsspiels zwischen Implantat und Prothesenbasis
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IMMEDIATE LOADING OF THE MAXILLA USING FLAPLESS SURGERY TO INSERT ONE-PIECE ZIRCONIA IMPLANTS IN PREDETERMINED POSITIONS
Objectives:In the aesthetic area, immediate implant placements are increasingly common. Using a 3-D custom-made guide for insertion is associated with less trauma and faster healing periods. Titanium implants may cause unfavourable soft tissue conditions or recession of gingiva in the area, and lead to compromised aesthetic outcomes. In this study, zirconia implants were chosen rather than titanium.. Methods:A 18-year-old woman, who had previously suffered serious trauma of frontal maxilla, was referred to our dental practice. Due to external root resorption, the central incisors were removed 15 months previously, and she had a fixed orthodontic retainer with two substitute acrylate teeth (#11 and #21) to preserve jaw line functionality and aesthetics. The patient was still adolescent, but thorough examination by cone beam CT established that her jaw development and growth was complete. We decided to insert two zirconia implants, with a comprehensive procedure because the bone loss at both positions was severe. The first step was horizontal augmentation of the alveolar ridge using a membrane technique in order to preserve necessary bone (BioResorb Macro Pore[tm]). Six months later, two zirconia implants (SDS, ATZ, 3.8x11.0mm, torque 35N/cm) were inserted using flapless surgery into predetermined positions using a 3-D custom-made guide. Two connected provisory acrylate crowns were inserted immediately, to stabilise the implants and give the patient functional teeth for the following five-month period. The crowns also aided the process of implant osteointegration, providing an ideal emergence profile and supporting the peri-implant soft tissue. Follow-up was uneventful. Three months after surgery, the final prosthetic restoration comprised of two connected ceramic, metal-free crowns. Results: The healing period was uneventful with no adversary reactions. Both procedures resulted in minimal trauma, due to the use of 3-D custom-made guides for both bone regeneration and implant insertion, which led to a good post-operative period. The first procedure (bone regeneration) gave satisfactory results, and the second (implant placement) gave excellent primary stability without radiographic bone loss or gingiva inflammation. Peri-implant soft tissue parameters showed promising results. Probing depth, clinical attachment level and modified bleeding index at the implant sites were all satisfactory. The restoration work showed a healthy gingival margin and no discoloration of the soft tissue. The most important patient feedback related to permanently improved perception of function, aesthetics, sense, speech and self-esteem (which is very important in adolescents). Conclusion: Use of 3-D custom-made guides for implant placement enables faster and better recovery because trauma is minimised. There is an increasing demand for metal-free implants because of the potential immunologic and aesthetic compromises associated with titanium implants entails. Unfavourable soft tissue conditions or gingival recession may lead to compromised aesthetics, which are particularly concerning when maxillary incisors are involved. Cervical bone loss and gingival recession associated with metal implants tend to cause bluish discoloration of the overlying gingiva, thus impairing aesthetic outcome. Zirconia implants are a good choice for the aesthetic zone. In our case, the gingival margin was healthy and there was no discoloration of the soft tissue. Zirconia implants are also suitable because they have a tooth-like colour, good mechanical properties (high strength, fracture toughness) and good biocompatability. -
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Research Academy - Registration for 2016 is open now
The Osteology Research Academy goes into its sixth year. In the past five years 184 people from 39 different countries have already been educated in the Foundations intensive courses on good scientific practice and research methodology. In 2016 three courses will take place. One Core Module Course is organised in Lucerne and one in Boston. The Expert Module on Hard Tissue Research will take place in Vienna.Registration is open now. Core Module Good Research Practiceand Essentialsof Research Methodology 12-16 September 2016 Lucerne, Switzerland 24-27 October 2016 Boston, USA Expert Module Hard Tissue Research 7-9 November 2016 Vienna, Austria Financial Support Education Grants are available for participation in the Research Academy. Grants are spoken based on the review of a curriculum vitae, a publication list, motivation letter, a copy of graduation certificate and a recommendation letter. Financial needs will be taken into account. The application deadline has been extended until 15 December 2015. Apply now!