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 | Event ID : AO
Academy of Osseointegration
2011 Conference Archive
Washington DC
March 3-5, 2011
The 26th Annual Meeting
Back to the Future: Combining Fundamental Principles with New Technologies for the Next 25 Years
Educational Objectives
The goal of this year’s Annual Meeting is to provide attendees with the most current information based on what has been learned for obtaining predictable results in implant therapy. The overall objective is to evaluate technological and biological breakthroughs made in implant dentistry. These advances will be explored relative to their influences on clinical practice.
Our aim is to provide a comprehensive program including patient risk assessment, diagnosis and treatment planning, advantages and limitations of restorative and surgical techniques currently in use today. Surgical and prosthetic tracks will provide information regarding computer guided surgery, tissue augmentation, maxillary over-dentures and surgical guides. There will also be information pertaining to identifying and avoiding complications.
The ultimate goal is to provide the attendee information on the most predictable and proven techniques to integrate into clinical practice to improve patient care.
Target Audience
This program is targeted toward everyone who has an interest in implant therapy. This includes: students in training programs; dentists with limited experience and specialists with extensive training in implant dentistry; auxiliary staff, including hygienists, assistants and laboratory personnel.
| ULTIMATE PACKAGE PRICE : $200.00 | 
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| March 3rd, 2011 | | Corporate Forum Sessions | | | | Target Audience : Annual Meeting attendees | |
Objectives :
This collection of sessions offers a unique and significant opportunity to view the latest research and developments in the field of craniofacial implant technology.
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The Progression of Implant Dentistry
BIOMET 3i Corporate Forum
Speaker(s) :
- The introduction of tissue engineering has complemented
our classical regenerative treatment regimens. Periodontal
regeneration and localized osteogenic procedures to
enhance bone volume can assist with implant
osseointegration. These procedures include sinus lift,
horizontal and vertical ridge augmentation and
compromised extraction sites.
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| March 3rd, 2011 | | Opening Symposium: Controversies in Implant Dentistry | | |
______________________
What is the Future of Implant Dentistry?
Speaker(s) : Steven E. Eckert, DDS, MS
- From the initial observation that bone could
closely adapt to alloplastic implants resulting in
a process now known as “osseointegration,” there
developed an appreciation that this process
could be beneficial towards support and
retention of dental prostheses. Years of scientific
documentation have identified a high degree of
predictability using this technique. Incredible cosmetic results
are often cited as the examples of potential for this technique,
however, esthetic considerations alone ignore the broadspectrum
of deficits experienced by patients suffering from
edentulism.
- Missing teeth lead to a myriad of concerns beyond those related
to cosmesis. Traditional methods of treatment may lack the
predictability associated with implant supported prostheses.
Consequently the future of this treatment approach may rest
more in the re-establishment of a comfortable and functional
support mechanism that is not highly susceptible to biologic
deterioration rather than efforts that appear to be directed
towards only one aspect of prosthetic concerns. This
presentation provides a broad view of the management of
patient complaints in the areas of comfort, function and
esthetics through the use of dental implants and also provides a
rationale for greater adoption of this technology.
- Objectives: Upon completion of this presentation, participants
should be able to: 1) discuss the current utilization of dental
implants in the management of edentulism and partial
edentulism; 2) explore future avenues for market development;
and 3) discuss research initiatives in implant and regenerative
procedures.
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______________________
Challenges for the Future in Implant Dentistry: Hard and Soft Tissue Regeneration - Report from the 2010 Summit
Speaker(s) : Michael S. Block, DMD
- The report from the AO’s 2010 Summit will
include a synopsis of the presentations by the
experts on the topics of: bioengineering, stem
cells, soluble growth factors, nanotechnology,
and outcomes assessment. These synopses will
be supplemented by the conclusions of the
breakout sessions and plenary sessions. Based
on this Summit, current new therapies are available for clinical
use, with other therapies realistic in the near future. The
discussion will focus on clinically relevant topics with a view
toward the future for patient benefit.
- Objectives: Upon completion of this presentation, participants
should be able to: 1) describe the use of current and future
nanotechnologies; 2) identify the current use of autologous and
allogeneic stem cells and the limitations of this technology with
a glimpse into future directions; 3) discuss the status of single
growth factor administration and multi-factor constructs; and 4)
identify the need for directed outcome assessment to
determine the significance of technology.
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______________________
Using Digital Dentistry for Implant Planning
Speaker(s) : Patrick Palacci, DDS
- General technical developments, especially in
the area of computers, have led to new and
fascinating tools becoming available for
medicine and dentistry. Contemporary methods
within radiology, such as computerized
tomography and medical imaging, have made
patient information available for diagnosis in a
totally new way. Furthermore, ongoing developments have
made these technologies less costly and therefore more readily
available for doctors and patients. Guided surgery is an example
of a technology that has developed in this way. The utilization
of new powerful technologies has to be conducted in close
consultation with experienced clinicians. The technology is just
a tool, no matter how powerful. These new concepts and
protocols are presented in a manner that allows clinicians to
provide their patients with practical and predictable immediate
function.
- Objectives: Upon completion of this presentation, participants
should be able to: 1) identify the benefits of digital dentistry; 2)
discuss the rationale for a computerized pre-surgical planning;
and 3) avoid surgical complications.
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Digital Dentistry: Do We Really Need It?
Speaker(s) : Louis Clarizio, DDS
- As we have moved into the digital age, a number
of “digital tools” have been introduced into the
armamentarium of implant dentistry. While
fashionable to some, practitioners continue to
obtain excellent results using tried and true “low
tech”methods. This presentation will review these
methodologies and demonstrate that optimal
results can be obtained without the use of “high tech” digital tools.
It will also elucidate some of the pitfalls with CBCT scans,
templates, and CT derived surgical guides.
- Objectives: Upon completion of this presentation, participants
should be able to: 1) discuss clinical examination techniques of
bone mapping and physical palpation of tissue; 2) identify the
importance of a diagnostic wax-up; and 3) describe the
fabrication and use of plane film radiographic template and
surgical templates. 4) understand current limitations of CBCT
scans, templates, and CT derived implant guides.
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Challenges for the Future of Implant Dentistry: Technology Transfer - Report from the 2010 Summit
Speaker(s) : Jocelyn Feine, DDS, MS, HDR
- Healthcare providers are regularly confronted
with advertisements promoting new oral health
technologies. Dentists have a professional,
ethical and legal responsibility to inform their
patients about any new technologies that have
been shown to be safe and effective. In order to
stay current and competitive, they must also
adopt and implement some of these technologies in their
clinics. But how do dentists know which new technologies are
truly safe and effective and how do they decide which to
integrate into their daily practices? Furthermore, while some
dental practitioners are willing to take additional clinical training
to develop competence in the provision of a new innovative
technology, some tend to be overwhelmed by the attributes of
the new technology and shy away from its use. Using implant
technology as an example, Professor Feine will describe the
process of technology assessment and transfer, as well as how
dentists can make better informed decisions about whether or
not to inform their patients about or to adopt a new
technology. She will also report on barriers to and incentives for
the adoption of new oral health technologies.
- Objectives: Upon completion of this presentation, participants
should be able to: 1) describe the path from development to
implementation of a new health technology; 2) list the
information sources on which an oral health clinician can rely
when considering whether or not to recommend or to adopt a
new oral health technology; and 3) describe the barriers and
incentives that dentists and patients may experience in the
adoption of implant technology.
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Long Term (5-year) Results: Immediate vs. Delayed Placement and Loading of Dental Implants in the Esthetic Zone
Speaker(s) : Dean Morton, BDS
- This lecture is designed to introduce treatment
teams to the concepts of early and immediate
surgical and restorative procedures in the
esthetic zone. The biologic foundation and
current evidence supporting accelerated
protocols will be considered. Multidisciplinary
assessment and pre-treatment risk analysis from
a functional and esthetic perspective will be considered for
accelerated procedures. Surgical considerations will include
minimally traumatic options, the concept of horizontal defect
dimension, implant morphology and surface and contemporary
grafting alternatives. Restorative considerations will include
diagnostic procedures and treatment preparation, templates,
provisional and definitive restorative alternatives.
- Objectives: Upon completion of this presentation, participants
should be able to: 1) describe indications and contraindications
for accelerated treatment protocols; 2) discuss multidisciplinary
patient and site assessment and appropriate implant selection;
3) identify minimally traumatic extractions and modified surgical
procedures; 4) discuss provisionals and restorations as they relate
to accelerated protocols; and 5) identify the biologic, esthetic and
functional advantages of accelerated treatment protocols.
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Long-Term Implant Success (5 years): Early Placement in the Esthetic Zone
Speaker(s) : Urs C. Belser, DMD
- Various clinical approaches for the replacement
of extracted teeth with implant-supported
restorations have emerged in recent years. This
presentation will focus on long-term data of
anterior implants, specifically addressing esthetic
parameters. Based on these results, the rationale
for an early placement/early loading concept will
be discussed in detail, comprising the related preoperative
analysis, decision making process and clinical/laboratory stepby-
step procedures. In particular, the fundamental difference
between single tooth sites, two adjacent missing anterior
maxillary teeth, and more extended edentulous segments, often
accompanied by significant horizontal and vertical tissue
deficiencies, will be addressed. Finally, a critical appraisal of the
recent evolution in implant design and novel restorative
components, such as CAD/CAM derived high-strength ceramic
elements will be made.
- Objectives: Upon completion of this presentation, participants
should be able to: 1) identify the principle risk factors
associated with anterior maxillary implant therapy; 2) provide a
detailed description of the early implant placement concept,
including simultaneous contour augmentation procedures; and
3) describe the critical appraisal of the respective currently
available long-term data.
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| March 4th, 2011 | | International Symposium | | |
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Management of the Deficient Maxilla
Speaker(s) : Joan Pi-Urgell, MD, DDS
- The phenomenon of osseointegration described
by Prof. Brånemark in the early 50’s and its
application in implant dentistry has represented
the most important breakthrough in the
rehabilitation of the edentulous patient.
Following tooth extraction, the maxilla undergoes
bone resorption in specific patterns. The atrophic
maxilla presents one of the most challenging treatments because
of its specific anatomy and the repercussion to normal function,
esthetics and facial expression; which will in turn influence the
patient’s psychological behavior. Implant therapy objectives are to
provide anchorage for a prosthesis to re-establish adequate
function and dental and facial esthetics. Different factors should
be analyzed for the correct diagnosis and treatment planning.
Bone resorption patterns, smile line, lip support and phonetics
will play an important role in determining the design of the final
restoration. This presentation will focus on the diagnosis of
different types of maxillary bone resorption patterns, the effects in
facial parameters and the different surgical approaches for each
type of situation. The different degrees of resorption are classified
as moderate, severe or totally atrophic. Surgical approaches
include guided bone regeneration, autogenous block grafting and
utilization of anatomical buttresses (pterigoid, zygomatic).
Evidence-based long term results of the different treatment
alternatives will be presented.
- Objectives: Upon completion of this presentation, participants
should be able to: 1) identify and classify different degrees of
maxillary bone resorption; 2) describe treatment modalities
depending on type and degree of bone resorption; and
3) project treatment outcomes.
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Evidence Based Protocols for Anterior Esthetics
Speaker(s) : Carlos Araujo, DDS, MS
- Installing an implant in the anterior region of the
mouth places no more challenges concerning
osseointegration, now a well-defined and safe
clinical issue. Nevertheless, predictability of
perfect esthetics remains controversial, especially
in situations that require side by side implants
and immediate extraction sites in the anterior
maxilla. The control of the hard and soft tissues perfect plastic
shape depends highly on delicate surgical procedures, correct
choice of implant design and materials, surface biological
enhancement and a careful prosthetic sequence of steps. The
clinician needs a safe and precise protocol that she or he might
follow in order to provide patients with trustable esthetic
solutions. Well conducted and high level studies must be
analyzed in order to extract from scientific facts the correct
clinical procedures. This presentation will address the most
recent study conclusions together with the best clinical variations
that might lead to beautiful accessible results, with special
concern to long endurance, since implants are now widely used
in very young patients.
- Objectives: Upon completion of this presentation, participants
should be able to: 1) describe the correct moment and adequate
circumstances to place an implant in extraction sockets; 2) discuss
the limitations and restrictions of different biotypes and
periodontal disease susceptibility in the prognosis of contiguous
implants; and 3) identify different biological characteristics related
to implant design stages of bone regeneration.
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Use of Mesenchymal Stem Cells in Alveolar Bone Augmentation
Speaker(s) : Minoru Ueda, DDS, PhD
- Tissue engineering is one of the most important
targets in the field of medicine in the 21st
Century. According to the concept, all of the
dental tissue can be regenerated by using stem
cell, scaffold and growth factors. In my lecture, a
new approach for alveolar bone regeneration
using bone marrow derived mesenchymal stem
cell is presented because it is thought to be the most important
and clinically available technique for implant surgery. We have
also developed the skin rejuvenation therapy in peri oral region
by using gingival fibroblast injection system which is combined
with implant treatment. In all, over 150 cases have been treated
by tissue engineering technology and showed good clinical
results in our clinic. The tissue engineering therapy in implant
treatment can provide the patient the higher esthetic result and
satisfaction.
- Objectives: Upon completion of this presentation, participants
should be able to: 1) describe the tissue engineering concept;
2) apply the concept in implant surgery; and 3) discuss the
future possibility of tissue engineering.
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Accuracy of Computer Guided Implant Placement using a Mucosa Supported Surgical Template
Speaker(s) : Dehuali Li, DMD
- Computer-assisted, template-guided implant
placement in general includes a workflow of the
following steps: a) pre-surgical fabrication of
radiographic guide to provide prosthetic
information; b) 3-D scanning to enable
visualization of bony anatomy, vital structures
and pre-fabricated denture; c) virtual implant
planning in a computer software based on the information of
bone structure and prosthesis, and d) production of surgical
template (i.e. CAD/CAM stereolithographic technique and
implant placement precisely guided by the template). Implant
information recorded in the surgical template makes prefabrication
of provisional prosthesis possible for immediate
loading. It is regarded as a future trend because of less
invasiveness, flapless surgery if mucosa supported template is
utilized, predictable implant position in correlation to prosthesis,
avoidance of possible bone grafting and destruction of vital
structure, etc. On the other hand, accuracy of this technique has
raised a great awareness about deviation of transferring the
virtual planning to real implant sites. This deviation as a whole is
supposed to result from every step of process, predominantly
from production of surgical template and the guided surgical
procedure of implant placement. This presentation will mainly
evaluate influential factors of accuracy in the surgical phase and
illustrate their effects on the deviation of implant positions
compared to the planned implants with the template having a
focus on maintenance of good accuracy.
- Objectives: Upon completion of this presentation, participants
should be able to: 1) describe linear and directional deviations of
implant position inherent to computer-guided implant placement;
2) identify the sources of deviation related to the whole process;
and 3) discuss how to ensure a good accuracy of implant
planning transfer from the standpoint of surgical procedure.
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Future Horizons for Growth Factor Applications in Implant Reconstruction
Speaker(s) : Henning Schliephake, MD, DDS, PhD
- The application of growth factors has been
introduced into implant dentistry mostly to
enhance peri-implant bone regeneration and
facilitate augmentation procedures. Among the
many different factors, molecules from the bone
morphogenic protein family have proven to
have the most reliable osteogenic activity. An
unresolved question is the mode of delivery of BMPs in clinical
applications. Loading of carrier systems such as collagen or
inorganic bovine bone is commonly accomplished by soaking
the carrier with the growth factor solution leading to simple
adsorption of the growth factor to the carrier surface.
Adsorptive coating, however, is associated with a rapid release
and hence loss of activity, which in turn requires large overdoses
of BMP to achieve clinically predictable results. This has
implications with respect to costs and safety issues. Future
horizons for growth factor applications would therefore be the
application of biotechnology to develop controlled release
carriers that can be moulded and at the same time proved
adequate mechanical strength and degradability. This
presentation reviews different approaches using alternative
growth factors and growth factor combinations as well as novel
carrier systems.
- Objectives: Upon completion of this presentation, participants
should be able to: 1) discuss how and why application of
growth factors is dependent on the carrier and release of
factors from the carrier; 2) describe how and why different
carrier systems affect release kinetics; and 3) identify how
problems with current carrier systems can be solved.
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Esthetic Design in Complex Cases
Speaker(s) : Fernando Rojas-Vizcaya, DDS
- Achieving an esthetic result is one of the most
important goals of implant dentistry. The art and
clinical science begins with conceptualizing the
management of the edentulous space by the
restorative and surgical teams. This becomes
essential in meeting the needs and expectations
of the patient. The restoration of cervical contour
of the planed crown will be a key to implant planning, placement
and restoration and the existing bone is a determinant in the
design of this new restoration. This presentation will show
protocols using a step by step format with guidelines to restore
complex fully maxillary cases in immediate or delayed placement
with immediate or conventional loading and using the Most
Apical Buccal Bone Level (MABL) in the esthetic zone as point of
reference during the design phase in order to simplify the
treatment plan and avoid, in some cases, the necessity of grafts.
Design, creation and transfer of new pink and white esthetics are
key aspects during the surgery that will determine the final
esthetic outcome as performance of bone reductions and 3-D
immediate implant placement, and use of different types of
abutment in different cases will be presented.
- Objectives: Upon completion of this presentation, participants
should be able to: 1) develop an esthetic design in a complex case
using the Most Apical Bucal Bone Level as point of reference;
2) create the new pink and white esthetics in the laboratory; and
3) transfer the new esthetics from the laboratory to the patient.
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| March 4th, 2011 | | Limited Attendance Lectures | | |
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LA-2 Review of Bone Grafting Techniques and Indications
Speaker(s) : Craig Misch, DDS, MDS
- Reconstruction of the deficient and/or atrophic
residual ridge presents unique challenges to the
implant surgeon. There are numerous materials
that may be utilized for bone augmentation
procedures. This presentation will review the
spectrum of reconstructive options for repairing
localized bone defects to severe deficiency. The
lecture will discuss an organized approach to diagnosing and
selecting graft techniques for particular clinical situations.
- Objectives: Upon completion of this presentation, participants
should be able to: 1) describe the various bone grafting
techniques for managing ridge defects; 2) discuss the indications
for specific bone augmentation procedures; and 3) review clinical
cases highlighting the use of bone grafting techniques.
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LA-3 Immediate Loading and Immediate Implants: Techniques and Indications
Speaker(s) : Ricardo Mitrani, DDS, MSD
- For more than a decade, the concept of
immediate loading of endosseous implants has
become increasingly popular. Dental literature is
flooded with articles describing numerous
techniques and discussing the concept. This
presentation will take a close look at
clinical/technical protocols evolving around this
modality. Consideration should be given to the fact that applying
the concept of immediate loading to the fully edentulous patient
either in the maxillary arch or in the mandible should be regarded
as a different entity when considering the esthetic outcome as a
variable in the anterior esthetic zone.
- Objectives: Upon completion of this presentation, participants
should be able to: 1) determine when immediate loading/
immediate placement is a feasible option; 2) discuss the
limitations and potential contraindications of utilizing these
clinical protocols; 3) describe the significant role of team
communication for these clinical protocols; and 4) determine
which techniques will give the most successful and longstanding
results.
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LA-5 Implant Provisionalization for Single Tooth and Extended Edentulous Situations: A Step-by-Step Process
Speaker(s) : William C. Martin, DMD, MS
- Evidence-based success has resulted in
increasing utilization of dental implants in the
treatment of all forms of edentulism. Successful
treatment outcomes are directly related to the
proper planning, placement and restoration of
these implants. This presentation will emphasize
one area of the implant rehabilitation process
that plays a large role in achieving these predictable outcomes;
the utilization of implant supported provisional restorations.
Clinical techniques will be presented that will focus on the stepby-
step fabrication of provisional restorations that shape the
transition zone, which will assist in maximizing esthetic
outcomes. Cemented and screw-retained options that can be
utilized in long-span situations will also be covered as well as
clinical techniques utilized to simplify provisional fabrication.
- Objectives: Upon completion of this presentation, participants
should be able to: 1) discuss the importance of the implant
transition zone and how provisional restorations can be utilized
to shape this area; 2) highlight current clinical procedures
utilized to fabricate cemented and screw-retained provisional
restorations; and 3) introduce various provisional materials that
can be used to fabricate provisional restorations.
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LA-6 Selection of Proper Abutments for Specific Prosthetic Indications
Speaker(s) : Baldwin W. Marchack, DDS
- Patients today are more informed about dental
implants and their expectations are for
esthetically and functionally pleasing implant
restorations that mimic natural teeth. This course
will focus on principles, guidelines and the
rationale for selecting appropriate abutments for
the single posterior and single anterior implant
to achieve optimum esthetic yet functional and practical
implant restorations. The presentation promises to be of interest
to both the experienced and the novice practitioner. It will result
in effortless decision-making as it enables the restorative dentist
to collaborate with the surgeon and direct the laboratory
technician in the design of each single implant situation. This is
an interactive lecture enhanced with the use of digital response
devices. Guidelines for developing a decision tree in using
screw-retained, cement-retained, custom or patient-specific
abutment will be presented. Multiple clinical cases are presented
in which audience members will key in their responses.
- Objectives: Upon completion of this presentation, participants
should be able to: 1) analyze clinical conditions for appropriate
abutment selection for the single implant; 2) identify how the
restorative dentist can better communicate with the surgeon
and the laboratory technician; and 3) demonstrate practicediagnosis
and treatment planning on multiple clinical cases.
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LA-7 A Retrospective of Implant Experience: From Day 1
Speaker(s) : Stephen M. Parel, DDS , Daniel Sullivan, DDS
- It is somewhat rare that the time
frame of practice from the
beginning of osseointegration in
North America (June, 1982) can
be chronicled through the
parallel experience of two
clinicians. Drs. Sullivan and Parel
were participants in the original Toronto conference, and have
since practiced implant dentistry almost exclusively in both
academic and private practice settings. Both have observed and
taught the discipline of osseointegrated implant dentistry for
over 27 years and bring a singular perspective to a retrospective
evaluation based on their evolutionary experience. This tandem
presentation will look at long term rehabilitation of the partially
edentulous patient, especially with regard to esthetics, and
advances in edentulous reconstruction over this time period.
Long term follow-up data will be utilized to support currently
accepted protocols for this range of patient presentations from
the unique perspective of two practitioners who have (almost)
“seen it all”.
- Objectives: Upon completion of this presentation, participants
should be able to: 1) discuss the evolutionary process of
implant technology for the partially edentulous patient;
2) discuss the rationale and effectiveness of changes in implant
arrangements that affect the edentulous patient; and
3) describe the changes in surgical techniques that have
evolved to improve esthetic and functional outcomes for
implant patients.
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LA-8 Management of Failed Sinus Grafts and Alveolar Ridge Augmentation
Speaker(s) : Michael A. Pikos, DDS
- Maxillary sinus augmentation for implant
reconstruction of the posterior maxilla is a
predictable surgical procedure. Although
complications are uncommon, some may result
in total graft failure with potentially serious
consequences. This clinical presentation will
focus on the causes, recognition, prevention and
management of failed sinus grafts and alveolar ridge
augmentation. Emphasis will be on treatment of the failed sinus
graft and will include a detailed surgical, CT and medical
approach to address this not often discussed topic.
- Objectives: Upon completion of this presentation, participants
should be able to: 1) describe the causes of sinus graft failure;
2) recognize and minimize sinus graft failures; and 3) utilize a
proven surgical, CT and medical protocol for management of
the failed sinus graft.
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LA-9 Prosthetic Support During Management of Failed Implant Cases
Speaker(s) : Gary A. Morris, DDS
- Implant dentistry has proven to be a successful
and predictable treatment modality used to
restore the most simple to the most complex
case type. Although complications do occur, the
restoration of the existing dental implant patient
due to case failure brings many challenges to
the surgical/restorative team. Patient
management both psychologically and clinically can be difficult
at best. Prosthetic management of the transition between the
failed case to the new restoration is of the utmost importance.
This lecture will address these challenges, along with provisional
restoration during case revision, management of the obsolete
dental implant system, redesign and revision of existing
prosthetics and management of teeth that fail adjacent to
existing implant restorations. Strategies to prevent failures will
be presented along with recommendations for maintenance.
- Objectives: Upon completion of this presentation, participants
should be able to: 1) recognize the failing dental implant case;
2) identify provisional restorations appropriate for managing
the transition from the failed case to the new implant
restoration; 3) describe strategies to manage the obsolete
dental implant system; and 4) discuss prevention of future
failures.
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LA-12 Use of rhBMP-2 for Reconstruction of Alveolar Ridge and Maxillofacial Defects
Speaker(s) : Daniel B. Spagnoli, DDS, MS, PhD
- Extensive multi-center controlled research
projects have validated that rhBMP-2/ACS
1.5mg/ml is a safe and efficacious alternative to
autogenous bone grafts for anterior maxillary
extraction sockets when facial wall defects are
present, and for deficient posterior maxillary
ridges grafted by a sinus lift technique.
Histological specimens obtained by trephine core biopsy of
grafted sockets and sinus sites have shown de-novo
intramembranous bone formation for the first time in the adult
human. This research has shown total regeneration of extraction
sockets including the facial wall, and sinus lift sites with viable
bone. This core science provides a basis for the application of
de-novo bone regeneration to a variety of maxillary and
mandibular alveolar ridge defects. During this lecture we will
introduce the concept of implant specific bone grafting
designed to provide efficiency and specificity to grafts placed for
the purpose of dental implants. We will discuss grafting in
conjunction with implant placement, as well as specific
osteotomy techniques and the use of intrinsic and extrinsic
matrices in conjunction with BMP to permit development of a
graft that is specific to the planned implant.
- Objectives: Upon completion of this presentation, participants
should be able to: 1) discuss rhBMP2 mediated cell and tissue
interactions that result in de-novo bone formation; 2) discuss
tissue, graft and scaffold requirements for alveolar ridge
augmentation; 3) review tissue reactions to rhBMP2 and patient
safety considerations; 4) describe the principals of simultaneous
rhBMP2 graft placement in conjunction with implants and
5) demonstrate flap development and soft tissue preservation
techniques used in conjunction with rhBMP-2 grafts that
facilitate implant outcomes.
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LA-13 Immediate Implant Placement: Esthetic and Functional Outcomes
Speaker(s) : Stephen T. Chen, BDS, MDSc, PhD
- Immediate implant placement has been widely
adopted in the management of patients for
tooth replacements with implants. Over the
years, this technique has proven to be a reliable
treatment option, with excellent long-term
survival rates. However, the esthetic outcomes
have not been as reliable, with recent studies
identifying a number of risk factors for recession of the periimplant
mucosa. In this course, patient and operator-related risk
factors for adverse esthetic outcomes with immediate implants
will be discussed. Strategies for case selection and appropriate
planning of treatment will be presented, with the aim of
increasing the reliability of esthetic outcomes with this mode of
therapy. Adverse and optimal esthetic outcomes will be
demonstrated by way of clinical cases and discussion.
- Objectives: Upon completion of this presentation, participants
should be able to: 1) describe the success rate for esthetic
outcomes with immediate implants; 2) discuss the risk factors
associated with adverse esthetic outcomes; and 3) describe
strategies for appropriate case selection for immediate implants.
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| March 4th, 2011 | | Point / Counterpoint: Controversies and Debates in Implant Therapy - Treatment of the Esthetic Zone | | |
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Immediate Implant Provisional Restoration: PRO
Speaker(s) : Stephen J. Chu, DMD, MSD, CDT
- Implant dentistry is continuously evolving,
offering new and more predictable forms of
therapy with minimally invasive protocols.
Innovative techniques now allow for better
esthetics and greater patient comfort. However,
these new techniques and therapies continue to
raise questions and concerns regarding the risk
and rewards of each. Specifically, controversial issues regarding
implant survival and esthetic outcomes related to immediate
single tooth anterior implant replacement and immediate
provisional restoration will be presented. This lecture will
address current concepts, research and innovations in
immediate implant placement and how they can enhance
treatment procedures, time and clinical outcomes for greater
patient care and satisfaction.
- Objectives: Upon completion of this presentation, participants
should be able to: 1) describe the treatment time and survival
rates associated with immediate protocols; 2) discuss the
treatment objectives of provisional prosthetic abutment/crown
contours; and 3) determine the impact on hard tissue buccal
modeling and peri-implant soft tissue thickness.
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Guidelines for Selecting Implant/Prosthetic Protocols in the Esthetic Zone
Speaker(s) : German O. Gallucci, DMD
- Modern implant-prosthetic restorations using
different implant designs call for a harmonious
esthetic integration with the pre-existing
environment. Thus, a scalloped gingival line with
distinct papillae and free of any abrupt vertical
differences in clinical crown length between
anterior implants, is paramount. In this context,
risk assessment, treatment planning, surgical/loading protocols,
biologic considerations affecting normal peri-implant soft tissue
integration and esthetic/prosthodontic parameters will be
discussed as treatment regulators for long-lasting esthetic
outcomes. Clinical considerations will be analyzed in the context
of their direct application to esthetic implant-prosthetic
rehabilitations and based on the current scientific evidence.
Finally, recommended planning steps and treatment procedures
will be presented through scientific evidence and illustrated
with clinical examples treated at the School of Dental Medicine
of the University of Geneva and Harvard School of Dental
Medicine.
- Objectives: Upon completion of this presentation, participants
should be able to: 1) describe current trends in esthetic implant
dentistry; 2) assess associated risk factors for suitable treatment
planning; and 3) widen treatment planning options using a
selective approach.
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Use of Analog Technology for Implant Restorations
Speaker(s) : Baldwin W. Marchack, DDS
- CAD/CAM custom implant abutments and
CAD/CAM implant restorations have become
more common treatment choices today. While
this technology will unquestionably be the way
of the future, the clinician should not be too
eager to discard tried and true analog
techniques. This presentation will discuss the
transition phase that we are in and how the combination of
both analog and digital technologies may give us the best of
both worlds for superior implant restorations.
- Objectives: Upon completion of this presentation, participants
should be able to: 1) compare analog and digital techniques for
single abutments; 2) compare analog and digital techniques for
implant supported fixed partial dentures; and 3) compare
analog and digital techniques for fixed full dentures.
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Use of Digital Technology to Improve Implant Restorations
Speaker(s) : Christopher B. Marchack, DDS
- The world of computer-assisted designing and
computer-assisted manufacturing, custom
implant abutments and implant restorations
have changed the world of implant dentistry
dramatically. This technology has helped
improve the esthetics of implant restorations,
clinical procedures, more predictable laboratory
procedures and using materials that are biocompatible for
patients. This presentation will discuss the use of digital
technology and the improvement of implant restorations.
- Objectives: Upon completion of this presentation, participants
should be able to: 1) describe the various types of CAD/CAM
implant restorations; 2) identify material choices of CAD/CAM
implant restorations; and 3) discuss use of the verified index in
CAD/CAM restorations.
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Flapless Surgery Yields More Esthetic Results: Use of Imaging and Planning Software
Speaker(s) : Stephen T. Chen, BDS, MDSc, PhD
- The long-term esthetic outcome with dental
implant therapy depends to a large extent on
the stability of the peri-implant hard and soft
tissues. It is recognized that the trauma
associated with the elevation of surgical flaps
compromises the vascularity of the mucosa and
underlying alveolar bone. This in turn increases
the risk of hard tissue resorption and soft tissue recession.
Flapless surgery has been advocated as means to minimize this
surgical trauma. Recent experimental and clinical research,
coupled with advances in imaging, planning and navigational
software, has demonstrated that flapless surgery holds
advantages over the traditional flap approach in defined clinical
indications. In this lecture, the evidence for flapless surgery will
be presented, and the clinical indications for this approach will
be presented.
- Objectives: Upon completion of this presentation, participants
should be able to: 1) describe the experimental and clinical
evidence for flapless surgery; 2) identify the diagnostic factors
required to select the appropriate cases for this approach; and
3) describe the use of imaging and planning software for use in
conjunction with flapless surgery.
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Is a Flap Required in Most Anterior Implant Cases?
Speaker(s) : Anthony G. Sclar DMD
- This presentation will specify the individual case
factors that determine whether a traditional flap
versus a minimally invasive approach such as the
palatal peninsula flap or pouch and tunnel
approaches are indicated for implant placement
in the maxillary anterior area versus the
indications and requisites for a “flapless”
approach. The influence that pre-treatment diagnostic findings
such as the patient’s desires and level of esthetic concern, the
results of an individualized esthetic risk assessment and the
indicated type of prosthesis have on determining which type of
soft tissue surgical access will be most beneficial for the patient
and implant surgeon will be demonstrated by a series of
detailed clinical case presentations.
- Objectives: Upon completion of this presentation, participants
should be able to: 1) describe the individual case factors that
determine whether a flap versus a minimally invasive approach
versus a “flapless” approach is indicated for implant placement
in the maxillary anterior area; 2) discuss the pre-treatment
diagnostic findings required to perform“flapless” surgery for
placement of an implant or implants in the maxillary anterior
area; and 3) discuss the pre-treatment diagnostic findings that
require a traditional open flap or minimally invasive approach
for placement of an implant or implants in the maxillary
anterior area.
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Papilla Augmentation: Prosthetic Enhancement of Soft Tissues
Speaker(s) : Christian Coachman, DMD, CDT
- Esthetically replacing missing teeth in areas of
significant anterior ridge deformities has been
and still is a significant challenge in dentistry.
High esthetic expectations and the addition of
implant therapy have only increased the
challenge. This presentation will outline a new
prosthetic option besides the existing surgical
and orthodontic options to enhance esthetically the soft tissue
architecture. Emphasis will be placed on the analysis, design and
benefits of the 3D prosthetic reconstruction of deficient ridge
and its ability to enhance the esthetic result of the final tooth
form (white esthetics) and gingival design (pink esthetics).
- Objectives: Upon completion of this presentation, participants
should be able to: 1) identify the relation between soft tissue
deformities and tooth morphology problems; 2) perform a
smile design project that incorporates white and pink esthetics
and will guide surgical and restorative procedures; 3) utilize
pink ceramics and pink composite to esthetically mimic natural
gingival tissue; and 4) adapt surgical procedures, such as 3D
implant placement, grafts and soft tissue conditioning to
enhance the final result of pink restorations.
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______________________
Papilla Enhancement in Implant Dentistry: Surgical Solutions
Speaker(s) : Michael S. Block, DMD
- Outside of clinical situations where gross ridge
destruction is caused by disease processes or by
iatrogenic surgical or restorative procedures, the
vast majority of tissue anatomy problems
encountered in implant treatment can be
handled by the surgical and restorative team
members. Comprehensive treatment planning,
surgical precision and appropriate use of emerging materials
and techniques can set the tone for ideal esthetics from the
surgical and prosthetic perspectives. Enhancing bone and soft
tissue volume, quality and stability in implant therapy either
prior to or in conjunction with implant placement is important
to both functional and esthetic success. New bone grafting
materials and techniques will be presented and the potential
strengths and limitations in vertical ridge enhancement will be
reviewed. The impact of implants with a platform switch
connection and 3D implant positioning considerations on tissue
volume and long-term stability will be discussed. The key step of
soft tissue grafting to improve tissue volume and to promote
long-term tissue stability will be emphasized.
- Objectives: Upon completion of this presentation, participants
should be able to: 1) illustrate commonly encountered esthetic
clinical dilemmas in implant dentistry; 2) recognize that ridge
augmentation can be accomplished with allograft blocks as an
alternative to autogenous blocks for the management of
moderate to severe ridge resorption problems in the esthetic
zone; 3) describe material handling and clinical outcomes;
4) identify cases where tissue grafting should be considered;
and 5) discuss the rationale for soft tissue grafting based on
literature results.
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| March 5th, 2011 | | Surgical Track | | |
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What Every Surgeon Must Know About Prosthetic Concepts
Speaker(s) : Hans-Peter Weber, DMD
- Treatment outcomes with dental implants and
implant-supported prostheses of various kinds
have consistently improved since the early days
of osseointegration. This steady increase in
survival and success rates of implants and
prostheses is certainly due to our better
understanding of contributing biological,
(bio)mechanical and clinical factors, including the recognition
that prosthetically driven implant placement is key.
Nevertheless, complications and failures in implant therapy
continue to occur. A substantial portion of those can be
attributed to implant malpositioning, or in other words,
implants, which are placed in a position or direction that creates
prosthetic problems of design, esthetics, function and
cleansibility. This presentation will highlight prosthetic concepts
for different indications in partially and fully edentulous patients
that should be considered in treatment planning and surgical
protocols of implant placement.
- Objectives: Upon completion of this presentation, participants
should be able to: 1) outline prosthesic concepts that will
reduce the risk for short – and long-term complications;
2) clarify that implant malpositioning is a major etiological
factor for compromised treatment outcomes and complications
with implant assisted prostheses; and 3) highlight the critical
components for implant placement in esthetic sites.
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What Determines Implant Success?
Speaker(s) : Neil Meredith, DDS, PhD, MSc
- Success – the achievement of an objective or
goal, the opposite of failure (Wikipedia). It would
seem from the meaning that it is essential to
define the objectives and goals of implant
treatment to define success. This presentation
identifies those clear parameters which are
essential to success and its goals; namely
primary, secondary and tertiary stability, esthetic outcome,
maintenance and time dependent parameters. It also brings into
question the concept that “implants live forever.”
- Objectives: Upon completion of this presentation, participants
should be able to: 1) describe methods for obtaining implant
stability at placement; 2) explain methods for measuring
implant stability and interpretation of results; and 3) identify
the different factors contributing to implant success.
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Computer Guided Surgery - CT Based Advanced Computer Guided Implant Dentistry
Speaker(s) : Richard Nejat, DDS
- In the constantly evolving field of implant
dentistry, the dentist plays a critical role in the
long-term success of dental implants. Due to the
predictability of dental implants in achieving
osseointegration, once considered the ultimate
goal, it is now the standard of care for tooth
replacement. A new paradigm in implant
dentistry is being developed. The goal in implant dentistry has
now shifted to delivering an esthetic implant-supported
restoration in as short a time as possible. Cases will be presented
where fixed restorations were placed at the time of implant
placement and including at the time of extraction of teeth.
Computer driven templates were used and the planning allowed
for the patients to leave, the same day, with a fixed immediate
loaded prosthesis in a minimally invasive manner without the
need for any ridge or sinus augmentation(s). New biologic
principles, computer guided treatment planning, surgical
procedures and restorative protocols have evolved to achieve
this rapid and long-term esthetic result. Attendees will gain a
clear understanding of these new implant modalities and how
these techniques will be utilized in a team approach to insure a
high level of patient comfort, acceptance and beautiful smiles.
- Objectives: Upon completion of this presentation, participants
should be able to: 1) review the benefits of computer based
planning to help promote better communication between the
surgical specialist, restorative dentist and the laboratory
technician; 2) identify case selection and treatment planning
required to avoid any problems; 3) discuss how to transform
pre-planned treatment into clinical reality; 4) use a flapless
approach to maximize patient comfort; and 5) demonstrate the
use of computer based treatment planning to help avoid bone
grafting – a solution for the partially and/or fully edentulous
patient.
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Hard Tissue Augmentation to Enhance Contours and Functional Support for Implants
Speaker(s) : Stefan Lundgren, DDS, PhD
- Maxillofacial reconstruction with iliac crest bone
grafts and titanium implants in the atrophic
maxilla will be presented including the 10 – 15
year follow up results. Bone and soft tissue
reformation with the combination of onlay bone
grafting, distraction osteogenesis and virtual
planning of implant placement in patients with
severe post-traumatic defects will be presented. The clinical, as
well as experimental, results from a novel surgical technique for
rehabilitation of the atrophic posterior maxilla with sinus
membrane elevation and simultaneously placement of implants
without the use of any graft material will be presented.
- Objectives: Upon completion of this presentation, participants
should be able to: 1) show the long term results after bone
reconstruction of the severe atrophic maxillae prior to
rehabilitation with implants; 2) describe the use of bone
grafting in combination with distraction osteogenesis and
endosseous implants for the reconstruction of the severe posttraumatic
defects in the anterior maxilla; and 3) describe the
augmentation of the atrophic posterior maxilla with the mere
lifting of the maxillary sinus membrane and insertion of
implants without the use of any grafting material.
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Soft Tissue Augmentation to Improve Esthetics
Speaker(s) : Markus Hürzeler, DMD, PhD
- Today’s patients are increasingly demanding
when it comes to their smile’s esthetic
appearance. In a time where physical beauty
surely plays its role, our contribution in
preserving or improving our patient’s smile has
become significant. The two areas of great
esthetic concern to patients are the length of
their teeth and the interdental loss of periodontium. Many
surgical concepts have proven to be successful in treatment of
these defects. But we have to be aware that every surgical
procedure has a certain margin of unpredictability during the
healing process. Therefore, the aim of this presentation is to
present first a microsurgical concept which will allow the
surgeon to fulfill the high esthetic demands from the patients in
the daily practice on a more predictable base. Second, the issue
of the long term stability needs to be discussed. Achieving good
esthetic is important, but maintaining it over a long time is even
more important for our patients. Can the use of connective
tissue graft improve the outcome by providing an increased
thickness over time?
- Objectives: Upon completion of this presentation, participants
should be able to: 1) discuss the new microsurgical concept in
periodontal reconstructive surgery; 2) describe predictable
surgical concepts to overcome demanding esthetic
compromised sites; and 3) discuss the effect of reconstructive
procedures over a long period of time.
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Growth Factors in Implant Dentistry - How Do We Continue to Improve?
Speaker(s) : Ronald E. Jung, PhD, DMD
- Further improvements in bone augmentation
procedures can either be related to
simplification of the clinical handling or
influencing biological processes. Growth factors
or bioactive proteins and peptides in
combination with adequate carrier systems are
nowadays able to stimulate the natural
regeneration process, to accelerate bone regeneration and to
increase predictability in bone regeneration therapy. Although
there are a lot of preclinical studies and a few clinical studies,
growth factors are still not in general practice. One reason might
be the lack of ideal carrier materials allowed to reduce the costs
and the dosage. The use of a newly developed synthetic carrier
system together with a biologic active factor has demonstrated
similar amounts of newly formed bone in experimental defects
as the use of autogenous bone. It can be concluded that
biologic tissue stimulation with the use new matrix systems has
the potential to overcome some of the present difficulties in
GBR procedures.
- Objectives: Upon completion of this presentation, participants
should be able to: 1) describe the problems encountered with
the clinical use of growth factors in implant dentistry; 2) identify
what indications rhBMP-2 has been approved; and 3) discuss
the possible advantages of a new synthetic carrier material for
growth factors in implant dentistry.
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| March 5th, 2011 | | Restorative Track | | |
______________________
What Every Restorative Dentist Must Know About Surgical Concepts
Speaker(s) : Dennis P. Tarnow, DDS
- This presentation will focus on the surgical
principles that must be understood by the
restorative dentist. These concepts will lead to
more ideal treatment of patients who want the
ultimate esthetic and functional result.
- Objectives: Upon completion of this presentation,
participants should be able to: 1) describe
incision design that can make esthetic result more ideal instead
of compromised; 2) discuss the sequence of events between
the restorative and surgical phase of treatment; and 3) identify
how and when to provisionalize for optimal functional and
esthetic result.
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Maxillary Overdentures: Non-Splinted Units
Speaker(s) : Rhonda F. Jacob, DDS, MS
- Implant overdentures in the mandible have
proved successful, efficacious and cost effective.
They have evolved to include several abutment
designs that have diminished the need and cost
for splinting. There is limited data on maxillary
overdentures using non-splinted implant units,
however patients still desire the benefits of
implants in the maxilla while also requesting cost containment.
The use of non-splinted implants in the maxilla are a means to
maintain peripheral seal when the number of implants are three
or less. When a greater number of implants are employed and
the distance and spread of implants is increased, the
independent units begin to bear more of the load and retention
demands. With an increased number of implants, the need for
full contact of the palate and posterior peripheral seal may be
less necessary.
- Objectives: Upon completion of this presentation, participants
should be able to: 1) consider positions of non-splinted implants
in the maxilla; 2) discuss the periphery of the maxillary prosthesis
when using non-splinted implants; and 3) consider tiered and
cost-effective implant overdenture prostheses designs.
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Short Implants: Indications and Long-term Success
Speaker(s) : Franck Renouard, DDS
- Very severe jaws represent a challenge for the
surgeon. Advanced surgical therapies were
developed in order to place the longest implants
possible. However, few practitioners are able to
perform bone grafting procedures or bone
regenerations in their daily practice. More and
more patients take medications which contraindicate
advanced surgical procedures. It is why short implants
are more and more proposed as a reliable therapeutic option.
According to the 2006 EAO Consensus Conference, a short
implant is an intra bony device with a length of 8mm or less.
However, literature review and theoretical analysis reveals that
the success rate of short implants could be compared to the
longer implants, while their morbidity remains very low.
Moreover, the deplacement of short implants into the bone
leads to flexibility which increases the resistance of the
implant/abutment/crown complex. During the lecture, it will be
suggested that the use of short implants can simplify the
surgical procedure and can allow the surgeon to concentrate on
the 3D implant placement. In conclusion, it will be suggested
that very short implants would represent a very elegant and
efficient solution for patients susceptible to periodontal
diseases. The notion of long term provisional restoration will
also be discussed.
- Objectives: Upon completion of this presentation, participants
should be able to: 1) indicate short implants in their routine
practice; 2) describe why short implants prognosis is as good as
long implants; and 3) discuss why the treatment morbidity is as
important as the implant success or survival rate.
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______________________
Soft Tissue Esthetics – Abutment Design and Materials
Speaker(s) : Yoshihiro Goto, DDS, MSD
- The ultimate goal of soft tissue esthetics of
implant treatment is mimicking the color,
texture and shape of healthy gingival condition
of natural teeth. In order to mimic natural teeth
gingival condition, we need to understand how
the periodontium react to current implant
treatment and prosthetic materials compare to
the prosthetic treatment of teeth. The topic of soft tissue
esthetics has been discussed so many times in numerous
articles. This presentation focuses on the abutment design and
material selection for soft tissue esthetics, reviewing past
experiences and the current concept, as well as finding the
future direction.
- Objectives: Upon completion of this presentation, participants
should be able to: 1) discuss major and minor factors which
influence soft tissue esthetic of implant; 2) discuss the
importance of abutment design and material for soft tissue
esthetics; and 3) review past experiences of different abutment
materials with soft tissue reactions.
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The Everyday Ultimate Surgical Guide
Speaker(s) : David L. Guichet, DDS
- Currently, the prosthetic technique for providing
computer guided treatment and immediate-load
prosthesis is technically demanding and time
consuming. A complete review of software
applications, guides, laboratory techniques and
steps used to perform guided surgery and
immediate-load prosthesis will be presented.
A new simplified prosthetic and surgical protocol than in most
previous studies will be discussed including performance data
on this treatment.
- Objectives: Upon completion of this presentation, participants
should be able to: 1) discuss the accuracy and application of
implant treatment planning software; 2) identify various types
of immediate load prosthesis and their performance; and
3) identify the computer, laboratory and clinical steps involved
in delivering an immediate load prosthesis.
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Digital Impressions and CAD/CAM Restorations
Speaker(s) : Urs C. Belser, DMD
- Two of the most significant developments that
have recently taken place in the field of dental
medicine are undoubtedly the spectacular and
rapid progress achieved in intraoral scanning
technology and directly linked CAD/CAM
restorations. One can clearly speak of a major
shift of paradigms, as traditional “analogue”
restorative treatment procedures which included physical
impression taking, plaster cast fabrication, articulator mounting,
wax patterns and finally casting and free-hand ceramic layering,
are now increasingly being replaced by a more virtual reality. In
fact, three-dimensional CAD planning based on the individual
patient’s data set can be performed directly and exclusively on
the computer screen. Thus the presentation will focus on the
impact of this development on daily practice and try to provide
a critical appraisal from a clinician’s point of view.
- Objectives: Upon completion of this presentation, participants
should be able to: 1) discuss the major progress made in
intraoral scanning technology and directly linked CAD/CAM
restorations; and 2) present a detailed description of practical
procedures as they relate to CAD/CAM of implant borne
restorations.
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| March 5th, 2011 | | Closing Symposium: Major Catastrophies and How to Avoid or Handle Them | | |
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Discussion of Implant Claims, Damages and Remedies
Speaker(s) : Michael R. Ragan, DMD, JD, LLM
- Over the past thirty years, the placement of
osseointegrated implants has become an
integral part of the practice of dental medicine.
The interest and acceptance by the health care
consumer has lead to unprecedented demand
and dental implants have become a significant
adjunct to the modern dental practice. As such,
many segments of the dental profession have sought to develop
expertise in the treatment planning, surgical placement, and
restoration of dento-alveolar implants. Accompanying this
phenomenon has been a significant number of failures of
procedures and expectations with the concomitant professional
liability claims and regulatory complaints. This program will use
case-based examples to outline the major areas of claim activity
and areas of interest by the plaintiffs’ bar. Additionally, we will
review the frequency and severity of various types of damages
and suggest standards of practice to decrease exposure.
- Objectives: Upon completion of this presentation, participants
should be able to: 1) describe the most common types of
implant claims; 2) discuss the most frequent and severe types of
damages; and 3) describe standards of professional practice to
limit exposure.
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______________________
Bisphosphonate Related Osteonecrosis of the Jaw (BRONJ): Prevention and Management
Speaker(s) : Salvatore Ruggiero, MD, DMD
- Bisphosphonates are a class of agents that are
widely used in the management of metastatic
disease to the bone and in diseases of altered
bone turnover. Despite these benefits,
bisphosphonate-related osteonecrosis of the jaw
(BRONJ) is an emerging complication that has
afflicted a subset of patients receiving these
drugs for the treatment of osteoporosis and metastatic bone
cancer. This complication usually presents following simple
dentoalveolar surgery but it can also occur spontaneously. The
risk of developing this complication appears to be related to the
potency of the bisphosphonate, the duration of exposure and
dentoalveolar trauma. Stage-specific management strategies
have been developed as well as guidelines for evaluating the
potential risks associated with this new and emerging
complication. In view of the widespread use of long-term
bisphosphonate therapy, the observation of an associated risk of
steonecrosis of the jaw should alert practitioners to monitor for
this previously unrecognized complication and to re-evaluate
the indications for and the duration of bisphosphonate therapy
in patients with osteopenia/osteoporosis and cancer.
Implementing prevention strategies and establishing an early
diagnosis might prevent or reduce the morbidity associated
with BRONJ. This presentation will review the current strategies
for prevention and management of BRONJ. Bisphosphonates are
a class of agents used to treat osteoporosis and malignant bone
metastases.
- Objectives: Upon completion of this presentation, participants
should be able to: 1) review the clinical signs and symptoms of
BRONJ; 2) discuss the risk factors and prevention strategies
related to BRONJ; and 3) identify treatment strategies for
patients who present with BRONJ.
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______________________
Major Catastrophies Associated with Full Arch Implant Reconstructions (Including Provisionalization During the Retreatment Phase)
Speaker(s) : Jorge Barrios, DDS
- The full arch Implant reconstruction can be
challenging and complex. There are many
variables that affect the longevity and
predictability of treatment. Proper diagnosis,
treatment planning and meticulous execution of
the surgical and prosthetic teams are key for a
successful outcome. Utilization of up-to-date
dental materials is crucial for long-term maintenance and
success of the reconstruction considering the increased
longevity of our population. Many difficulties can be overcome
with proper planning. It is imperative to communicate these
possibilities to the patients and how to prevent and resolve
them if they occur. Careful considerations by clinicians with
reliable and proven materials and techniques should be carefully
considered in this reconstruction with the entire team. Degree
of difficulty should be classified from the surgical and prosthetic
plan in the diagnostic phase. The experience and success of
each member of the team, which includes the surgeon,
restorative dentist and dental technician, should also be
considered for the execution of straightforward, advanced and
complex cases.
- Objectives: Upon completion of this presentation, participants
should be able to: 1) predict failure and eventualities that can
occur in full arch reconstruction; 2) evaluate risk factors in full
arch implant reconstruction; and 3) prevent failures and be
prepared for the possible occurrence.
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Challenging Maxillary Implant Cases: How to Manage Them and Avoid Complications
Speaker(s) : Stephen R. Rimer, BDS
- In treating patients with atrophic maxilla,
whether in the partially or totally edentulous
atrophic maxilla, the final prosthetic plan must
determine both the sequencing and techniques
used in planning and executing the surgical
phase of treatment.
In spite of all the advances in computer generated treatment
planning, the fundamental approach of determining through
traditional prosthetic evaluation, both the patient’s esthetic and
functional expectations as to the type of surgical reconstruction
required is still the key in planning these cases.
While many cases might best be treated with a telescopic type
fixed/removable prosthesis supported by a few implants only
requiring localized grafting using autogenous, allografts,
xenografts or growth factors, this presentation will focus more
on those cases where the patient desires a fixed “permanent”
reconstruction necessitating a much more inclusive
interdisciplinary approach.
If we are able to provide the proper bony foundation and
alveolar relationship relative to the planned occlusal scheme,
with appropriate surgical techniques, the patient can be
reconstructed with a prosthesis that mimics replacement of the
lost anatomy without mechanically correcting the jaw
discrepancy through prosthetic design alone, thus avoiding long
term prosthetic failure.
- Objectives: Upon completion of this presentation, participants
should be able to: 1) treatment plan the management of the
atrophic maxilla – identifying the correct sequence of therapy;
2) describe hard and soft tissue requirements to avoid failure;
and 3) discuss the role of maxillary/mandibular relationships on
the final outcome.
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Dealing with Unanticipated Adverse Events: Skills to Move Forward
Speaker(s) : Kenji Higuchi, DDS
- Proper management of an unexpected serious
complication can be considered as the most
challenging event in implant rehabilitation.
Successful resolution of unanticipated adverse
events requires ethical patient communication
and support, as well as appropriate clinical
treatment. Professional liability carriers and
malpractice defense attorneys estimate that communication
failure is a contributing factor in 80% of professional liability
claims and 20% of the filing of the claim. This presentation
outlines essential skills in the process of effective patient
communication, the “I’m sorry” approach and clinical steps taken
on the patient’s behalf to resolve the complication in a
satisfactory manner. Specific case reports will be presented to
demonstrate the skills to move forward following a serious
complication or failure.
- Objectives: Upon completion of this presentation, participants
should be able to: 1) describe the ethical rationale for disclosure
of adverse events; 2) implement the “I’m sorry” approach
following a complication or treatment failure; and 3) provide
two alternative clinical approaches to resolve the consequences
of the adverse event or failed treatment results.
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| March 5th, 2011 | | Dental Assistant, Dental Hygienist and Office Coordinator Program | | |
______________________
Osseointegration: What We Know Now that We Didnt Know Then! (Part 1)
Speaker(s) : Robert N. Eskow, DMD , Valerie Sternberg-Smith, RDH, BS
- The success of implant dentistry
is contingent on both achieving
and sustaining ossseointegration.
The long term prognosis of
implant dentistry is complicated
by the changing complexity of
the patient. Intraoral and systemic
factors can negatively influence long-term outcomes. The
development of periodontal/pathogenic flora can be influenced
by medications that affect quantity and quality of saliva and
crevicular depth. Similarly, the development of diseases can result
in changes of the flora and impair the host response and
negatively impact bone remodeling. The loss of integrity between
any of the restorative components can have a negative effect on
the bone. Preventive care is not merely daily plaque control and
debridement at the appropriate interval. Awareness of the
patient’s systemic state and correlating peri-implant changes with
an etiologic basis serves as a means by which a patient-specific
preventive strategy can be developed.
- Objectives: Upon completion of this presentation, participants
should be able to: 1) identify systemic factors that can influence
osseointegration; 2) list medications that can affect the tissues
and flora around implants; and 3) recognize complications that
can appear during the preventive phase of treatment.
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Basics of Implant Dentistry Treatment Planning: How Assistants Participation Facilitates the Process
Speaker(s) : Michele Landolt, DMD
- The dental assistants and hygienists are the link
between the dentists and the patients. Often the
patients ask the staff for their opinion. Therefore,
it is important for the whole team to understand
treatment goals. Implant dentistry offers many
treatment options that were not available 20
years ago. Today, we may have one diagnosis
but multiple treatment plans. In this session the success rates
and complications of different implant treatment options will be
discussed, along with the advantages of an implant restoration
over conventional dentistry. Single- and multiple-unit implant
restorations and implant-supported versus tooth-supported
overdentures will be presented. The interim phase often worries
patients, as they are afraid that they have to walk around
without any teeth. It is important to be able to explain to them
every step of the treatment, including the provisional phase.
- Objectives: Upon completion of this presentation, participants
should be able to: 1) discuss the success rates and complications
of single and multiple implant restorations; 2) educate patients
about different implant treatment options; and 3) explain the
different provisionalization methods.
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Dental Implant Practice Marketing - Internal and Online Marketing Secrets
Speaker(s) : Jay Levine
- This session will discuss important Internet
based techniques that effectively promote a
dental implant practice (surgical and restorative)
on all major search engines via organic, viral and
social media marketing. We will also familiarize
participants with the ability to pre-educate
prospective dental implant patients online prior
to the initial visit. We will review how to best use the practice
website and facilitate treatment planning and increase case
acceptance. Online collaboration with referring colleagues will
be demonstrated, along with Internet methodologies that will
enhance office productivity.
- Objectives: Upon completion of this presentation, participants
should be able to: 1) appropriately promote a practice website to
patients and referring doctors; 2) describe how search engines
find and rank dental implant websites; and 3) communicate
online (securely) with patients and referring doctors.
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Osseointegration: What We Know Now that We Didnt Know Then! (Part 2)
Speaker(s) : Robert N. Eskow, DMD , Valerie Sternberg-Smith, RDH, BS
- The success of implant dentistry
is contingent on both achieving
and sustaining ossseointegration.
The long term prognosis of
implant dentistry is complicated
by the changing complexity of
the patient. Intra oral and
systemic factors can negatively influence long-term outcomes.
The development of periodontal/pathogenic flora can be
influenced by medications that affect quantity and quality of
saliva and crevicular depth. Similarly, the development of
diseases can result in changes of the flora and impair the host
response and negatively impact bone remodeling. The loss of
integrity between any of the restorative components can have a
negative effect on the bone. Preventive care is not merely daily
plaque control and debridement at the appropriate interval.
Awareness of the patient’s systemic state and correlating
periimplant changes with an etiologic basis serves as a means
by which a patient specific preventive strategy can be
developed.
- Objectives: Upon completion of this course, the participant will
be able to: 1) recognize iatrogenic factors that can cause
periimplant mucosal inflammation; 2) identify restorative
designs that can hamper effective plaque control; and 3)
describe how different implant systems will affect bone levels
around implants.
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The Implant Coordinator: A Vital Component of Your Implant Team
Speaker(s) : Susan S. Wingrove, RDH
- Take the pulse of this vital component of your
implant team; the implant coordinator. In times
when offices are downsizing and referrals drop; a
well-trained implant coordinator is invaluable to
your team. Revisit the importance or addition of
this critical position to a well-balanced implant
team.
What are the important steps for treatment planning and case
presentation in the pre-surgical, post-surgical and restorative
phases of implant dentistry.
Building relationships are key. The implant coordinator is your
link for a successful implant practice to the referring office,
laboratory, implant company and most of all…the patient.
- Objectives: Upon completion of this presentation, participants
should be able to: 1) evaluate the value of an implant
coordinator, including which team member would qualify, how
much time is needed for this position and what are the
responsibilities; 2) describe the three areas which the implant
coordinator position revolves around, including patient care,
marketing and educational support for referrals; and 3) discuss
how the implant coordinator is the extension of the office for
public relations with the laboratory, specialists and implant
companies.
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