CV-061
Dr. Francesco Mintrone
Over the years, the need to combine esthetic results and rapid surgery-prosthetic completion of implant-retained restorations have led to the development of new techniques and materials able to reduce the amount of time needed to undertake the entire treatment and, at the same time, ensure the same predictability and end results as if using traditional techniques.<br /><br />In this clinical video the treatment of an hopeless central incisor will be demonstrated using the immediate tooth replacement protocol with a connective tissue graft.<br /><br />This type of technique can be used in a predictable and safe way if certain anatomical prerequisites exist, depending on the bio-type of the patient and on local conditions derived from the health of soft and hard tissues in the area to be treated.<br /><br />Moreover, it is shown that the repeated disconnection of the transmucosal components can generate tissue recession due to the alteration of the delicate environment created between abutment and surrounding soft tissue.<br /><br />For this reason, from a biological point of view, seems advisable to place the final abutment at the time of the surgery.<br /><br />There are different types of preformed abutments available on the market and they can easily adapt to the different needs of the patient, even if, using these abutments, it may not always be possible to fully reproduce the many and varied anatomical needs of every single patient.<br /><br />Moreover, the need to obtain a cementation slightly lower than the tissue level requires ever more versatility.<br /><br />In this case we will consider a specific technique for the creation of individual abutments, starting from presurgery impressions that can ensure complete and perfect support of surrounding tissues.<br><br><span style="font-size:9px">Release: 6/18/2014 | Expires: 6/18/2017</span>
Vertical Ridge Augmentation (Part 4): Aesthetic Tissue Augmentation
CV-060
Prof. Massimo Simion
1) Simultaneous scalloped implant (Nobel Perfect) placement with crestal bone augmentation using a bovine bone xenograft and a Bio-Gide resorbable membrane, soft tissue augmentation by means of a connective tissue graft harvested from the palate.<br /><br />2) Abutment connection, provisional and final prosthetic restoration.<br /><br />3) Final full ceramic restoration in place after 6 months of soft tissue maturation with temporary prostheses.
Vertical Ridge Augmentation (Part 3): Vertical Distraction Osteogenesis (DO)
CV-059
Prof. Massimo Simion
1) Vertical ridge augmentation of a deep bone defect in the anterior mandible with an external device: flap design, block preparation, distractor device fixation with screws, suture.<br /><br />2) Device removal after 4 months.<br /><br />3) Horizontal and vertical ridge augmentation with TR Gore-Tex membrane and autogenous particulated bone, and simultaneous placement of 2 Ti-Unite Nobel Biocare implants.<br /><br />4) Membrane removal and final prosthetic restoration.
Vertical Ridge Augmentation - 2-Stage Vertical Ridge Augmentation (GBR)
CV-058
Prof. Massimo Simion
1) Vertical and horizontal ridge augmentation of anterior maxilla with particulated autologous bone graft harvested from the chin, tent screw, titanium reinforced Gore-Tex membrane, bone tacks, periosteal incision and suture.<br /><br />2) Removal of the membrane after 9 monts of healing and placement of 2 Nobel Biocare implants: 1 narrow and 1 regular platform. Placement of an interdental bone graft harvested from the nasal spine and a Bio-Gide resorbable membrane.<br /><br />3) Final restoration and radiograph of bone level after 1 year in function.
Vertical Ridge Augmentation (Part 1): 1-stage Vertical Ridge Augmentation (GBR)
CV-057
Prof. Massimo Simion
1) Treatment of a resorbed posterior mandible with a vertical GBR procedure and simultaneous implant placement. Flap elevation, placement of 3 Nobel Biocare implants protruding from the bone crest, titanium reinforced Gore-Tex membrane adaptation, autogenous bone graft harvested from the mandibular ramus, membrane fixation, periosteal incision and tension free suture.<br /><br />2) Membrane removal after 9 months, abutment connection.<br /><br />3) Final restoration on 3 implants and radiograph after 1 year of loading.
Sinus and Socket Bone Augmentation with Simultaneous Placement of 3 Dental Implants
CV-056
Dr. Sascha A. Jovanovic
The posterior maxillary partially edentulous patient is in need of a solution that stabilizes a crown or bridge, supports healthy gingival tissues, develops a functioning occlusion and prevents the need for removable appliances. Sinus lift protocols have been developed over the last 30 years but depend on existing bone volume, general and dental health, social and professional activities, patient wishes and budget of the patient. Success relies on the bone anatomy, soft tissue management, proper planning, surgical and restorative technique used, bone graft material of choice and factors related to patient's healing behavior.<BR><BR>The referred patient in this video is a healthy, 62-year old non-smoking asian male with 3 missing upper-right teeth. The teeth were previously removed due to endodontic and periodontal involvement. At the time of extractions, the premolars were grafted with a biomaterial. The case is shown from the surgical side and the final result after 2 years of loading. Cone beam 3-D planning is used to plan the bone graft method, the flap design and surgical steps of implant placements.<BR><BR>Incisions, horizontal and vertical, lateral open sinus window technique with a diamond rotary instrument, sinus lift procedure with hand instruments, autogenous and xenograft placement, resorbable GBR membrane adaptation, 3 optimal implant positions, flap release and suture placement are shown in detail through each step. The uncovering technique with a soft tissue papilla management procedure is shown with the 2 year follow-up with a functional and esthetic result in the patient.
CV-055
Dr. Sascha A. Jovanovic
The single missing tooth patient in the anterior esthetic zone is in need of a solution that stabilizes a crown, supports healthy gingival margins, develops an esthetic emergence profile with full gingival contour and prevents the need for invasive dental treatment of the adjacent teeth.<BR><BR>Implant protocols for the single tooth patient depend on bone resorption, gingival biotype, Smile-line, general and dental health, social and professional activities, age, and budget of the patient. Success relies on the bone anatomy, soft tissue management, proper planning, surgical and restorative technique used, and factors related to patient's healing behavior.<BR><BR>The referred patient in this video is a healthy, 32-year old non-smoking male with a high lip-line and a single missing upper-right canine with no previous restorative treatment. The canine was previously removed due to boney impaction. The case is shown from the surgical side and the lab technical side. Cone beam 3-D planning and surgical template are used to plan the flap design and surgical steps of implant placements.<BR><BR>Incisions, horizontal and vertical, optimal implant position, apical GBR bone graft placement, flap release and suture placement are shown in detail through each step. The fabrication and adaptation of the zirkonia abutment and the acrylic temporary and the cementation and occlusal adjustment are shown with an exit interview of the happy patient. A follow-up result of 6 weeks and 6 months shows the guided soft tissue growth.<BR><BR>Part 1 of this patient treatment (available on CV-55) demonstrates the patient consultation, oral examination, 3D treatment planning and preparation for the surgical step and implant temporization.