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.
Anterior Implant Placement with Immediate Temporization Part 1 - Diagnostics, Examination, Planning
CV-054
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. This video will demonstrate the important steps of patients examination, the pre-treatment guidelines and considerations, the first intake and second planning interview and the 3-D planning with Cone-Beam CT scan software and the fabrication of the surgical template and acrylic temporary, choice of zirkonia implant abutment.<BR><BR>Part 2 of this patient treatment (available on CV-55) demonstrates the surgical implant placement, a moderate apical bone graft, and an immediate temporization.
Immediate Implant Placement in the Esthetic Zone
CV-053
Dr. Robert Carvalho da Silva
In this case presentation, Dr Silva will demonstrate, step-by-step, the procedures associated with implant placement from diagnosis to final prosthesis delivery. He will present a useful decision-tree that will serve as useful reference when approaching similar cases.
CV-052
Dr. Sascha A. Jovanovic
The edentulous patient is in need of a solution to stabilize a prosthesis to prevent malnutrition, progressive bone loss and social embarrassment.<BR><BR>Rehabilitation concepts for the edentulous patient depend on bone resorption, Smile-line, general and dental health, social and professional activities, age, and budget of the patient. Success relies on the edentulous anatomy, 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, 50-year old non-smoking male with a low lip-line and an edentulous upper jaw with an old ill-fitting denture. The case is shown from the surgical side and the lab technical side. NobelClinician 3-D planning software and surgical template are used to plan the flap design and surgical steps of implant placements.<BR><BR>Alveolar reduction, All-on-4 guide and axial and tilted implant positions are shown with the details of these steps. The fabrication and transition of the denture to a fixed hybrid denture are shown with an exit interview of the happy patient.<BR><BR>Part 1 of this patient treatment (available on CV-51) demonstrates the patient consultation, oral examination, 3D treatment planning and preparation for the surgical step.
CV-051
Dr. Sascha A. Jovanovic
The edentulous patient is in need of a solution to stabilize a prosthesis to prevent malnutrition, progressive bone loss and social embarrassment.<BR><BR>Rehabilitation concepts for the edentulous patient depend on bone resorption, Smile-line, general and dental health, social and professional activities, age, and budget of the patient. Success relies on the edentulous anatomy, 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, 50-year old non-smoking male with a low lip-line and an edentulous upper jaw with an old ill-fitting denture. This video will demonstrate the important steps of patients examination, the pre-treatment guidelines and considerations, the first intake and second planning interview and the 3-D planning with NobelClinician software and the fabrication of the radiographic and surgical template.<BR><BR>Part 2 of this patient treatment (available on CV-52) demonstrates the surgical implant placement and the transition to a fixed hybrid prosthesis.
CV-049
Dr. Sascha A. Jovanovic
This high-quality clinical video demonstrates the vertical ridge augmentation technique using a bone graft combination with rhBMP-2, Autograft, Xenograft and Ti-mesh in a 71-year old healthy female treated for severe posterior left mandibular vertical ridge resorption.<BR><BR>The patient had received 2 implants in the same area 9 years prior which failed and resulted in vertical and horizontal ridge resorption. One implant in position 19 and tooth # 21 were still in place but presented with advanced bone loss and were planed for extraction/removal 2 months prior to the vertical augmentation technique as a step 1 treatment. The patient had further a stable periodontium and remaining dentition.<BR><BR>This video demonstrates in detail the surgical steps with micro- and macro surgical techniques of step 2: a staged vertical ridge augmentation technique and the placement of a bone graft combination with rhBMP-2, Autograft, Xenograft and Ti-mesh. The following details are discussed and demonstrated in this video: the diagnostics and treatment planing, the flap design, and -elevation, the bone graft protocol with 2.8 cc rhBMP-2 and a 1:1 ratio of autogenous and xenograft, the trimming, placement and fixation of the Ti-mesh, the periosteal flap release and coronal repositioning and the primary closure with PTFE sutures.<BR><BR>As a follow-up the clinical photo is shown of the 4-week uneventful healing outcome. The patient is presented from initial start of treatment to the follow-up appointment during healing and narrated before and after treatment by Dr Sascha Jovanovic. A part 2 of this video will follow and demonstrate the result of the vertical BMP graft and the placement of implants.<BR><BR>For further information on rhBMP-2 science and clinic view the LOD 054 by Dr Wikesjo and the CV-37/38/39 by Dr Jovanovic in the gIDE library.
CV-048
Dr. Sascha A. Jovanovic
This high-quality clinical video demonstrates the implant placement 12 months after a horizontal ridge augmentation procedure and the treatment results in a 50-year old healthy female treated for a thin, knife edge ridge in the mandibular posterior zone using a resorbable membrane and particulated autogenous bone with xenograft and rhPDGF (GEM-21).<BR><BR> This video demonstrates in detail the surgical steps with microsurgical techniques to evaluate a staged horizontal ridge augmentation and the placement of 3 implants. The following details are discussed and demonstrated in this video: the diagnostics and treatment planing, the flapdesgn and -elevation, the bone regeneration result evaluation, three implant placements, the periosteal flap release and coronal repositioning and the primary closure with PTFE sutures.<BR><BR>As a follow-up the panoramic radiograph are shown of the 2-week outcome. The patient is presented from initial start of treatment to the follow-up appointments during healing and narrated throughout by Dr Sascha Jovanovic. A part 1 of this video was released under CV-45 will demonstrate the first step of the treatment and the placement of the Bone Graft mixtur.
Zygomatic Implants - Treatment Plan
CV-046
Dr. Francesco Mintrone
<p style="margin: 0px; text-align: justify;">Zygomatic implants are indicated where:</p> <p style="margin: 0px; text-align: justify;"><br /> </p> <p style="margin: 0px; text-align: justify;">1. sufficient anterior bone remains for the installation of standard implants, and the posterior alveolar crest has resorbed to the extent that additional implants would require the support of onlay or inlay grafts, and</p> <p style="margin: 0px; text-align: justify;"><br /> </p> <p style="margin: 0px; text-align: justify;">2. Where an anterior onlay graft is reuired for implant placement and the need to extend the graft posteriorly can be eliminated by placing the Zygoma implant.</p> <p style="margin: 0px; text-align: justify;"><br /> </p> <p style="margin: 0px; text-align: justify;">In this video Dr. Mintrone will walk you through a case where 4 zygomatic implants are placed in a 71 year old female edentulous patient with extreme atrophe in the upper arch and where the conventional implant will not be able to be positioned in the anterior area.</p> <p style="margin: 0px; text-align: justify;"><br /> </p> <p style="margin: 0px; text-align: justify;">Unfortunately, computer-aided guided surgery for the Zygomatic Implant is not available yet, making the entire case much more challenging.</p>