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Event ID : AO_SANDIEGO
Academy of Osseointegration
2016 Conference Archive
San Diego, CA
February 17-20, 2016


The 31st Annual Meeting
Globalization of Implant Dentistry: A World Collaboration

PURCHASED CONTENT IN NOW READY FOR DOWNLOAD ACCESS.

The goal of this year’s 2016 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 clinical, 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 addressing current challenges and solutions in both restorative and surgical techniques currently in use today including surgical and prosthodontic treatment planning, maintaining implant success, team management and solving implant complications. Information will be presented on team treatment collaborations, treatment options for edentulous patients and what the future holds in implant dentistry. 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.

Highlights of the Academy of Osseointegration's 2016 Annual Meeting are also available on a USB Flash Drive. Click Here to Order. Estimated ship time is 8-10 weeks post meeting.

MEMBER DISCOUNT:
$200.25 - Please enter the coupon code AOdiscSANDIEGO16 at the time of checkout for member discount.

AVAILABLE FORMATS:
Video (MP4 Format) -  MP4 files are synchronized video files that combine all recorded audio with presentation slides. MP4s are playable on a computer or MP4 compatible device.

ULTIMATE PACKAGE PRICE : $225.00


Table of Contents
Welcome Remarks and Opening Symposium: Risks vs. Rewards in Implant Dentistry
Morning with the Masters
Management of the Esthetic Zone: A Team Approach
Management of the Esthetic Zone: When to Perform Surgical Treatment and When to Perform Prosthetic Treatment
Restorative / Surgical Team Management of the Edentulous Patient
Focus on China Symposium (presented in English with Mandarin translation)
Avoiding Complications in Implant Dentistry
Management of Complications in Implant Dentistry
Closing Symposium: A Look into the Future


February 18th, 2016
Welcome Remarks and Opening Symposium: Risks vs. Rewards in Implant Dentistry
______________________

Risks and Rewards of Grafting with Growth Factors/Biologics
AUDIO ONLY

Speaker(s) :

  • Henning Schliephake, DDS, MD, 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 provide the strongest osteogenic activity. Successful application of growth factors has been shown to be linked to the use of suitable carriers that allow for the reduction of growth factor dosage through controlled delivery and thereby can achieve more effective enhancement of bone regeneration. Adverse effects such as swelling and infection have occurred and appear to be associated to the dosage applied. Although growth factors are already in widespread use, improvements in the application will be required to achieve controlled delivery with predictable results. This presentation reviews the positive and adverse effects of the use of osteogenic growth factors and discusses different approaches for their application. Upon completion of this presentation, participants should be able to: 1) discuss how growth factors can affect bone regeneration and facilitate augmentation procedures; 2) explain how and why carrier systems can improve the efficacy of growth factors; and 3) discuss how adverse effects of growth factor applications occur and can be handled.

______________________

Risks and Rewards of Not Grafting

Speaker(s) :

  • Franck Renouard, DDS

  • Severe jaw resorption represents 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. Moreover, more and more patients take medications which contraindicates advanced surgical procedures. This is why short implants are proposed as a reliable therapeutic option. The notion of human factors, derived from the author’s aviation experience, will be discussed. It will be demonstrated that the simplest solution, based on the Stress Minimizing Concept, must always be the first choice. The goal of the lecture is to demonstrate that short implants can be used in routine practice with a high success rate and a low morbidity. Upon completion of this presentation, participants should be able to: 1) recognize that short implants are a reliable option; 2) discuss how the morbidity of each therapeutic options must be assessed before making a decision; and 3) explain how the simplest procedure should be always be the first choice.

______________________

Risk and Rewards of Bone Augmentation Procedures

Speaker(s) :

  • Dehua Li, DMD, PhD

  • Alveolar bone defects are anatomical challenges to implant application and sufficient bony support is considered a key factor for long-term implant predictability and esthetics. Bone augmentation based on the principle of guided bone regeneration provides good solutions to ridge deficiency around implants. Nonetheless, the bone defect resolution has not been demonstrated as 100% predictable under circumstances of dehiscent and fenestrative defects, according to literature. Stability of the grafting region is regarded as one of the prerequisites for bone formation. From the standpoint of stabilization determinants, diverse procedures of bone augmentation, such as GBR procedure, ridge expansion, onlay grafting and titanium mesh technique, will be introduced with main discussion on the decision making of selection. Upon completion of this presentation, participants should be able to: 1) recognize the classification of ridge defect according to its topography and location on the alveoli and differentiate the complexity of cases in terms of conditions of bone deficiency; 2) choose proper procedures for specific clinical circumstances with high predictability; and 3) describe the potential risks of different procedures.

______________________

Risks and Rewards of Guided Surgery and Prosthetics

Speaker(s) :

  • Alessandro Pozzi, DDS, PhD

  • Cutting-edge CAD/CAM technologies in oral surgery and prosthodontics can enhance the 3D diagnosis and treatment planning process. The novel, straightforward and efficient digital workflow enables the clinician to face the challenges of modern implant dentistry in a more predictable manner. Decision-making and the virtual surgical and prosthetic plan can be easily duplicated into reality within a minimally invasive fashion. The digital diagnosis allows the 3D visualization of the bone and soft tissue architectures, merging the anatomical needs with the patient requirements of a natural-looking restoration and facial rejuvenation. This lecture will provide a comprehensive review of risks and rewards related to guided surgery and prosthodontics. Ten years of scientifically proven experience and clinical follow-up on CAD/CAM dentistry will be shared with the audience to support clinical protocols as well as practical tips and tricks to introduce the digital workflow in our implant practice while maintaining the fundamental principles of osseointegration. Upon completion of this presentation, participants should be able to: 1) explain how to treat partial and fully edentulous patients with the new efficient integrated digital workflow; 2) discuss hard and soft tissue surgical management with guided surgery; and 3) recognize the advantages and drawbacks of using guided surgery and immediate implant placement and loading.



February 19th, 2016
Morning with the Masters
______________________

M-2: Digital Restorative Dentistry
AUDIO ONLY

Speaker(s) :

  • Curtis Jansen, DDS

  • Practitioners are constantly faced with how to retain their implant restorations. This lecture will review the status quo on when one should consider cementing or screwing down a restoration to an implant. Upon completion of this presentation, participants should be able to: 1) explain the importance of retrievability with implant restorations; 2) identify the advantages and disadvantages of using screw and cement-retained implant restorations; 3) recognize future alternatives to cement and screw retained restorations; and 4) discuss the use of abutments with screw-retained and cement-retained restorations.

______________________

M-3: Controlling the Cementation Process

Speaker(s) :

  • Chandur Wadhwani, MSD

  • Abutment design is rudimentary and based on 50-year old-tooth preparations and does not help the clinician. New abutment designs are now being developed using sophisticated computational fluid dynamics, finite element analysis and CAD/CAM modeling. This session will discuss how these designs are being developed and how they can be used the next time you cement implant crowns. Titanium is still the material of choice for biocompatibility and we will learn about its properties and their effect on your clinical practice. Upon completion of this presentation, participants should be able to: 1) colorize titanium abutments to become esthetic simply cheaply to improve their color; 2) discuss the issues with healing abutments and how to better control the soft tissue attachments to implant abutments; 3) explain how to condition abutment surfaces improving micromechanical retention; and 4) determine which healing abutments to use, and how they protect the tissues during healing.

______________________

M-6: Soft Tissue Manipulation and Papillae Reconstruction around Implants for Optimal Esthetics

Speaker(s) :

  • Patrick Palacci, DDS

  • Optimal placement is a key factor for success in soft tissue manipulation in order to optimize final esthetic results. Rationale for implant placement related with soft tissue enhancement will be presented as well as soft tissue techniques allowing predictable papillae reconstruction. Long-term results will be presented keeping in mind that simplicity is the ultimate sophistication. Upon completion of this presentation, participants should be able to: 1) identify the objectives before surgery; 2) recreate a proper soft tissue environment; 3) explain the rationale for papillae reconstruction; and 4) explain how soft tissue esthetics is the key to success.

______________________

M-7: Strategies for Managing the Full Arch, Terminal Dentition

Speaker(s) :

  • Alessandro Pozzi, DDS, PhD

  • The primary aims in modern implant dentistry are to ensure the health and safety of patients, while meeting their clinical and personal needs. Both patient demands and expectations have changed dramatically in the past couple of decades, so that only by utilizing cutting-edge technologies and the latest treatment protocols, are clinicians able to meet the needs of today’s patients. Ten years of scientifically proven experience and clinical follow-up in digital planning, guided surgery and CAD/CAM biomimetic restorations will be shared with the audience to support clinical protocols as well as practical tips and tricks. Case studies teaching method will demonstrate step-by-step how to face the challenge of the terminal dentition and complete edentulism. New surgical and prosthetic proof-of-concept techniques will be presented to carry on a minimally invasive predictable esthetic implant rehabilitation with immediate function. Upon completion of this presentation, participants should be able to: 1) discuss how to rehabilitate the terminal dentition and full edentulism; 2) discuss principles, scientific basis, benefits and risk factors related to full-arch immediate load implant prosthesis on straight and tilted implants; and 3) describe surgical and prosthetic proof of concepts to simplify the overall treatment in case of complete arch rehabilitation.

______________________

M-8: Growth Factors for Soft Tissue Augmentation

Speaker(s) :

  • Nicola De Angelis, DDS, DMSc

  • Current techniques on soft tissue augmentation are effective but highly invasive with low patient approval. The use of growth factors in combination with biomaterials can give predictable and long-term stable results. Upon completion of this presentation, participants should be able to: 1) discuss tissue biology; 2) identify specific clinical conditions suitable for augmentation; and 3) assess the proper technique for soft tissue augmentation.

______________________

M-9: Fundamental Perspectives of Implant Esthetics - Presented in Mandarin

Speaker(s) :

  • Dehua Li, DMD

  • Implant esthetics have been incorporated into the criteria of implant evaluation. Due to the loss of functionally oriented gingival fibers after tooth loss, it is not the reconstruction of gingival tissue around dental implants, but the natural contour of peri-implant soft tissue that can be expected to be rebuilt to a harmony of soft tissue margin, emerging profile and papilla filling. Without presence of the gingival fibers, the peri-implant soft tissue works differently from the gingiva. Nonetheless, some features of peri-implant tissue provide fundamentals of biological and clinical principles for esthetic restoration of dental implants. In this presentation, such biological properties as biologic width, papilla filling and marginal bone remodeling will be discussed first, followed by a discussion that will deduce the surgical and restorative principles and procedures. Risk factors of implant esthetics and a corresponding treatment plan will be illustrated with individual cases. Upon completion of this presentation, participants should be able to: 1) discuss the importance of pre surgical workup and diagnostic studies to assess esthetics with the implant patient; 2.) provide surgical and prosthetic treatments properly to assure esthetic treatment outcomes; and 3) explain the risks associated with treating the esthetic zone with dental implants.

______________________

M-10: How to Get Your Paper Published

Speaker(s) :

  • Steven Eckert, DDS, MS

  • Writing a scientific article can be a daunting task. Understanding the process of scientific writing may make this a more comfortable endeavor. This presentation will identify the reasons for writing and the ways in which an author should structure their article. From creating a rational purpose for the article through the various sections, the attendee will become familiar with the process of writing and submitting an article for publication. The review process will be discussed and the attendees will learn the likelihood that their submission would reach publication. Upon completion of this presentation, participants should be able to: 1) identify the reasons for writing a scientific article; 2) differentiate among various types of articles; and 3) create a structure that matches that of the journal to which an article is submitted.



February 19th, 2016
Management of the Esthetic Zone: A Team Approach
______________________

Esthetic Implant Restoration: Beginning with the End in Mind

Speaker(s) :

  • Feilong Deng, DDS, PhD; Jing-Ping Li, PhD, MDS

  • Anterior esthetics is a major challenge for clinicians when managing patients with implant restorations. Tissue deficiencies caused by periodontal disease and post-extraction ridge collapse is very common among patients seeking implant restoration. The situation becomes even more difficult when the loss of hard and soft tissues is combined with malocclusion and a patient’s high expectation. In the Department of Oral Implantology, Guanghua School of Stomatology, Sun Yat-sen University, we apply a more classical approach to managing aesthetic problems in implant dentistry. We look to safeguard teeth to preserve the alveolar ridge; favor immediate or early implantation rather than late or delayed placement; and augment the ridge for a fixed, implant-supported prosthesis or simulate the soft tissue with a removable restoration. Finally, the implant team works to provide the implant patient with harmonious dentition whenever possible. The decision-making between implant team members before, during, and after treatment is based on the best predictable outcomes measurements that current technology can offer with a multidisciplinary approach. Upon completion of this presentation, participants should be able to: 1) identify key biological factors influencing the aesthetics of implant restorations for single or continuous teeth missing in the anterior region; 2) select optimal treatment protocols for the management of the esthetic zone; and 3) discuss why team approach is critical for a pleasing implant prosthesis and how to achieve a multidisciplinary cooperation.

______________________

The Orthodontist, Prosthodontist, Surgeon Team: Managing the Esthetic Zone

Speaker(s) :

  • Krista Janssen, DDS, MOrth, RCS(Ed); Gerry Raghoebar, DDS, MD, PhD; Anita Visser, DDS, PhD

  • Missing teeth can result in aesthetic, functional and psychological problems, particularly when the esthetic zone is involved. Treatment of these conditions is often complex and is in need of a multidisciplinary approach. Usually a combination of orthodontics, pre-implant surgery (bone augmentation), placement of dental implants and implant-based restorative therapy is needed. It is not uncommon that also orthognathic surgery is needed for complex cases. The ultimate goal of this complex treatment is to re-establish aesthetics and function, allowing the patient to achieve greater self-esteem and better social acceptance. In order to enable the restorative dentist to provide patients with an optimal oral rehabilitation, orthodontics is often needed to place the teeth in the desired positions needed for restorative treatment. Orthognathic surgery is required in many cases to correct dysgnathy or disharmony of the jaw(s) and/or malocclusion. Based on a set-up of the prosthodontic outcome which is strived for, the surgeon needs to provide proper bony and soft tissue conditions for implant placement at the wished positions. Factors that the restorative dentist, who coordinates the team, has to consider when determining the optimal aesthetic and functional outcome include; the distribution of space within the jaws and between the teeth; the size of the teeth; the age and skeletal development of the patient and the appearance of the prosthetics and the surrounding soft tissues, which should be harmonious with the adjacent dentition. It is therefore of utmost importance that all team members should have knowledge of each other’s expertise. Thus, restorative dentists, orthodontists and oral and maxillofacial surgeons have to work close together to achieve the optimal result for the patient especially in challenging cases. Usually backward planning with a clear aim for the treatment outcome is the starting point to consider whether it is feasible for the orthodontist and oral and maxillofacial surgeon to provide the restorative dentist with the oral framework that he or she needs to provide the patient with the required oral rehabilitation from an esthetic and functional point of view. This team effort will be discussed in detail and will be illustrated with cases in which this effort was applied. Upon completion of this presentation, participants should be able to: 1) illustrate the importance of good teamwork to achieve the optimal result for the patient, especially in challenging cases; 2) discuss backward planning with a clear aim for the treatment outcome; and 3) explain fabrication of a set-up based on the desired restorative outcome.



February 19th, 2016
Management of the Esthetic Zone: When to Perform Surgical Treatment and When to Perform Prosthetic Treatment
______________________

When to Go with Pink Porcelain and When NOT! (Part I)

Speaker(s) :

  • Kenneth Malament, DDS, MScD; Joerg Strub, DMD, PhD

  • The preservation or reproduction of a natural mucogingival architecture surrounding dental implants placed in the anterior maxilla is esthetically challenging, particularly when patients present with a high lip line when smiling. The challenge arises from the loss of hard and soft tissue after extraction of traumatically injured or periodontally compromised teeth, or is due to a traumatic surgical extraction or congenital defects. While surgical reconstructive procedures have been used for the improvement of hard and soft tissue defects prior to or during implant placement, the preservation of appropriate soft tissue architecture around implants remains challenging. Various prosthodontic techniques reported to improve the soft tissue deficiency include the use of a gingiva-colored acrylic resin facade, a flexible silicone-based tissue-colored mask, or a removable prosthesis. The loss of hard and soft tissue can also be corrected by applying gingiva-colored porcelain on the cervical portion of implant supported metal-ceramic restorations. This esthetic advantage needs to be balanced against the likelihood of increased difficulty in keeping the implant abutment interface plaque-free. This presentation will focus on the indications and contraindications of pink porcelain in implant-prosthodontics. Upon completion of this presentation, participants should be able to: 1) identify which defects can be treated surgically and/or prosthetically; 2) select and design the suprastucture for complex scenarios; and 3) explain the long-term outcomes of the different treatment modalities.

______________________

When to Go with Pink Porcelain and When NOT! (Part II)

Speaker(s) :

  • Aldo Leopardi, BDS, DDS, MS; Patrick Palacci, DDS

  • Implant dentistry in the maxillary anterior aesthetic zone is considerably more challenging than other regions. Additionally, when complications and/or hard/soft tissue deficiencies are encountered, management of the soft-tissue profiles becomes exponentially difficult. The purpose of this presentation is to discuss the clinical realities of dental implant treatment in the aesthetic zone, soft tissue management and when to use prosthetic equivalents. Upon completion of this presentation, participants should be able to: 1) discuss aesthetic zone anterior implant treatment planning; 2) illustrate when hard and soft tissue surgical intervention is indicated and the appropriate techniques; and 3) discuss prosthetic soft-tissue equivalents.



February 19th, 2016
Restorative / Surgical Team Management of the Edentulous Patient
______________________

Guided Full Arch Immediate Implant Reconstruction: 2016

Speaker(s) :

  • Carl Magyar, DDS, PA; Michael Pikos, DDS

  • This clinically based presentation will focus on the integration of restorative, surgical and laboratory disciplines, combined with CBCT technology, to provide a seamless approach for totally guided full-arch and full-mouth immediate implant reconstruction. This protocol includes placement of a prefabricated computer-guided monolithic acrylic bar supported prosthesis for both edentulous and dentate arches. Clinical cases will be presented that will feature indications and protocol for this approach, as well as advantages over the All-on-4 conventional conversion denture protocol. Upon completion of this presentation, participants should be able to: 1) explain the indications and protocol for computer-guided, full-arch and full-mouth immediate placement with a prefabricated monolithic acrylic bar supported provisional; 2) compare the advantages of this protocol over All-on-4 for full-arch and full-mouth implant reconstruction; and 3) discuss the limitations of this totally guided surgical and prosthetic protocol.

______________________

The Partially Edentulous Patient: Creating Harmony

Speaker(s) :

  • James Cassidy, DDS; Robert Faulkner, DDS

  • Dental implants are now an accepted mode of treatment for virtually any patient, whether it is the completely edentulous patient, the partially edentulous patient, or the single missing tooth scenario that presents in the esthetic zone. All of these situations present challenges, yet the expectations of the partially edentulous patient can provide specific demands involving both form and function. Many patients prefer a fixed option rather than removable and so the placement of dental implants must allow function that is compatible with the remaining natural dentition and provide the esthetic form that is acceptable to the patient. This presentation will provide insight into the necessary evaluation and work-up of the partially edentulous patient prior to initiating treatment with dental implants and the communication necessary between the implant team. Once the proper diagnosis and plan of treatment has been established, the sequence of treatment must be executed with great care to ensure a successful outcome. Upon completion of this presentation, participants should be able to: 1) identify the necessary steps to assess the partially edentulous patient prior to treatment; 2) explain the importance of communication between implant team members; and 3) discuss the symbiotic nature of form and function to provide a successful treatment outcome.

______________________

Single Missing Tooth

Speaker(s) :

  • Jeffrey Ganeles, DMD; Scott Ganz, DMD

  • Replacing missing teeth in the esthetic zone requires successful osseointegration, as well as fulfilling esthetic parameters. Maintaining or creating stable hard and soft tissue volume as well as color and contour are critically important objectives in addition to bone-to-implant contact. Surgical factors that influence these outcomes include timing of implant placement, procedures used for placement and time-to-provisionalization. This presentation will incorporate some of the literature which includes esthetic parameters related to implant placement in the esthetic zone. Clinical examples and a decision-tree type guideline will be proposed. Upon completion of this presentation, participants should be able to: 1) review and categorize definitions of timing of implant placement and distinguish from time-to-loading of implants; 2) review and categorize ridge and socket assessment and apply this to decision making for timing and method of implant placement in the esthetic zone; and 3) illustrate different treatment protocols to optimize outcomes in the esthetic zone based on diagnostic criteria.



February 19th, 2016
Focus on China Symposium (presented in English with Mandarin translation)
______________________

Clinical Outcomes with Immediate Loading of Zygomatic Implants in 188 Patients: a 10-Year Report

Speaker(s) :

  • James Chow, MBBS, MDS

  • Upon completion of this presentation, the participants should be able to: 1) discuss the different surgical techniques for the placement of zygomatic implants; 2) describe how to carry out immediate loading with zygomatic implants; and 3) explain how to manage complications of zygomatic implants.

______________________

Long-term Results after Lateral Sinus Floor Elevation: A Retrospective Analysis over 10 Years

Speaker(s) :

  • Bo Chen, DDS, MD

  • Upon completion of this presentation, the participants should be able to: 1) formulate feasible treatment options of implant placements in the edentulous posterior maxilla with limited residual bone height and determine priority choice; 2) identify possible risk factors, especially anatomy related factors of LSFE by CBCT; and 3) explain how to prevent and treat complications especially postoperative infection at its early stage to achieve highly successful outcome.

______________________

Dental Implant Management for Adult Ectodermal Dysplasia Patients with Extremely Atrophic Jaw

Speaker(s) :

  • Yiqun Wu, PhD, MD

  • Ectodermal dysplasia (ED) represents a group of inherited conditions characterized by anomalies in two or more structures of ectodermal origin. The hypohidrotic ED (HED) is a severe form and is associated with more dental defects. The oral conditions of adult edentulous patients with HED often lead to decreased physical and psychological health. Meanwhile, restoring oral function of adult edentulous patients with ED using dental implants remains challenging for dentists because of the severe atrophic alveolar process and base bone. Several bone augmentation techniques including intra/extra-oral autogenous bone grafting, artificial bone grafting and vertical distraction osteogenesis have been applied for treating with these patients before implant placement. Effective osseointegration of the implants has been obtained in augmented bone. However, donor site mobility and bone resorption are key focuses for these patients for long -term evaluation. An alternative for functional and esthetic management for extremely atrophic maxilla is a zygomatic ‘quad-approach’. Some modifications including surgical technique note and real-time navigation have been made to reduce the potential risk of orbital cavity penetration and its content damage in performing this approach. Upon completion of this presentation, the participants should be able to: 1) identify the extreme difficulties in functional and esthetic management for adult ectodermal dysplasia patients with dental implants; 2) discuss how the zygomatic implants work in the extremely atrophic maxilla of adult ectodermal dysplasia patients; and 3) explain some modifications, especially real-time navigation, in helping with zygomatic implant 'quad-approach' to reduce potential risks.

______________________

Modified Sinus Floor Elevation Using Lateral Mini-Window Approach
AUDIO ONLY

Speaker(s) :

  • Huiming Wang, DDS, MD, PhD

  • Upon completion of this presentation, participants should be able to: 1) discuss the lateral mini-window technique and its predictability in achieving adequate bone volume in the maxillary sinus; 2) compare this method with the traditional technique of creating a large lateral window; 3) explain the benefits of using the mini-window technique routinely in clinical practice.



February 20th, 2016
Avoiding Complications in Implant Dentistry
______________________

Improving Clinical Techniques to Avoid Cementation Issues

Speaker(s) :

  • Chandur Wadhwani, MSD

  • Evidence is emerging that restorative techniques can influence long-term health of implants, especially the use of luting cements. Cemented implant restorations will be with us for the foreseeable future. Although most dentists are highly familiar with techniques and materials, there is little understanding how they work as a system: crown; abutment; cement. This is better understood by engineers who know this is akin to a piston moving within a chamber, with the whole being greater than the component parts. By using advanced computer fluid dynamics we can now reverse engineer the system- making form follow function. The lecture will explore an evidence based approach towards the issues and how we solve them. Upon completion of this presentation, participants should be able to: 1) discuss how science can improve what we do; 2) explain systems approach and how cement actually works; 3) describe alternatives and their limitations; and 4) use evidence to form clinical decisions for best practices.

______________________

Soft Tissue Complications

Speaker(s) :

  • Bobby Butler, DDS

  • Implant Failures are extremely difficult to correct. They usually result from the loss of bone and soft tissue volume. It's really an equal balance of bone and soft tissue that must be present for ideal long-term success. Keratinized gingiva is beneficial around implants but not essential for health, however with increased soft tissue volumes we do see less complications. When preventing esthetic soft tissue failures we must augment any deficiencies with implant placement. Esthetic complications fit into two areas: failures with missing papillary volume and deficient facial gingiva/bone. This lecture will focus on how to prevent these complications. Proper planning and sequencing with connective tissue grafts/immediate or delayed placement will all be discussed. Upon completion of this presentation, participants should be able to: 1) recognize the role keratinized soft tissue volume plays with implant success; 2) sequence and plan soft tissue augmentation procedures with esthetic implant sites; and 3) identify when connective tissue grafts should be considered with immediate implant placement.



February 20th, 2016
Management of Complications in Implant Dentistry
______________________

Managing Soft Tissue Complications

Speaker(s) :

  • Kirk Pasquinelli, DDS

  • Soft tissue complications around dental implants can negatively affect the aesthetics, health and longevity of implants. This talk will present the etiology for several of the most common soft tissue complications as well as their therapeutic solutions. We will focus on the utilization of connective tissue grafts with and without particulate bone grafts to repair aesthetic soft tissue defects on implants in the aesthetic zone. Upon completion of this presentation, participants should be able to: 1) explain the cause and effect of the most common soft tissue complications around dental implants; 2) describe how to avoid these complications; and 3) discuss how to treat these complications when they occur.

______________________

Managing Hard Tissue Complications

Speaker(s) :

  • Fouad Khoury, DMD, PhD

  • Complications cannot be avoided completely in spite of the high successful rate in modern implantology and bone grafting procedures. Burning of the bone during implant placement can lead to severe complications with chronic pain, infection, fistula and non-osseointegration. The risk of failure, complication and infection depends of the complexity of surgical interventions. With the need for augmentative procedures to improve the implant site, a limited healing potential is present from the beginning. This is due to the poor soft tissue condition in addition to the poor regeneration potential of the area with a deficit in hard tissue. Good soft tissue quality is very important for an uneventful primary healing of the grafted area. In the case of high-risk surgical procedures, for example vertical bone augmentation in smoker patients, some special surgical modifications (e.g. two layer closure with lateral approach, tunnel approach) can be useful to reduce the risk of complications. Beside the possible intra-operative complications, for example strong bleeding, nerve injury or rupture of the Schneiderian membrane, post-operative complications present the main complication rate in bone grafting procedures. Early exposure of the grafted bone is a heavy complication, combined with soft tissue necrosis and can lead to a total failure of the grafting procedure. The goal of the treatment protocol is to improve the volume of the soft tissue and to save at least a part of the grafted bone, thus allowing the implant placement in acceptable conditions. Antibiotic prophylaxis with a penicillin derivate is a must in all grafting procedures, however the risk of infection, especially in sinus lift procedures, is high in the case of those with a penicillin allergy. Alternative antibiotics such Clindamycin are not offering similar protection due to increased resistance in the last 10 years. Upon completion of this presentation, participants should be able to: 1) discuss prevention and treatment protocol of burned bone syndrome; 2) describe improvement of the soft tissue quality; 3) explain prevention & management of intra-& postoperative complications; 4) define the lateral and tunnel approach to avoid exposure of grafted bone; 5) recite the treatment protocol for exposed bone graft; and 6) explain treatment protocol for infection after sinus lift procedure.



February 20th, 2016
Closing Symposium: A Look into the Future
______________________

Orofacial Mesenchymal Stem Cell-mediated Tissue Regeneration: A Future in Implant Dentistry?

Speaker(s) :

  • Songtao Shi, DDS, PhD

  • The orofacial region contains multiple-type mesenchymal stem cells (MSCs), including bone marrow MSCs, dental pulp stem cells (DPSCs), periodontal ligament stem cells (PDLSCs), Stem cells from Human Exfoliated Deciduous teeth (SHED), Stem Cells from root Apical Papilla (SCAP), and Gingival Stem/Progenitor Cells (GMSC). All these orofacial MSCs show elevated proliferation rate and population double numbers when compared to long bone marrow-derived MSCs. DPSCs and SHED are capable of regenerating dentin and pulp tissues in vivo. PDLSCs can be successfully used to treat periodontitis with regeneration of cementum, periodontal ligament and Sharpey’s fibers in swine and humans. Implantation of bone marrow MSCs can regenerate jaw bone to support dental implants. Moreover, the proof-of-concept study showed that orofacial stem cells were capable of regenerating bio-root in swine. In addition to their ability to differentiate into various kinds of cell types, orofacial MSCs possess immunomodulatory properties capable of interplaying with immune cells, such as T cells and reducing inflammatory cytokine production. These immunosuppresion functions make orofacial MSCs of great interest for clinical applications in treating a variety of human diseases such as SLE and osteoporosis by reconstructing the osteoblastic niche and restoring immune homeostasis. Upon Completion of this presentation, participants should be able to: 1) list a variety of dental tissues that contain unique stem cell population; 2) explain the potential of dental stem cell-mediated orofacial tissue regeneration; and 3) discuss the current status of dental stem cell-based regeneration in clinics.

______________________

The Emergence of "Tau": A Clinically Relevant Measure of Implant Osseointegration Potential and the Importance of Mesenchymal Stromal Cells

Speaker(s) :

  • John Davies, DDS, PhD, DSc

  • Wound healing, particularly of connective tissues, is made possible by the recruitment and migration of mesenchymal stem/stromal cells (MSC) into the wound site. In endosseous healing, this phenomenon is called Osteoconduction and represents a critically important phase of early bony healing and thus an essential pre-requisite to osseointegration. Tissue resident MSC are perivascular cells that migrate to the implant surface, differentiate into osteoblasts and form bone on the implant surface – Contact Osteogenesis. However, the functional anchorage of bone to the implant surface is dependent on the topography of the implant surface. We have established that three topographic scale ranges are critical, for different biologic reasons, to long-term functional osseointegration under load. Accelerating such osseointegration can not only be achieved by modifying implant surface design, but the time constant to achieve osseointegration, Tau, provides a unique and objective measure to compare the osseointegration potential of different implant surfaces. Upon completion of this presentation, participants should be able to: 1) identify the major biological events in early peri-implant wound healing; 2) explain the biologic rationale for implant surface design; and 3) discuss the new methods of being able to compare the osseointegration performance of different implant surface designs.

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Achieving Excellence with Implant Dentistry: Techniques Using Today's Evidence-based Principles
AUDIO ONLY

Speaker(s) :

  • Joseph Kan, DDS, MS

  • Achieving excellence in implant esthetics and function is a challenging and demanding procedure. Only by understanding the biologic and physiologic limitations of the soft and hard tissue as well as proper 4D implant position will facilitate predictability in simple to complex implant situations. This presentation will evaluate current implant treatment philosophies and methodologies for replacing missing teeth and the management of patients who will be losing a tooth or teeth, and ponder if these rules still apply in the future. Emphasis will be placed on the diagnosis and treatment planning, surgical and prosthetic management of soft and hard tissue. Upon completion of this presentation, participants should be able to: 1) discuss past and current principles in achieving peri - implant hard and soft tissue stability and will these rules still apply in the future; 2) determine the time for implant placement and loading and its effect on the outcome; and 3) describe 4D implant position and how it affects prosthetic submergence and esthetics outcomes.

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The Future for Osseointegration and Implant Dentistry and How Do We Prepare for the Future?

Speaker(s) :

  • Kenji Higuchi, DDS, MS

  • Since Brånemark's introduction of osseointegration, implant therapy has become synonymous with oral rehabilitation. Expanded clinical applications, evolving technologies and increased provider and public awareness of benefits have contributed to significant growth in implant procedures by specialists and general restorative dentists. The manner in which implant services are being delivered has been affected by socioeconomic and attitudinal changes within the profession and society. Factors such as educational debt, limited training and experience, industry marketing claims, social media, alterations in referral patterns and dental service organizations have influenced how implant treatment is delivered to our patients. This lecture provides an assessment of current challenges in contemporary implant practice as well as a discussion of opportunities to improve the quality of patient care for the future. Upon completion of this presentation, participants should be able to: 1) list three non-clinical factors that may influence the treatment planning decision process and execution of implant therapy; 2) identify a treatment modality commonly utilized but not fully supported by the evidence-based literature; and 3) describe two recommendations which may improve the quality of patient care in the future.


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