A comprehensive planning and perfect execution of implant dentistry protocols for full arch cases always has been challenging. Minor errors can have detrimental repercussions on the longevity of the work we do. This presentation aims to present a novel classification system for planning of full arch cases. From assessing the available bone, to lip lines and determining the final prosthetic material and design; all this keeping the patients age in sync with the proposed treatment is the need of the hour. The classification is open ended to allow room for all philosophies of implant dentistry from tilted implants to zygoma or pterygoid implants and any grafting protocol in between. It has the bandwidth to allow all the current digital protocols as well as time tested analogue ones, thereby making this a truly patient-centered approach.
Understand the interplay of factors in the ABCD algorithm and use it for effective treatment planning
Understand the selection criteria for materials and designing options in modern full arch implant dentistry
Understand the workflow of Digital Dentistry in full arch implant prosthodontics
The evolution of Implantology has allowed for new standards to be reached, hard to imagine only a few years ago. Now, new challenge is to treat the patient through a simpler way while maintaining or even improving the high level of treatment quality.
The accurate planning of the clinical case is extremely important in achieving this goal and, during the last few years, the impact of digitalization has hugely improved the way to address the implant treatment.
In fact, computer-guided planning, intra oral scanning and digital tools are the modern keys to optimize the implant positioning in relationship with the bone availability and the ideal prosthetic plan.
Nevertheless, there are few details of the procedure that, even nowadays, are still well managed by using an analog approach.
During this lecture, these details will be taken into account with the purpose to discuss when the complete digital workflow is not the first choice and which are the steps that should be treated from the analog side.
Abstract For a successful and predictable implant therapy in the esthetic zone we need to know that advantages and disadvantage of delayed versus immediate implant placement.
As a clinician you need to know the long-term prognoses of both treatment modalities, you need to know the limits and chances for the esthetic outcome and you need to know your personal limits in different clinical situations.
Based on complications of esthetic cases you will better understand how to make the right decisions for every individual case and to choose the right timepoint after tooth extraction.
You will learn the advantages and disadvantages of delayed implants
You will learn about the long-term outcome of immediate implants versus delayed implants in the esthetic zone
You will understand how to make the right decisions for every individual case related to immediate versus delayed implant placement
Ronald E. Jung
Session 3 – Treatment of soft tissue defects: do we have relevant innovation?
Treatment of soft tissue defects: Do we have real innovation? The role of keratinized mucosa
Dental implants have demonstrated high survival rates in the last decades, however with the ever-increasing attention to esthetics and integration of the restorations that are placed in the patients oral cavity, the pink esthetics have gained relevance. Dental implants, particularly in the anterior zone, are expected to blend within the patients smile and subtle changes in the length of the restoration, color and contour of the soft tissue may be quickly appreciated by the patients. It is for this reason that the prevention and treatment of soft tissue defects around implants has recently gained attention by the scientific community. The keratinized mucosa has been considered to have a protective role in development of peri-implant mucositis and peri-implantitis but also in the development of mucosal dehiscence’s around implants. The objective of this presentation is to elaborate on the role of keratinized mucosa in the development of these conditions and to describe the available surgical techniques used to improve the amount of keratinized mucosa around dental implants.
To be functionally useful, oral implants have to pierce the gingiva and enter the oral cavity, thus establishing a transmucosal connection between the external environment and the inner parts of the body. Still, the major goal is to obtain long-term peri-implant health based on stable soft tissue dimensions. Thus, periodontal plastic microsurgical soft tissue grafting procedures are increasingly performed in conjunction with dental implants. From a biological point of view the gain of keratinized mucosa and soft tissue thickness is associated with stable peri-implant health. From an esthetic point of view, increased soft tissue thickness (thick peri-implant phenotype) may decrease the risk of recessions and loss of papilla-like tissue. Since almost 50 years the connective tissue graft is used for periodontal indications (Edel 1974). Hundreds of studies were published and made this technique to the Golden Standard. Nowadays new biotechnological materials enter the dental field to replace the subepithelial connective tissue transplant in order to avoid the donor harvesting surgery. The lecture checks wether there are still advantages for CTGs and which modifications in microsurgical techniques surpass those of biotechnological matrices.
Treatment of soft tissue defects at dental implants is still a great challenge for the clinician. A number of factors such as position of the implant within the bony envelope, presence or absence of supporting bone, recession depth and width, and thickness of the soft tissues may limit the management of soft tissues and consequently impair the outcomes. Emerging evidence indicates that by having a correct indication, the modified coronally advanced tunnel (MCAT), the laterally closed tunnel (LCT) or the very recently described combination of MCAT and LCT in conjunction with connective tissue grafts, certain collagen based soft tissue grafts alone or combined with biologics may result in predictable outcomes and long-term stability.
Xenogeneic three-dimensional (3D) collagen matrices may represent an alternative to autologous soft tissue grafts in periodontology and implant dentistry. In a series of experiments, we have investigated the adsorption and release of growth factors from four 3D collagen-based matrices and the migratory, proliferative, wound healing, and differentiation potential of primary human oral fibroblasts (hOF), primary human periodontal ligament cells (hPDL) as well as two osteoprogenitor cell lines in response to four clinically used matrices.
Among the evaluated matrices, a newly introduced hydrated acellular dermal matrix (HADM) has consistently been shwon to exhibit stronger positive effects on the oral cellular behavior. Furthermore, new data strongly support the biofunctionalization of the 3D matrices as a potential treatment modality for soft tissue and bone defects in the clinical setting.
The aims of the presentation are
To outline the indications and contraindications for correction of soft tissue defects at dental implants.
To present the biologic rationale and the clinical indication for using soft tissue replacement materials for the correction of soft tissue defects at dental implants.
Session 4 – CAD/CAM implant supported restoration – are they a must?
The dental world is changing and making the right decision for our patient gets more and ore complex nowadays. Especially the digital workflow goes far beyond intraoral scanning and CAD/CAM of dental restorations. Especially in the field of implantology, digital planning and full digital processes are possible, however still have limiting factors. The fast development in technology and the range of uncountable material-options for all treatment steps make it difficult for dentists and technician to keep an overview.
The lecture will give an overview of current technological possibilities, workflow and material options and dares to bridge the gap between scientific background and clinical application in daily routine. Starting at impression taking – over individual gingiva formers to implant supported restorations.
In short – which workflow, which material make sense and what are the parameters that matter to be successful because the knowledge makes the difference!
The one abutment one time concept presents biological advantages. In this lecture, the literature background and the practical aspects of this concept will be introduced and discussed.
For worfklow efficiency purpuses, and thanks to the possibilities the Ti-base components and the digital workflow offer, the one crown one time concept was developed. The approach of the Geneva Team of Fixed Prosthodontics to this evolved concept will be presented, reviewing its advantages, limitations, and tips and tricks for its application in the clinics.
Participants’ learning objectives
Literature background of The One Abutment One Time concept.
Advantages, limitations and application of The One Crown One Time concept.