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Event ID : AO_SEATTLE
Academy of Osseointegration
2014 Conference Archive
Seattle, WA
March 6-8, 2014


The 29th Annual Meeting
Real Problems, Real Solutions

The 2014 Annual Meeting of the Academy of Osseointegration is an intensely educational three-day learning session for all dental professionals interested in gaining cutting-edge insights and continuing education from the world's most noted researchers and clinicians in the field of implant dentistry. This year's meeting "Real Problems: Real Solutions" will focus on how to diagnose, treat and prevent implant problems that are commonly encountered, especially with older implant cases. This is an excellent opportunity to learn from the past to provide better care for your dental implant patients, now and in the future.

Highlights of the Academy of Osseointegration's 2014 Annual Meeting are also available on a USB Flash Drive. 
Click Here to Order

AVAILABLE FORMATS:
Audio (MP3 Format): Individual MP3 files require a computer or MP3 player.
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 : $100.00


Table of Contents
Corporate Forum
Opening Symposium: Strategies to Address Implant Retreatment - Dealing with the 25 Year Old Implant
Limited Attendance Lectures
International Symposium
Surgical Track
Restorative Track
Innovative Treatment Approaches
Problem Solvers & Innovators
Closing Symposium: Our Better Future


March 6th, 2014
Corporate Forum
______________________

What are the Best Clinical Practices for Integrating Sustainable Implant Aesthetics into Smile Design?

Speaker(s) :

  • Ernesto Lee, DMD



March 6th, 2014
Opening Symposium: Strategies to Address Implant Retreatment - Dealing with the 25 Year Old Implant
______________________

Implants in the Esthetic Zone: Techniques and Perspectives After 20 Years of Collaboration

Speaker(s) :

  • Jonathan Ferencz, DDS and Burton Langer, DMD

  • This presentation will demonstrate the seamless collaboration of two experienced specialists. It will focus on time proven techniques for both the surgical and prosthodontic aspects of implant treatment in the esthetic zone, which have been the key elements of their success. In addition to numerous clinical "tips and tricks," there will be a discussion of the relevance of prevailing treatment concepts, such as immediate loading and platform shifting.

  • Objectives: Upon completion of this presentation, participants should be able to: 1) identify the key steps in implant placement in the esthetic zone; 2) recognize the key steps in restoring individual implants in the esthetic zone; and 3) discuss the value of the two-specialist collaboration in implant dentistry and how to better facilitate the relationship.

______________________

Is Crestal Bone Loss Around Titanium Implants a Risk to Long-Term Patient Care?

Speaker(s) :

  • Hom-Lay Wang, DDS, MSD, PhD

  • Implant crestal bone loss has recently become a main focus of implant dentistry and long-term stability. This presentation will address factors, such as biological bone remodeling, peri-implant diseases, biomechanical presentation complications and others that may cause implant marginal bone loss. Special emphasis will be placed on how the crestal bone loss may or may not influence implant long-term stability. Methods used to prevent and treat this initial crestal bone loss around titanium implants will also be presented.

  • Objectives: Upon completion of this presentation, participants should be able to: 1) recognize factors that contribute to implant crestal bone loss; 2) explain how to prevent implant crestal bone loss; 3) discuss how implant crestal bone loss may impact long-term implant stability; and 4) describe how to manage implant crestal bone loss and maintain long-term implant stability.

______________________

Decisions Regarding Implant Failure

Speaker(s) :

  • Frank Schwarz, DMD

  • In recent years, several treatment procedures such as access flap surgery debridement and chemical conditioning of the implant surface, topical or systemic antibiotic and/or antimicrobial therapy, and bone regenerative procedures have been advocated for both the resolution of the peri-implant infection and the restoration of the implant supporting tissues. While bone grafting techniques primarily attempt to fill and subsequently obstruct the osseous defect, rather than to address disease resolution, the latter aspect might primarily be achieved by a proper method of surface debridement/decontamination. The lecture will provide an evidence-based overview on currently available approaches for surgical regenerative/rexective therapy of peri-implantitis.

  • Objectives: Upon completion of this presentation, participants should be able to: 1) discuss how bacterial plaque biofilms may alter the chemical composition of the titanium oxide layer and therefore compromise the process of re-osseointegration; 2) discuss the impact of the method of surface decontamination on the clinical outcome following surgical regenerative therapy of peri-implantitis; and 3) describe currently available approaches for surgical regenerative/resective therapy of peri-implantitis.



March 7th, 2014
Limited Attendance Lectures
______________________

LA-1 Digital Implant Technology: Prevention and Solutions to Typical Problems

Speaker(s) :

  • Scott Ganz, DMD

  • Digital information has changed the manner in which we practice implant dentistry. Three dimensional data acquired through lower dosage CBCT scan technology allows the clinician to understand individual patient anatomy with greater accuracy and precision than two-dimensional peri-apical or panoramic radiography. The digital workflow however, often starts prior to the scan being taken with a proper diagnostic wax-up and radiopaque representation of the desired tooth position. The digital workflow continues with the use of sophisticated interactive treatment planning software, empowering the clinician with the tools required to plan restoratively-driven implant reconstruction. The digital workflow can be further enhanced with the use of intra-oral optical impressioning or optical scanning of stone casts to merge with the CBCT dataset, refining the diagnostic phase and providing the pathway to the CAD/CAM process for the restorative phase. All of these steps help to minimize potential risks and complications of both the surgical and prosthetic aspect of implant dentistry.

  • Objectives: Upon completion of this presentation, participants should be able to: 1) explain the new diagnostic digital workflow and how it can enhance clinical assessment of patient anatomy; 2) discuss how interactive treatment planning software provides new digital tools to relate the desired tooth position to the underlying bone; 3) describe potential complications associated with and without the use of this technology; and 4) provide the latest concept for the digital workflow and pathways to CAD/CAM restorative modalities.

______________________

LA-2 Maxillary Sinus Augmentation: Pitfalls, Complications and Management

Speaker(s) :

  • Zvi Artzi, DMD

  • Complications in sinus grafting procedures can occur mainly due to misinterpretation of anatomic factors and/or surgical pitfalls. Anatomical limitations such as thickness of the lateral bony wall or the lining mucosal membrane, the existence of an osseous septum in buco-lingual or anterior-posterior direction, can influence the success of the surgical outcome. Minor and/or major Schneiderian membrane perforations can be predictably resolved. A diminished (0-3mm) residual ridge height is another factor that should be taken into account. Innovative techniques will be highlighted on how to confront/control such obstacles. Finally, the issue of infection (pre and post op) will be raised by alternative solutions and how to manage such hazardous events.

  • Objectives: Upon completion of this presentation, participants should be able to: 1) recognize the components of the sinus anatomy; 2) anticipate and manage hazardous situations in sinus grafting procedures; 3) minimize the occurrence of sinus grafting complications; and 4) confront the post-operative infection.

______________________

LA-3 Factors Influencing Esthetic Results: Treatment Decisions

Speaker(s) :

  • Harold Baumgarten, DMD

  • All too often, the esthetics of an implant supported restoration look good on the day of insert but deteriorate over time. Success in the esthetic zone requires the clinician to understand the many factors that must come together to achieve and maintain the esthetic result for the long term. This lecture will discuss issues related to surgical and restorative techniques as well as implant design.

  • Objectives: Upon completion of this presentation, participants should be able to: 1) determine when to place an immediate implant with an immediate restoration and when to delay the implant; 2) describe the properties an implant must have to maximize esthetic results; and 3) discuss how impression techniques can impact the final esthetic result.

______________________

LA-4 Occlusal Complications with Implants: Over Twenty Years of Porcelain Fractures and Tooth Provisional Changes

Speaker(s) :

  • Gary Solnit, DDS, MS

  • This presentation will show how critical the occlusion is in designing implant restorations. Dr. Solnit will show over twenty year of clinical documentation of porcelain fractures and resultant tooth positional changes. Changes such as tooth intrusion, opening of proximal contacts and incisal edge discrepancies will be shown. As these complications occur, the occlusion changes with time and if the clinician doesn't recognize the changes, the restorative failures build upon themselves. Implants may "survive" for many years, however if the porcelain is fractured or an adjacent tooth moves away from an implant, the restoration is not a "success." This presentation will explore methods for designing different occlusal schemes and recognizing potential problems before they lead to porcelain fracture or movement of adjacent teeth.

  • Objectives: Upon completion of this presentation, participants should be able to: 1) explain how to develop different occlusal schemes based upon position of natural teeth and implants; 2) discuss how to prevent and identify potential catastrophes in large restorations; and 3) describe how to manage complications once they occur.

______________________

LA-5 Why are Provisionals Necessary to Create Ideal Esthetics in Implant Dentistry?

Speaker(s) :

  • Sonia Leziy, DDS

  • Brahm Miller, DDS

  • Achieving the best-likely implant esthetics requires precise steps beginning with diagnosis through to the restorative phase. This necessitates a clear understanding of what is possible, along with the skills required to meet the desired end-point. Each small advancement, whether a new concept or technique, will help in the initial and long-term stability of the treatment outcome. Provisionalization is a pivotal point and a significant stage in a surgical and restorative blueprint for predictable implant esthetics. Although it is characteristically thought of as a potential first step in the restorative treatment phase, increasingly, this has been incorporated into the surgical phase where possible. In fact, for immediate restoration and even for conventional load it should be viewed more accurately as the final surgical phase which defines the transmucosal tissue architecture, thus setting the groundwork for the definitive abutment design including the form and position of the margin as it enters the tissue which is of particular significance when cementing the final restoration.

  • Objectives: Upon completion of this presentation, participants should be able to: 1) explain why provisionalization is important to the durability of tissue contours and to superior post-restoration gingival levels; 2) discuss the clinical scenarios where provisionalization can be considered for single and small edentulous spans at the time of surgery vs. where it should be delayed to post-integration; 3) review the various provisionalization approaches, materials and design concepts that can be considered in the surgical setting or coordinated with the restoring dentist; 4) recognize how the developed tissue anatomy sets the framework for abutment design and how this needs to be communicated to the dental technician; and 5) discuss how provisionalization is closely tied to cementation success where screw-retained restorations cannot be considered.

______________________

LA-6 Inter-Implant Papilla Management in the Esthetic Zone
***AUDIO ONLY***

Speaker(s) :

  • Joseph Kan, DDS, MS

  • Achieving anterior implant esthetics is a challenging and demanding procedure. To create implant papilla that emulates nature is a fusion of science and art. Understanding the biologic and physiologic limitations of the soft and hard tissue will facilitate predictability in simple to complex esthetic situations. This presentation will focus on current implant treatment philosophies and methodologies for papilla management around multiple adjacent implants in the esthetic zone. Equal emphasis will be placed on the diagnosis and treatment planning as well as surgical and prosthetic management of soft and hard tissue for anterior implant papilla esthetics.

  • Objectives: Upon completion of this presentation, participants should be able to: 1) create diagnosis and treatment plans for multiple tooth replacement in the esthetic zone; 2) identify prognostic variables for predictable implant papilla esthetics; and 3) discuss the benefit of minimal invasive surgery and provisional support on inter-implant papilla.

______________________

LA-7 Placement of Implants into Extraction Sockets: Is there a Need for Speed?

Speaker(s) :

  • Stephen Jacobs, BDS MJDF RCS

  • This presentation will provide a look into the science and techniques that apply for the placement of implants into extraction sockets and their immediate restoration. There is much controversy surrounding the immediate placement of implants into fresh extraction sockets. This lecture will examine some of the evidence base, discuss case selection, explain the techniques that can be used and describe a protocol that can be implemented for the management of these cases. The fabrication of provisional crowns, the importance of implant design, implant position and the presence or absence of bone will be discussed.

  • Objectives: Upon completion of this presentation, participants should be able to: 1) identify and select patients who are suitable for immediate implant placement into fresh extraction sites; 2) select a suitable abutment and fabricate a provisional crown chairside, for the restoration of single tooth implants; 3) assess and describe which cases will need bone and/or soft tissue augmentation when carrying out immediate implant placements; and 4) discuss the risk factors that will determine the protocols followed and optimize their success rates.



March 7th, 2014
International Symposium
______________________

Placing and Maintaining Implants in Patients with Periodontal Disease
(Session presented in Japanese)

Speaker(s) :

  • Tetsuya Mizukami, DDS

  • Peri-implantitis is one of the more serious problems with implants. As is generally known, peri-implantitis has some risk factors, especially with a history of periodontitis. However at the same time, the implant plays a vital role in the treatment of periodontal disease by supporting occlusion. Needless to say, implants are very useful to secure occlusal support while treating advanced periodontitis. The progress of implant therapy in the last decade has brought faster osseointegration and a higher level of aesthetic treatment. However, along wih that innovation, issues such as rough surface fixture and/or new, various style and morphology of superstructure can be the causes of peri-implantitis. Today, even though several treatment approaches for advanced peri-implantis are available, they are not a definitive solution. Therefore, to prevent peri-implantitis when we place implants for the patients with periodontal disease, a prophylactic approach is necessary. In addition, signs of peri-implantitis should be identified at an earlier stage and risk factors should be diminished by rapid inflammation resolution.

  • This presentation will discuss some crucial points of implant therapy for the patient with advanced periodontal disease from the time of placing implants to maintaining, by showing some clinical cases from the view point of preventing peri-implantitis.

  • Objectives: Upon completion of this presentation, participants should be able to: 1) explain the key points of placing implants in patients with periodontal disease; 2) discuss the important points of implant restoration for the patients with risk of periodontal disease; and 3) describe the points of maintenance, earlier intervention and recovery for the patients who have a higher risk of periodontal disease.

______________________

Treating Multiple Supra-Alveolar Defects Caused by Advanced Periodontal Disease: Esthetic Outcomes and Real Solutions
(Session presented in Japanese)

Speaker(s) :

  • Tomohiro Ishikawa, DDS

  • This presentation will introduce five possible treatment options for the esthetic damage caused by advanced periodontal disease. Three options will be covered in detail. Using orthodontic extrusion, root submergence, and 3-D ridge augmentation allows the practitioner to treat the tissue damage of multiple supra-alveolar defects to ensure functionality and esthetics. At the core of all treatment planning is the goal of patient satisfaction. It is with this in mind that I will introduce a number of challenging cases and walk through the process of defect evaluation, treatment selection, and final esthetic tissue management.

  • Objectives: Upon completion of this presentation, participants should be able to: 1) assess the five possible methods for treatment of esthetic problems arising from supra-alveolar defects and advanced periodontal disease; 2) explain how to use an implant as an anchor and vertical support for orthodontic treatment including methods of communication with orthodontists and establishing a framework for optimal orthodontic extrusion; 3) discuss the potential of viable roots for ridge preservation and the creation of an esthetic soft tissue architecture using the root submergence technique; and 4) list the 3-dimensional requirements and tissue regeneration for implant placement and esthetic management in areas of multiple tooth loss.

______________________

Application of Gum-Colored Titanium Abutments in the Esthetic Region
(Session presented in Japanese)

Speaker(s) :

  • Takashi Sumi, DDS, PhD

  • Use of a titanium abutment in the anterior/lateral region often compromises esthetics due to the gray color showing through the gingival tissues. As a solution to this disadvantage, this presentation will discuss a developed anodization technique to give a warm gum-color to the surface of titanium abutments

  • Objectives:Upon completion of this presentation, participants should be able to: 1) explain how the gum-colored abutment surface achieved by the anodization technique could deliver good esthetics when replacing the anterior teeth in the maxilla; 2) describe the advantages of using zirconia and gold alloy abutments; 3) explain how to manufacture the gum-colored abutment; and 4) consider the importance of an abutment more earnestly.

______________________

Stem Cell Therapy and Clinical Long-Term Progress, and the Future Possibilities for Dental Implants

Speaker(s) :

  • Yoichi Yamada, DDS, PhD

  • A golden standard of bone grafting is still autologous bone transplantation. However, it requires injuring a healthy region. The collection amount is limited and absorption of grafted bone occurs. To overcome these problems, we applied tissue engineering and regenerative medicine (TERM) technology with minimal invasiveness for severe bone atrophy. In this presentation, we show the clinical protocol and results that were applying for dental implants such as socket preservation, sinus floor elevation, guided bone regeneration and periodontal disease. The favorable outcome was obtained and long-term prognosis remained in stable condition without bone resorption. Next, the possibility of bone regeneration using dental pulp stem cells will be introduced. It has high proliferative and bone regenerative ability and may be a useful cell source for tissue-engineered bone around dental implants. This TERM technology would develop a novel treatment option and contribute to dentistry and medical fields such as refractory disease.

  • Objectives: Upon completion of this presentation, participants should be able to: 1) discuss the concept and application of regenerative medicine; 2) explain the clinical application method and the process by the novel regenerative medicine approach; 3) describe the characterization and bone regeneration ability by bone marrow derived mesenchymal stem cells, periosteal cells, and dental pulp stem cells from permanent and deciduous teeth;and 4) review the future clinical application views of stem cell therapy.

______________________

Options and Decision Factors for Implant Treatment with Esthetic and Functional Results

Speaker(s) :

  • Kenji Tsuchiya, DDS

  • This presentation will focus on the important factors to perform successful implant therapy. It is important to manage soft tissue depending on the biotype and search confirmation of the risk factors in implant surgery and methods of solution. It is also necessary to select the material of superstructure toward occlusal force for long-term stability. Case studies will be shown as the most effective process for desirable outcome will be discussed.

  • Objectives: Upon completion of this presentation, participants should be able to: 1) discuss the methods to avoid risk factors of failures in peri-implant esthetics and function; 2) describe effective methods of CAD/CAM planning for implant position; and 3) explain material selection and design the implant restoration for long-term stability.

______________________

Retrospective Evaluation of Success and Failure in the Esthetic Zone: Problems, Treatment and Prevention

Speaker(s) :

  • Ken Akimoto, DDS, MSD

  • Using dental implants to treat a missing tooth or missing teeth in the esthetic zone has always been a major challenge, both surgically and restoratively. With better understanding of biology around implant, the effect of its macro design to the surrounding tissue, achieving good esthetic result has now become predictable. This presentation will focus on problems, treatment and prevention of replacing a single tooth in the esthetic zone.

  • Objectives: Upon completion of this presentation, participants should be able to: 1) discuss the biological and mechanical factors that influence outcomes of treatment in the esthetic zone; 2) recognize what makes peri-implant tissue esthetic or unesthetic; 3) explain when you should be selecting an immediate implant and when not to; and 4) describe different techniques to prevent esthetic failure.



March 7th, 2014
Surgical Track
______________________

How to Manage Failing Implants with Peri-implantitis: Advisability and Predictability

Speaker(s) :

  • Paul Rosen, DMD, MS

  • Implants are an important treatment approach for managing a broad range of clinical problems due to their high level of predictability and their ability to be used for a wide variety of treatment options. While in many cases, dental implants have been reported to achieve long-term success, they are not immune from biologic complications associated with their maintenance or lack thereof. Peri-implantitis is an inflammatory condition of the soft and hard tissues of a dental implant leading to progressive loss of supporting bone beyond biological bone remodeling The dilemma for clinicians is how to manage this difficult conundrum. This lecture will explore some of the treatment options ranging from non-surgical approaches to regeneration to extraction with the inherent risks and limitations. Emphasis will be placed on how surgery, in particular a regenerative algorithm, can be a predictable means for dealing with peri-implantitis.

  • Objectives: Upon completion of this presentation, participants should be able to: 1) discuss the limitations of non-surgical approaches for treating peri-implantitis; 2) describe possible reasons for why some attempts at surgical therapy for peri-implantitis have failed; 3) explain why and when a regenerative surgical approach may be implemented to restore maintainable health; and 4) list methods for optimal implant surface decontamination.

______________________

Bone Grafting for Vertical Augmentation

Speaker(s) :

  • Craig Misch, DDS, MDS

  • Vertical bone augmentation of the maxilla and mandible is the most difficult type of graft to perform successfully. The biologic environment is less conducive to bone growth requiring the use of graft materials that have greater capacity to form bone. In addition, soft tissue closure and provisionalization of the patient can be challenging. This lecture will review the current literature on the topic as well as present clinical cases describing the management of these types of cases. The use of autogenous bone and bone substitutes with growth factors such as PRP, rhBMP-2, and rhPDGF will be highlighted.

  • Objectives: Upon completion of this presentation, participants should be able to: 1) describe why vertical augmentation is biologically and clinically more challenging; 2) explain the limitations of some methods of vertical bone augmentation; 3) review various clinical techniques for vertical bone grafting and methods to manage soft tissue closure and provisionalization; and 4) discuss the use of growth factors to enhance outcomes with bone substitutes as an alternative to autogenous bone.

______________________

Grafting the Failed Maxilla

Speaker(s) :

  • Ole Jensen, DDS, MS

  • The failed maxilla is most often due to failure or complication from previous surgical prosthetic dentistry. These failures can be particularly ablative especially in the maxilla. Failed implant cases for example can essentially cause complete alveolectomy as well as disturbance of basal bone. At other times, failed sinus grafts placed to support implants is another complication difficult to reconstruct. Reconstruction of these lesions is reminiscent of tumor ablation surgery that have well established protocols using iliac or cranial only grafts, even vascularized grafts. But in a dental treatment setting, in which a large reconstruction on implants has failed or partially failed, what is the clinician to do?

  • Objectives: Upon completion of this presentation, participants should be able to: 1) explain why diagnosis and treatment of a failed maxillary treatment should be carefully considered as healing potential and patient resilience is reduced; 2) discuss the major breakthrough in treatment of complex alveolar deficiency using BMP-2 under a titanium mesh or Printed titanium shell; and 3) explain why the use of osteoperiosteal flaps, even in the presence of sinus or nasal involvement, is the most dramatically effective of all augmentation procedures particularly in the esthetic zone.

______________________

Esthetic Failures and Retreatment

Speaker(s) :

  • Kenneth Hinds, DDS

  • Treatment of esthetic failures in the partially edentulous patients requires an interdisciplinary team approach, patient management and good communication. With all the modern augmentation techniques and materials available today, treating ridge deformities is still a significant challenge in dentistry. This presentation will outline parameters to assist in determining when a surgical approach is indicated and when a prosthetic approach (pink esthetics) is required. Intraoral digital impressions utilizing a custom scan body to produce an accurate soft tissue transfer of implants in both an ideal and non-ideal position will also be discussed.

  • Objectives: Upon completion of this presentation, participants should be able to: 1) define parameters which distinguish treatment options for ridge deformities by a surgical approach or prosthetic approach; 2) discuss diagnostic aids to determine treatment solutions; and 3) explain intraoral digital impressions utilizing a custom scan body to enhance soft tissue transfer of an implant in a non-ideal position.

______________________

Paresthesias/Dysthesias: Prevention and Management

Speaker(s) :

  • Daniel Taub, DDS, MD

  • Surgical placement of endosseous mandibular implants can result in injuries to peripheral branches of the trigeminal nerve. Careful treatment planning, surgical technique, radiographic imaging and software applications can minimize this risk. If an injury occurs, surgeons should understand the type of injury and options for treatment. This presentation will review classifications of nerve injuries and provide recommendations for practitioners to manage these patients.

  • Objectives:Upon completion of this presentation, participants should be able to: 1) recognize that successful implant placement lies in appropriate diagnosis of the disease and fabrication of a comprehensive treatment plan to avoid neural injury; 2) identify neural structures and associated anatomy on radiographs which may include 3-dimensional CT imaging and/or 2-dimensional radiographs such as panorex and periapical films; 3) identify neurosensory disturbances and diagnose them in an organized fashion, including direct nerve injuries (needle stick/drilling) vs. indirect (compressive/stretching) nerve injuries; and 4) describe the availability and application of conservative therapy and its effectiveness and when to surgically intervene.



March 7th, 2014
Restorative Track
______________________

Provisionalization Problems

Speaker(s) :

  • Harel Simon, DMD

  • The concept of provisional restorations in implant dentistry was introduced to the dental literature more than a decade ago. Various types of provisional prostheses can be created with different materials for numerous applications. However, it is not always clear which method of provisionalization is appropriate for each clinical situation and what benefits should be expected from each kind. This presentation will review the challenges of provisionalization in implant dentistry and demonstrate their ability to allow the clinican to turn a treatment plan from vision into reality.

  • Objectives: Upon completion of this presentation, participants should be able to: 1) discuss the importance of provisional restorations to predictable esthetics and function; 2) identify methods for transferring prosthetic teeth positions from a tentative plan, through a provisional to a definitive prosthesis; 3) select and design provisional prostheses for different treatment scenarios; and 4) differentiate between a treatment provisional and a prototype provisional.

______________________

Peri-implant Cement Extrusion: Prevention and Resolution

Speaker(s) :

  • Chandur Wadhwani, MSD

  • The choice of implant restoration has been shown to potentially affect the long-term health of implant and surrounding tissue. Many factors play a role in the link between residual excess cement and peri-implant disease. The amount of cement remaining, the type of cement, the interaction with titanium, that patient's response to allergenic materials all play a role. While it is almost impossible not to use cement restorations, this session will provide the latest evidence for what is occurring as well as offer solutions to this problem. Latest scientific research from around the world will be presented.

  • Objectives: Upon completion of this presentation, participants should be able to: 1) explain why a link between cements and peri-implant disease exists and how the restorative dentist must factor this into the treatment plan prior to surgery to minimize the possibility of an issue developing years later; 2) discuss what cements to definitely avoid as well as the limitations of all cements that exist today and how microbiological aspects as well as cements can cause titanium to lose its passive nature; 3) describe how he most current research will change how we cement implant restoration; and 4) explain alternatives to the way implants are restored.

______________________

Abutment Design: Problems and Solutions

Speaker(s) :

  • Ingeborg De Kok, DDS, MS

  • For years, patients have received long-term benefits with implant supported restorations. However, while implant success is high, there are still a good number of patients that experience problems with these prostheses. Many of these complications are related to the abutments that support the prostheses and some could be avoided by choosing the right design. This presentation will focus on the various challenges that we experience as restorative dentists and possible solutions.

  • Objectives: Upon completion of this presentation, participants should be able to: 1) recognize the important role that the abutment plays in the final outcome of the restoration, in order to avoid common problems; 2) discuss abutment characteristics to consider when selecting the components and how they affect the esthetics of the final prostheses; 3) describe the mechanics of different abutments in order to reduce implant complications; and 4) discuss different approaches to the problems encountered with implant abutments.

______________________

Solving Esthetic Problems After Implant Placement

Speaker(s) :

  • WIlliam Martin, DMD, MS

  • Dental implants are a viable option for the restoration of form, function and esthetics in our patient population. Unfortunately, there are clinical situations where the implant team is faced with esthetic challenges in restoring implants post-placement. These challenges can be related to the position of the implant, volume of available soft-tissue for shaping and shade of the surrounding dentition, to name a few. This presentation will introduce clinical techniques and materials that can be utilized to overcome these restorative obstacles to achieve esthetic success.

  • Objectives: Upon completion of this presentation, participants should be able to: 1) discuss clinical techniques and abutment selection that can be utilized to restore malpositioned implants; 2) identify provisional contours to shape peri-implant tissue and provide optimum emergence and tissue support; 3) describe techniques to replace missing tissue with prosthetic alternatives; and 4) explain evolving prosthetic materials and abutments to match the surrounding dentition.

______________________

Esthetic Failures on Dental Implants: Remediation and Prevention

Speaker(s) :

  • Stephen Chu, DMD, MSD, CDT

  • The criteria for esthetic success of anterior implants is the absence of midfacial and interproximal tissue loss. Unfortunately, it is not uncommon when such deficiences exist, lending to patients to seek corrective treatment. This presentation will focus on managing midfacial esthetic defects around anterior single tooth implants from diagnosis, etiology, to treatment and sequence. A discussion of immediate post-extraction socket implants will be given, encompassing the risks and benefits of such therapy. In addition, how to avert the potential for midfacial recession with immediate anterior implants will be covered, and whether grafting and/or a provisional restoration or custom healing abutment makes a difference in esthetic treatment outcomes. Lastly, new innovative techniques in provisional restoration fabrication will be presented.

  • Objectives: Upon completion of this presentation, participants should be able to: 1) explain the importance of proper implant positioning to prevent midfacial recession; 2) describe how to contour the prosthetic restoration when excessive buccal implant position exists; 3) list the benefits of bone grafting with provisional restoration fabrication; and 4) discuss how to create the proper supportive subgingival contour to the peri-implant soft tissues.

______________________

Prevention and Management of Complications with Fixed Implant Rehabilitation of the Edentulous Jaw

Speaker(s) :

  • German Gallucci, DMD, PhD

  • This lecture explores the current scientific and clinical evidence on different implant-prosthodontic parameters affecting the success of implant-supported rehabilitations in the edentulous jaws. Different treatment regulators such as implant placement protocol, prosthetic design, loading protocols, retention mechanism, prosthodontics material, etc. will be presented based on the current evidence. Emphasis will be given to the importance of an appropriate implant-prosthodontic treatment planning in order to increase the long-term success and minimize the frequency and severity of complications.

  • Objectives: Upon completion of this presentation, participants should be able to: 1) discuss the prosthodontic, biological and technical complications in complete fixed implant-prostheses in the edentulous jaw; 2) discuss the common factors that may affect the implant-prosthodontic success; and 3) recommend established clinical protocols for the prevention of complications.

______________________

Implication of Prosthetic Design on Speech

Speaker(s) :

  • Bruno Collaert, DDS, MSc, PhD

  • Speech problems may occur in up to half of the implant patients undergoing rehabilitation for maxillary edentulism. The scientific community has not paid much attention to this problem. To date, most clinicians have taken a wait and see stance, hoping patients will adapt their speech as time goes by. Recent research has shown that a majority of the patients experience speech problems after rehabilitation and only a minority fully adapt. After understanding that speech problems originate from anatomic changes in the oral cavity when edentulousness comes about, a hypothesis was formulated and tested. If the prosthetic rehabilitation is adapted to a form which agrees more with the original anatomic contours, speech problems will get solved or minimized. This was studied in a population receiving maxillary full-arch, screw-retained restoration. 3-D evaluation of changes in anatomic contours of the restorations and their impact on speech will be highlighted. Guidelines on how to handle and avoid speech-related problems will be provided.

  • Objectives: Upon completion of this presentation, participants should be able to: 1) discuss the prevalence of speech problems with prosthetic designs; 2) explain why speech problems may occur after rehabilitation in the maxilla; 3) identify patients with speech problems after rehabilitation in the edentulous maxilla; and 4) adapt prosthetic design to solve or minimize speech problems.



March 7th, 2014
Innovative Treatment Approaches
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Bone Grafting Techniques and Materials

Speaker(s) :

  • Mark Reynolds, DDS, PhD

  • An understanding of bone grafting techniques and materials is cited for achieving successful and predictable alveolar ridge augmentation in clinical practices. This program will review current bone grafting techniques and materials as well as emerging technologies. Emphasis will be placed on the clinical parameters that are important in selecting a surgical approach and graft materials.

  • Objectives: Upon completion of this presentation, participants should be able to: 1) describe the different types of bone grafting techniques and materials; 2) explain the role of clinical parameters important in the selection of surgical approach and graft material; 3) recognize strategies to avoid complications common to different regenerative approaches; and 4) describe clinical applications of outcomes based on recent evidence-based reviews.

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Connective Tissue Grafts in Implant Therapy

Speaker(s) :

  • Kirk Pasquinelli, DDS

  • In the esthetic zone, the soft tissue form, appearance and volume around an implant can make the difference between a restoration that is perceived as esthetic or as an eyesore. This presentation will describe the soft tissue anatomy around implants, the surgical procedures to improve the appearance of these tissues and how implant restorations influence this tissue. Treatment of soft tissue aberrations via restorative and surgical approaches will be explained through a review of several cases. The participant will gain an understanding of the relationship of bone and soft tissue implants and implant restorations as well as how to manipulate the soft tissues in order to improve esthetic outcomes.

  • Objectives: Upon completion of this presentation, participants should be able to: 1) describe the anatomical relationship between bone and soft tissues surrounding teeth and implants and how it affects esthetics; 2) discuss when tissue augmentation procedures will be necessary to improve esthetic outcomes with implants; and 3) explain a variety of techniques to enhance the esthetic outcomes of implant-supported restorations.

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Milled, Screw Retained Prosthesis Evolution

Speaker(s) :

  • David Guichet, DDS

  • The traditional methods of creating implant supporte restorations are on a precipice of change and are being replaced. The multiple technologies of 3D CBCT imaging, 3D modeling, digital restorative design and CADCAM production have contributed to this trend. Simultaneously, restorative materials have ben introduced that have improved strength and esthetic qualities. Integration of these capabilities create opportunities for enhanced restorative performance and practice efficiency. This presentation will highlight a practice-based model centered on Digitally Enhanced Treatment.

  • Objectives: Upon completion of this presentation, participants should be able to: 1) recognize digital treatment protocols in contrast to traditional workflows; 2) identify digital technologies that enhance treatment outcomes and explain the difference of open and closed systems and “best in breed;” 3) anticipate the uses and limitations of digital restorative design and CAD/CAM production; and 4) discuss the trends in esthetic implant restorative material selection and design options.

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Esthetics and Pink Ceramic vs. Composite Material Evolution

Speaker(s) :

  • Enrico Steger, MDT

  • Transferring an individual dentition onto the working model is a complex and time-consuming process, involving a high risk of error, particularly when placing implants. This is the area where the new CAD/CAM technologies open up new ways in terms of eficiency, quality and precision. The new digital techniques provide an improved collaboration and coordination between dentist and dental technician, especially in implant prosthetics for the benefit of the patient. The import of CT-DATA into the CAD software allows creating precise drilling templates and operation plans. The design of provisory restorations in resin enables the realization of suitable restorations.

  • Objectives: Upon completion of this presentation, participants should be able to: 1) describe construction process of a monolithic circular zirconia bridge; 2) discuss general knowledge of CAD/CAM technology; and 3) discuss in-depth information about zirconia and its properties.

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Perils and Pitfalls of 3D Treatment Planning

Speaker(s) :

  • Gary Orentlicher, DMD

  • The use of Computer Aided Design/Computer Aided Manufacturing (CAD/CAM) and digital technologies in the surgical and restorative disciplines of dentistry is no longer a concept for the future. These technologies are being commonly used for patient evaluation, planning, and treatment today. The use of CT Guided implant surgery has greatly expanded over the last decade as concepts and techniques have become more refined and more manufacturers have adapted their implant systems by developing surgical and laboratory armamentarium. Although these technologies have been proven to improve the accuracy of implant placement using minimally invasive techniques, their widespread adoption by the dental community is yet to be seen.

  • Objectives: Upon completion of this presentation, participants should be able to: 1) explain the workflow using CT Guided Surgery; 2) discuss some of the possible problems that can develop with each step in the Guided Surgery workflow; and 3) identify the necessary steps to successfully incorporate CT Guided Surgery into their practices.



March 8th, 2014
Problem Solvers & Innovators
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How to Make a Decision Between Short/Narrow Implants and Longer/Wider Ones and Bone Grafts

Speaker(s) :

  • Franck Renouard, DDS

  • The goal of this lecture is to help the practitioner make the decision between using short implants vs. longer implants along with a bone graft. Decisions based on success/survival rates will be discussed as well as considering other parameters such as the morbidity and feasibility of the different procedures. This presentation will also discuss the selection of treatment procedures and weigh the benefits and risks of simple vs. complex procedures.

  • Objectives: Upon completion of this presentation, participants should be able to: 1) describe the difference between the competence and the performance; 2) they will discuss that the more complex a procedure is, the higher the risk of complications will also be; 3) explain how the decision making process is a very complex task and how it is illusory to think that the best decision is taken only from literature review; and 4) identify the human factors (stress, fatigue, overload, routine etc.) which interfere both during the decision making process (clinical examination) and during the procedure (surgery).

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When and Why Prosthesis Fail

Speaker(s) :

  • Urs Brägger, DMD

  • This presentation will provide an overview on the expected complication and failure rates over time with reconstructions based on systematic reviews an dour own data. Risk factors which are associated with increased rates of mechanical and technical failure/complication rates will be discussed as well as attempts to avoid/reduce failures and complications.

  • Objectives: Upon completion of this presentation, participants should be able to: 1) explain a synoptic overview related to the incidences of failures/complications over time with different types of reconstructions; 2) identify which factors can elevate the risk for failures/complications; and 3) apply preventive measures to avoid/reduce the risk.

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Fixing Component Failure and Fracture

Speaker(s) :

  • Charles Mastrovich, DDS

  • This presentation will clarify the clinical dilemma of clearing fractured components from otherwise useable implants. The mechanical algorithm that will be discussed, will clearly allow the clinician to effectively evaluate the difficulty of a case to avoid common clinical errors which can rapidly escalate into a difficult iatrongenic problem, or worse, create a non-usable implant.

  • Objectives: Upon completion of this presentation, participants should be able to: 1) evaluate the difficulty in retrieving a fractured abutment or screw; 2) explain how retrieval techniques apply to clinical situations and what action to take; and 3) describe the specialized tooling necessary for success in difficult areas.

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Implants and the Maxillofacial Predicament
***AUDIO ONLY***

Speaker(s) :

  • Lawrence Brecht, DDS

  • The art of reconstruction of the mandible and maxilla has rapidly progressed due to the advent of virtual surgery. The development of computer-aided, three-dimensional planning along with computer-fabricated surgical splints and cutting jigs now allow for a prosthetically-driven, occlusally-based rehabilitation in combination with unprecedented precision in surgical reconstruction of form and function. The culmination of technology employed in an active multidisciplinary team setting has resulted in the ability to deliver an implant-supported prosthetic rehabilitation for the mandibular or maxillary resection patient during a single reconstructive surgical episode. This presentation reviews the evolution of the collaborative effort of our team of an oral and maxillofacial surgeon, a microvascular plastic surgeon, and a maxillofacial prosthodontist in optimizing the outcomes in our mandibular resection patients.

  • Objectives: Upon completion of this presentation, participants should be able to: 1) identify the importance of pre-surgical computerized planning and functional occlusal design; 2) review the benefits of interdisciplinary, virtually planned, and prosthetically-driven functional maxillomandibular reconstruction and rehabilitation; 3) provide an algorithm for one-stage jaw rehabilitation; and 4) discuss future trends in computer-aided surgical simulation and rehabilitation (CASSAR).



March 8th, 2014
Closing Symposium: Our Better Future
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Advances in Biotechnology Related to Implant Therapy

Speaker(s) :

  • Peter Wöhrle, DDS, DMSc, CDT

  • Recent advances in implant prosthodontics have focused on several areas: 1) digital data collection and management prior to treatment, with the possibilities to plan the exact prosthetic reconstruction in advance, allowing for precise execution of a well-designed plant to maximize prosthetic outcomes; 2) dental materials and prosthetic design to enhance tissue response by using biocompatible materials and subgingival contours that promote tissue stability; 3) CAD/CAM designed prosthetic restorations that allow for a more esthetic, predictable restoration at less cost thus allowing more patients to afford this treatment modality. This program will focus on each of these three areas and the relationship between them.

  • Objectives:Upon completion of this presentation, participants should be able to: 1) discuss how digital data acquisition and planning can help establish the potential and limitation of any proposed treatment; 2) develop strategies that allow for long-term predictability and anticipate potential future treatment; and 3) apply a materials selection algorithm to select the most appropriate dental materials for the various indications.

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Digital Dentistry: Foundation for Ultimate Communication

Speaker(s) :

  • Lee Culp, CDT

  • As dentistry evolves into the digital world, the successful incorporation of computerized and new acquisition and manufacturing technologies will continue to provide more efficient methods of restoration fabrication and communication while at the same time retaining the individual creativity and artistry of the skilled dentist and technician. The utilization of new technology will only enhance the close cooperation and working relationship of the dentist/technician team. The evolution from hand design to digital design and the application of diagnostic 3-D previews, along with provisional restorations and their digital replicas to guide the restorative team in the creation of CAD/CAM and implant restorations will be presented along with the latest developments in laboratory and intraoral scanning, materials and computer milling/printing technology.

  • Objectives: Upon completion of this presentation, participants should be able to: 1) describe the communication possibilities for digital 3D communication between dentist and laboratory; 2) explain the process for creating digital diagnostic previews and provisional restorations for treatment planning and patient education; and 3) discuss the different types of restorative materials and the digital process of fabrication with milling and printing technology.

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Advances in Clinical Implant Prosthodontics

Speaker(s) :

  • Peter Wöhrle, DDS, DMSc, CDT

  • Recent advances in implant prosthodontics have focused on several areas: 1) digital data collection and management prior to treatment, with the possibilities to plan the exact prosthetic reconstruction in advance, allowing for precise execution of a well-designed plant to maximize prosthetic outcomes; 2) dental materials and prosthetic design to enhance tissue response by using biocompatible materials and subgingival contours that promote tissue stability; 3) CAD/CAM designed prosthetic restorations that allow for a more esthetic, predictable restoration at less cost thus allowing more patients to afford this treatment modality. This program will focus on each of these three areas and the relationship between them.

  • Objectives:Upon completion of this presentation, participants should be able to: 1) discuss how digital data acquisition and planning can help establish the potential and limitation of any proposed treatment; 2) develop strategies that allow for long-term predictability and anticipate potential future treatment; and 3) apply a materials selection algorithm to select the most appropriate dental materials for the various indications.

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The Realities In an Implant Dentistry Future

Speaker(s) :

  • Dennis Tarnow, DDS

  • This presentation will focus on the innovations in the implant world that will shape what we put into people's mouths. Focus on stem cell research of new abutment and implant surfaces will be highlighted as well as new innovations in biomaterials that are in our future.

  • Objectives: Upon completion of this presentation, participatns should be able to 1) discuss the limitations of the implants that we presently use; 2) explain the future possibilities of new surfaces; and 3) describe the types of attachments to abutments and implants that are not yet available but soon will be.


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