Implant placement in fresh extraction sockets. Key decision factors

LOD-193-00

Prof. Mariano Sanz

It is well established that tooth extraction will result in an apico-coronal as well as bucco-lingual reduction of the alveolar ridge, mostly in the buccal aspects of the extraction site.<BR><BR>In order to avoid this physiological bone loss some clinicians have advocated the immediate installation of implants in fresh extraction sockets. Different clinical studies have evaluated the impact of this implant placement surgical approach on different outcomes, such as: implant survival, bone crest alterations and aesthetic results.<BR><BR>However, in spite of these reports, there is a lack of well-designed clinical trials that have evaluated these outcomes systematically and there is a lack of knowledge on the possible factors associated with different hard and soft tissue outcomes of this surgical protocol.<BR><BR>This presentation will review the results from clinical trials evaluating the immediate implant placement approach and we hall review the important risk factors (implant design, implant position, implant location, thickness of bony walls, etc.) involved in the clinical outcome.<BR><BR>Finally we shall provide some clinical recommendations on the use of this surgical approach.

Predictable and Successful Maxillary Sinus Augmentation

LOD-192-00

Dr. Toshiro Sugai

In this presentation, we will identify safer and more predictable maxillary sinus augmentation procedures. We will discuss how to utilize CT imaging to evaluate and interpret the 3D anatomy of the sinus, including ostium, superior alveolar artery, and septa. Dr. Sugai will describe how to predictably lift the sinus membrane and avoid complications.

Predictable Soft Tissue Grafting for Esthetics in Thin Periodontium

LOD-191-00

Dr. Paul Lin

This presentation will discuss the thin periodontium and how to utilize this to achieve predictable soft tissue grafting for esthetics.<br /><br />Soft tissue grafting by root coverage and augmentation can improve the facial esthetics not just for natural teeth, but also for implants.<br /><br />By utilizing the same concept of placing the soft tissue on the thin periodontium we can help augment the tissue around implants and dentures and improve and enhance the facial esthetics.<br /><br />Animations will illustrate this concept and provide insight as to how we take the soft tissue away from the pallate and harvest it in an elegant, more predictable fashion.<br /><br />This will also show how to secure the covering flap so the patient will not experience any pain after the surgery.<br /><br />This presentation is intended to increase your understanding, comfort and confidence in performing soft tissue grafting in a more predictable way.

The All on 4 Concept - Diagnosis to Delivery - 4 Lecture Set (Parts 1 - 4)

LOD-190-00

Dr. Saj Jivraj

<br><strong>PART 1: Diagnosis and Treatment Planning, Concepts of Immediate Loading</strong><BR><br>A. Clinical and radiographic evaluation of the patient<BR>B. Specific clinical factors which determine the sucess of treatment<br>C. Restorative space requirements<br>D. Principles of immediate loading (Science and Techniques)<hr><strong>PART 2: Principles of Graftless solutions and surgical Protocols</strong><BR><BR>A. What is All on 4?<BR>B. Principles of All on 4, armamentarium needed<br>C. Surgical protocols - flap design, implant placement, radiographic evaluation<BR>D. What the surgeon must know prior to placing implants<br>E. Communication between the restorative dentist and surgeon<hr><strong>PART 3: Clinical Patient Presentations<BR>Surgical and Prosthetic Protocols for Fabrication of a Full Arch Immediate Load Prosthesis</strong><BR><BR>A. Clinical treatment presentation of a dentate patient. Diagnosis, treatment planning and fabrication of the immediate load prosthesis<BR>B. Clinical treatment presentation of an edentulous patient. Diagnosis, treatment planning and fabrication of the immediate load prosthesis<hr><strong>Section 4 - Prosthetic principles and techniques for fabrication of the final prosthesis<BR>Complications and maintenance.</strong><BR><BR>A. Fabrication of the final prosthesis from Impressions to delivery<BR>B. CADCAM design of the titanium bar and laboratory procedures involved in fabrication of the final prosthesis<br>C. Commmon complications and how to address them<BR>D. Maintenance

The 3D Click Guide - A New Direction for Model-Based Guided Implant Placement

LOD-187-00

Dr. Lambert Stumpel

<p style="margin: 0px; text-align: justify;">Guided surgery holds the promise to place dental implants in predetermined positions; allowing many clinical decisions to be made before the actual surgical procedure.   <br /> </p> <p style="margin: 0px; text-align: justify;"><br /> </p> <p style="margin: 0px; text-align: justify;">Computer guided surgery has been made possible through the increased accessibility of (CB) CT technology.  It allows clinicians who do not have the experience of placing 1000+ implants per year, to deliver, in selected cases, the same superior care as the master surgeons.</p> <p style="margin: 0px; text-align: justify;"><br /> </p> <p style="margin: 0px; text-align: justify;">Model based guided surgery has historically been in the shadow of its high tech cousin; until now. The 3 D Click Guide is a modularly adjustable surgical guide system.  While primarily a model based system, utilizing minimally invasive bone sounding, it allows easy integration with CBCT as needed.  It

A New Common Sense Approach to Full Mouth Rehabilitation Using Direct Composite and Limited Implants

LOD-185-00

Dr. Jose Luis Ruiz

<div style="text-align: justify;">All of us have patients who have destroyed their teeth usually due to occlusal disease...patients who have missing teeth.  And, unfortunately, many of these patients do not have the funds to pay for a full mouth rehabilitation.  And, even if they did, we do not believe that the full-mouth rehabilitations are ideal anymore.<br /> <br /> We see journal articles showing patients who have virgin teeth, and in the end they are treated with a full mouth of crowns.  We know from experience in our practices that these patients do not do very well: The margins below the gums cause our patients to have unhealthy gums; and, then when they have caries below the gums, trying to treat this becomes a nightmare.  That is why using minimally based super-gingival dentistry is the best for our patients.  We do not have to grind the teeth.  We can use new adhesive dentistry.  And we can give our patients excellent results without having to destroy their natural teeth.<br /> <br /> We will examine cases where patients who might have traditionally been treated with full-mouth rehabilitation, are instead treated with bonded dentistry.  In one case we will use direct composites and some indirect composites and almost no grinding on the natural teeth.  Meanwhile, we are able to provide the patients with the esthetics and the function that the patient needs.<br /> <br /> We will discuss the seven signs and symptoms of occlusal disease which is a very practical way to learn how to diagnose occlusal disease on your patients.<br /> <br /> We will talk about smile design using the Dento-Facial Esthetic Diagnosis System.<br /> <br /> We will also cover the 3 Golden Rules of Occlusion which are the engineering principles that we need for durability.</div>

Provisional Restoration - The Overlooked Link to Aesthetic and Functional Perfection

LOD-179-00

Dr. Stefan Paul

<p style="margin: 0px; text-align: justify;">This presentation is about Provisional Restorations.  You may wonder why.  What is so interesting about Provisional Restorations?  But consider a perfect temporary restoration as the foundation of any restorative excellence you might strive for.</p> <p style="margin: 0px; text-align: justify;"><br /> </p> <p style="margin: 0px; text-align: justify;">We have all experience clinical situations where you do a direct temporary restoration based on a silicon mold that you took before you removed the old crown.  Easy, right?  Nevertheless, coming up with the nice marginal fit necessary to create a healthy biological sulcus epithelium which is the prerequisite for a good, easy impression, and good adhesive cementation requires more consideration.  This presentation will examine this in full detail.</p> <p style="margin: 0px; text-align: justify;"><br /> </p> <p style="margin: 0px; text-align: justify;">How about a situation where we use an indirect lab made temporary restoration that is a little more complex, including crown lengthening procedures?  This presentation will discuss not only the temporization, but also additional clinical issues.</p> <p style="margin: 0px; text-align: justify;"><br /> </p> <p style="margin: 0px; text-align: justify;">This presentation will focus on temporaries for veneer-prepared teeth.  What do we do?  How can we make them stay in place, and not fall off every-so-often?</p> <p style="margin: 0px; text-align: justify;"><br /> </p> <p style="margin: 0px; text-align: justify;">We will look at implant retained situations, either using multiple implants where we have use of temporary restorations for a longer period of time, maybe making it necessary to use metal-reinforced temporary restorations.  And, when it comes to really demanding clinical situations where the immediate approach means tooth extraction, immediate placement of implants, and immediate temporization followed then by a final restoration.  What aspects should be taken into consideration to achieve the best possible esthetic result?</p> <p style="margin: 0px; text-align: justify;"><br /> </p> <p style="margin: 0px; text-align: justify;">And, finally, various materials and cements to be used in the temporary approach will also be reviewed.</p>

Guidelines for Aesthetic Peri-Implant Gingival Tissue (JAPANESE LANGUAGE ONLY)

LOD-178-00j

Dr. Toyohiko Hidaka

Guidelines for Aesthetic Peri-Implant Gingival Tissue (JAPANESE LANGUAGE ONLY)

Bio-Integrated Restorative Dentistry

LOD-177-00

Dr. Costin Marinescu

<p style="margin: 0px; text-align: justify;">We want to achieve long-lasting results for our patients in treatments that are perfectly tolerated by the body, restore good health, and look beautiful.   This presentation will outline the logical flow-chart that Dr. Marinescu utilizes every day in his own practice (Exam >> Diagnosis >> Treatment >> Maintenance) and the interconnection of each individual step with each other.</p> <p style="margin: 0px; text-align: justify;"><br /> </p> <p style="margin: 0px; text-align: justify;">The Stomatognathic System (the ensemble of bones, muscles, joints, teeth and supporting structures) has two states: Pathological  and Physiological.  How these two conditions influence each other will be discussed, and how important it is for us to find the threshold between the two.</p> <p style="margin: 0px; text-align: justify;"><br /> </p> <p style="margin: 0px; text-align: justify;">This presentation will also look at occlusion concepts: how teeth come in contact, and the pathways through which they are moving in performing everyday functions like chewing, and how to design our restorations so we can achieve beautiful results but that are functionally tolerated and perfectly integrated with our patients" health.  A history of occlusion concepts will be presented that will cover all the way through to the latest research that are empowering us more and more to offer our patients minimally invasive restorative dentistry that will balance their Stomatognathic System and that will offer a predictability for long term.</p> <p style="margin: 0px; text-align: justify;"><br /> </p> <p style="margin: 0px; text-align: justify;">Offer your patients the most conservative treatments with the minimum impact and the stability of the Stomatognathic System with a long term impact in quality of life...and a beautiful esthetic result.</p>

Restorative Excellence - Occlusion on Implant Retained Restorations

LOD-176-00

Dr. Stefan Paul

<p style="margin: 0px; text-align: justify;">In this in-depth presentation regarding Occlusion on Implant Retained Restorations, we will examine several cases. We will look at a case that is all to common where right after final delivery, major chipping takes place.  <br /> </p> <p style="margin: 0px; text-align: justify;"><br /> </p> <p style="margin: 0px; text-align: justify;">Sometimes we receive an emergency case where perhaps a patient has a bicycle accident.  <br /> </p> <p style="margin: 0px; text-align: justify;"><br /> </p> <p style="margin: 0px; text-align: justify;">What do we do?  <br /> </p> <p style="margin: 0px; text-align: justify;">Do we place an implant?  <br /> </p> <p style="margin: 0px; text-align: justify;">Do we deliver an immediately fixed temporary restoration?  <br /> </p> <p style="margin: 0px; text-align: justify;"><br /> </p> <p style="margin: 0px; text-align: justify;">And what occlusion are we going to give in order not to interfere and cause loosening of the implant and losing osseointegration?  <br /> </p> <p style="margin: 0px; text-align: justify;"><br /> </p> <p style="margin: 0px; text-align: justify;">What about an even more demanding clinical situation, such as a missing canine where the plan is to place an implant and deliver an immediate temporary restoration?  <br /> </p> <p style="margin: 0px; text-align: justify;"><br /> </p> <p style="margin: 0px; text-align: justify;">What occlusal concept are we going to utilize to prevent interference with good bone healing?  To make it even more demanding we will look at a case where there is an interior gap, canine to canine, where, again implant placement is the plan. <br /> </p> <p style="margin: 0px; text-align: justify;"><br /> </p> <p style="margin: 0px; text-align: justify;"> How are we going to design our occlusal schematic so that the patient is not going to clench on these teeth at night, and possibly punch out our implants?  <br /> </p> <p style="margin: 0px; text-align: justify;"><br /> </p> <p style="margin: 0px; text-align: justify;">And, finally, we will examine a very challenging case where we have a maxillary and mandibular full-arch restoration, and incorporate an occlusal concept of a mixed dentition with implants on natural teeth (vs implants on implants).</p>