Outline - Modified tubed flap - NobelActive implant placement - Flapless facial bone augmentation - Immediate provisionalization Materials Checklist: NobelActive™ Surgery Kit Twist drill ø 2, 7-15 mm Twist drill ø 2, 10-18 mm Twist step drill ø 2.4/2.8, 7-15 mm Twist step drill ø 2.4/2.8, 10-18 mm Twist step drill ø 3.2/3.6, 7-15 mm Twist step drill ø 3.2/3.6, 10-18 mm Surgical driver NobelActive™ Man torque wrench, surgical NobelActive™ Internal RP implant Procera® esthetic abutment, NobelActive™ Internal Implant replica, NobelActive™ Internal RP Impression coping, open tray, NobelActive™ Internal RP Protect analog, NobelActive™ Internal.

Clinical steps for the fabrication of implant-supported restorations - Single-tooth restoration - Fixed partial denture - Electroplated cone-retained restoration - Conical copings using a pre-fabricated abutment matrix system

Contents - Flap design according to the layering technique - Piezoelectric bone surgery - Bone spreading with osteotomes - Augmentation and suturing Materials Checklist: Piezo surgery unit (ADS); Osteotome (Altatec GmbH); Surgical tray, individual.

Procedure: - 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.

Procedure: - Incision Technique 36, 44 - Gentle Flap Mobilization - Pilot Hole Preparation using a CT Template - Sequential Preparation and Implantation - Bone Removal and Augmentation - Wound Closure Contents: Systematic Total Rehabilitation is very challenging, especially in patients with Periodontal Disease with Loss of Supporting Structures. Precise Treatment Planning is essential. The Treatment of Periodontal Disease begins after Conservative Pretreatment. It is not possible to predict the Soft Tissue Esthetic Outcome before the Healing Process is completed. We selected Endosteal Implants for the Augmentation of Lost Support Zones in this Atrophic Mandible. A Three-Dimensional Analysis was performed as the Basis for Navigated Implantation. After Completion of the Periodontal Treatment and Implantation, the patient must wait for approximately 6 months for the Completion of the Healing Process before Prosthetic Reconstruction Procedures can be initiated.

Procedure: - Presentation of procedure for immediate implant loading in the edentulous mandible according to the Ledermann concept - Surgical implantation of XIVE® TG implants - Bite registration and impression-taking - Presentation of prosthetic components - Fitting and passive fixation of the mesostructure in the mouth - Integration procedure Contents: This video demonstrates the extraction of teeth in a partially dentate mandible followed by immediate loading of six XIVE® TG implants. Following the Ledermann immediate loading concept, a mesostructure will be used for tension-free primary interlock in this special case. Bridge-like lower full dentures with plastic teeth will then be inserted on this frame and retained with an occlusal screw. Since the dentures can only be removed by the dentist, they are \fixed\ as far as the patient is concerned. This simple and quickly produced yet extremely well-fitting restoration, which requires only minimal time and effort for the implant components, is the subject of this contribution.

Contents - History - Emdogain Application - Incision - Periosteal Incision - Root Smoothing - Suture Technique - PrefGel Application Synopsis: Regenerative periodontal surgery with Emdogain enamel matrix protein: The goal of regenerative periodontal surgery is to rebuild destroyed periodontal structures. Bone transplants, bone replacement materials, and nonresorbable and resorbable membranes have been and still are being used. In a new therapeutic approach to periodontal regeneration, the root surface is conditioned using an enamel matrix protein derivative (Emdogain, Biora). The protein complex stimulates the regeneration of root cement, which in turn leads to the regeneration of bone and collagen fibers. Since the early 1980's, Professor Lars Hammerström's Swedish research team has performed extensive research and studies on this method and its mode of action. Emdogain is now used for treatment of vertical bone defects and furcation defects. The exposed root surface is first carefully scaled using handheld instruments or a rotating, fine-grain diamond drill. PrefGel EDTA suspension (Biora) is then applied for 2 minutes, then thoroughly rinsed with physiological saline solution. The EDTA suspension serves to remove the smear layer and opens the dentinal tubules, leading to improved binding of Emdogain to the root surface. Emdogain is applied to the blood- and saliva-free root surface immediately after rinsing. Finally, the wound is sutured closed.

Contents - Laser - Basic Concepts - Principles of Fluorescence Measurement - Nonsurgical Periodontal Therapy - Surgical Periodontal Therapy - Treatment of Cervical Dentin Hypersensitivity Synopsis The primary goal of periodontal therapy is to remove bacteria-laden dental plaque otherwise that will lead to progressive decay. In addition to the classic forms of periodontal therapy, laser modalities have also been proposed in recent years. The Er:YAG laser appears to be the most promising laser system for the treatment of marginal periodontitis. Several studies have demonstrated this laser's excellent ability to remove subgingival calculus without producing thermal effects in adjacent tissues. In addition, controlled clinical studies have shown that the Er:YAG laser leads to a signifi cant increase in clinical attachment in both nonsurgical and surgical periodontal therapy. Preliminary clinical results indicate that this minimally invasive tool permits instrumentation of very deep and fl at pockets (eg, when removing root cement or in patients with increased gingival recession) without injuring hard and soft dental tissues. This live operation video demonstrates use of the Er:YAG laser for both nonsurgical and surgical periodontal therapy.

Female patient looking for a treatment to improve the appearance of her smile.

The old reconstructions have to be replaced. But how? A challenging case treated by Dr. Sven Mühlemann, University of Zurich.

Before starting the full-mouth reconstruction, the oral-maxillary sinus fistula (oroantral fistula) has to be closed.