Forum Speakers Index
M Tareq Ahmado
Tareq Ahmado qualified with honours from Hama Dental School, Syria in 2000 and has over ten years of UK experience in Oral and Maxillofacial Surgery. He is a Speciality Doctor in Oral Surgery at St Helens and Knowsley NHS Trust, and along with this has run the referral Implant service the Implant and Graft Portal since 2011.
He has been a Member of the Royal College of Surgeons of England since 2006 and has gained his advanced implantology skills throughout his training and teaching career with a range of courses in the UK and Sweden. He has also taken the further step and engaged himself in an MSc in implantology in Manchester in addition to his Diploma in Oral and Maxillofacial Surgery gained in 2002. He recently obtained a PG Diploma in Clinical Education.
Qualifications: MFDS RCS ENG LDS SE LON
Lecture: Do we need to develop a soft-tissue bio-type assessment tool?
Introduction and background: The importance of soft tissue or gingival biotype in implant dentistry is well documented in the literature, although various methods exist to determine soft tissue biotype; each has a different documented reliability. What is the gold standard for assessment? And do we need to research a reliable tool? A literature review has been conducted to explore the topics of the importance of gingival biotype and the methods of assessment of gingival biotype and its recorded reliability, in addition to a dentist based survey of the dentist perceived view of the importance of gingival biotype and the adopted method of assessment used.
Aims: To improve the outcomes of implant therapy by dentists who provide implant therapy.
Objectives: To compare the survey responses of the currently adopted methods of assessing gingival biotype with the documented literature.
Methodology and study design: Data collection is through an electronic online questionnaire, where we are gathering basic and detailed information about whether gingival biotype is assessed and for what reason it would be assessed, the method of assessment and the classification used also. The questionnaire also asks the clinician to indicate how important this assessment is with regards to implant therapy. This questionnaire has been posted at an online website engine. Results are collected and compared to the existing literature and conclusions are drawn and recommendations follow.
When: Forum B: Restorative & General - 16:10
Anthony Bendkowski is a specialist in oral surgery in practice limited to implant reconstructive surgery in London and the South East of England. He qualified from University College Hospital Dental School, London in 1982 and subsequently gained extensive experience in both hospital and practice-based oral surgery. He has over 25 years’ experience in both the surgical and restorative management of implant cases. He has a keen interest in all aspects of dental education and has lectured on and run bone augmentation and implant training courses, as well as lecturing on business skills for successful implant practice for a number of years. He is a Past President of the Association of Dental Implantology (UK) and an examiner for the Edinburgh Diploma in Implant Dentistry as well as for Membership in Oral Surgery for the Royal College of Surgeons, England.
Qualifications: BDS LDS DPDS MFGDP DipDSed MSurgDent
Lecture: For better or for worse - how a dental implant can affect a life
Dealing with a poorly placed implant in the aesthetic zone for a patient with a high smile line is a daunting prospect for an implant dentist. This case report demonstrates how an inappropriately placed implant can result in a poor outcome for a patient. Management to include the atraumatic removal of the well integrated implant with additional soft and hard tissue reconstruction and subsequent replacement with a further implant supported restoration are described.
When: Forum A: Surgical - 14:25
Nicholas Claydon qualified in 1986 from Cardiff Dental School and completed his foundation training to Registrar level. He attained his MScD by research at the University of Wales and his PhD from the University of Bristol.
An accredited specialist in Periodontics, Nick has established a reputation for aesthetic treatment of complex restorative cases involving periodontal, implant and prosthodontic disciplines.
He is a researcher and lecturer at the Bristol Dental School, utilising his skills as mentor for dentists managing implant cases. He is a reviewer for international research journals and conducts clinical studies which are published in peer reviewed journals. In 2009 Nick established his state of the art specialist Dental Practice at The Pines in Whitchurch.
Qualifications: BDS MScD PhD
Lecture: The slow drilling protocol for implant site preparation
Implant preparation is characterised by the creation of a tunnel within the alveolar bone which is used to accommodate the titanium fixture. The standard preparation of the osteotomy site with rotational drills is characterised by the conversion of mechanical energy into thermal energy. This can create a transient and localised increase in temperature above the normal physiological limits with resultant osteonecrosis and/or impairment of osteogenic potential.
A multitude of temperature abatement strategies aimed at minimising the collateral damage resulting from implant preparation are implemented and considered routine. Broadly speaking these can be classified as equipment or technique protocols. Some of the equipment protocols include the use of cooled irrigants, the deployment of sharp (or disposable) sequential drills, the use of piezo surgery. Standard technique protocols advocate the use of light pressure, a pecking motion and drill speeds of the order of 450-1000 rpm.
The slow drilling protocol utilises a significantly lower drilling speed of 150 rpm to bore through the cortical plate and 50 rpm to prepare the medullary bone. This maintains the heat generated to levels well below the physiological level for which osteonecrosis may occur. The protocol is a simple adaptation of current standard practice but confers additional advantages. It allows for the use of rotational ridge expanders, the simple and safe elevation of the sinus floor with the internal sinus lift technique, it increases significantly the quantities of autogenous bone collected and it allows for excellent integration with blood plasma technologies.
When: Forum A: Surgical - 09:30
Nick Fahey divides his time between Harley Street Dental Studio in London and Woodborough House Referral Practice in Pangbourne, Berkshire. In both practices he works as a specialist prosthodontist with a special interest in oral surgery and dental implantology.
After training in his native New Zealand, Nick also studied at the Eastman Dental Institute. There he obtained the M.Clin.Dent degree in Prosthodontics. Nick also holds the MRD RCS (Ed), FRACDS and MFDS RCS (Eng).
His areas of interest include all aspects of dentistry related to dental implants and fixed and removable prosthodontics.
Of particular recent interest has been his involvement in digital dentistry. He is particularly interested in computer-guided surgery for simplification of surgical placement of dental implants. This is facilitated by using C.T. scans in conjunction with virtual implant planning software, intraoral scans and 3D printing of surgical guides.
Nick enjoys membership of the ADI and the ITI, where he is a study club director. He has presided over the LDSC and was a founding member of the NZDSL. He also is a past president of the Reading Branch of the BDA (2012).
Qualifications: BDS MClinDent (Pros) FRACDS, MRD RCS (Ed) MFDS RCS (Eng)
Lecture: Simple computer guided surgery. How to use a digital work flow to simplify computer guided surgery
Presentation of the use of digital workflow for dental implant planning, surgery and restoration. CAD STL files (Digital Impression Files) are inserted into DICOM files (CBCT scan files), prior to planning computer-guided surgery with coDiagnostiX 9.0. Surgery is then planned knowing the exact preoperative soft to hard tissue relationship. A CAD CAM drill guide is then designed for 3D printing and fabricated. At surgery, or at a subsequent appointment, digital impressions of the implant fixture(s) are taken, and CAD/CAM restorations constructed
Aims and objectives: I will present how I use the digital workflow currently in my practice. How often, for which indication and at which step of the treatment. I will also discuss how digitization is supporting me to grow my practice.
When: Forum A: Surgical - 15:30
Peter Fairbairn is currently visiting Professor in the Department of Periodontology and Implant Dentistry at the University of Detroit Mercy School of Dentistry, Michigan, US and has been involved in the placement of Dental Implants since 1991. He was initially taught and mentored by Barry Edwards and for the last 10 years has solely used synthetic particulate graft materials in the regeneration of bone.
With nearly 2,000 grafts in this period Peter has been able to develop not only materials but also the techniques in their use to hopefully improve the outcomes for the Dentist and Patient alike.
He is an active member of the ADI, BACD, BDA and the Honorary Secretary of the London Dental Fellowship.
Qualifications: BDS (Rand)
Lecture: Ridge preservation in the lower molar area
The loss of a tooth especially when associated with extensive pathology in the lower molar area may often lead to one of the most difficult situations in implant placement.
When allowing for full healing of 3 to 4 months the modelling of the hard tissue is often mostly on the buccal aspect which can lead to angled bone profile complicating implant placement at that time. But it may also lead to the loss of the attached gingival tissue and this can have a detrimental effect on the long term health of the Implant.
Thus ridge preservation may be of great value in reducing this early bone loss with the associated retention of the attached keratinised soft tissue.
This can be achieved in two ways, firstly using delayed immediate placement at 3 weeks post extraction where we have soft tissue closure but prior to hard tissue modelling (Schropp). Secondly where the socket is devoid of good hard tissue or vital tissues (IAN) and areas (Sinus) are too close, preventing placement. Here we can socket graft and place later at 3-4 months.
When: Forum A: Surgical - 11:20
Koray Feran qualified in 1989 from Guy's Dental Hospital, winning the Final Year Prize for overall excellence and the S.J. Kaye Prize in Oral Medicine and Pathology. He remained at Guy's for two separate House Surgeon appointments in Prosthetic Dentistry and then Oral and Maxillofacial surgery till 1991 when he went into general practice in North London.
In 1993 he completed the Master of Science degree in Periodontology from Guy's Hospital and obtained a Restorative Dentistry Fellowship in Dental Surgery from the Royal College of Surgeons of England. He has since been in practice dedicated to quality dental care and has now founded The London Centre for Implant and Aesthetic Dentistry Ltd alongside specialist colleagues in Wimpole Street at the heart of London's dental and medical community.
Koray also co-presents implant and bone augmentation courses with Dr Phil Bennett and Professor Cemal Ucer and is a lecturer on the Salford implant MSc course and treatment planning co-author of the new ADI web learning programme. Koray is the London Committee Representative of the Association of Dental Implantology (UK).
Qualifications: BDS MSc (Lond) FDSRCS (Eng)
Lecture: The maxillary sinus - avoid or invade?
The loss of teeth and consequently bone from under the maxillary sinus has led to the development of some ingenious methods in the augmentation of new bone as well as complete avoidance of this airspace by utilisation of short or cleverly angled implants to replace posterior teeth.
This lecture will cover the pros and cons of sinus augmentation and discuss the spectrum of available options to successfully restore the upper posterior adult dentition with dental implants.
When: Forum A: Surgical - 13:45
Daniel Flynn, after qualifying from Trinity College Dublin in 2002, spent a year as a House Officer in the Dublin Dental Hospital, concentrating on both restorative dentistry and oral surgery.
Following this, he worked in private practice for over two and a half years and completed the MFDS exams before beginning a three-year programme in Endodontics at the Eastman Dental Institute. Daniel is on the endodontic specialist list. He lectures nationally and abroad and delivers hands-on courses for general dentists at Endocare, 99 Harley Street and also teaches Endodontics at the Eastman Dental Institute for Oral Healthcare Sciences.
Over the last 5 years he has developed a special interest in Endodontic Microsurgery and has worked with oral surgeons and periodontists in order to refine and master the techniques.
Qualifications: BDentSc MFDS RCSI MClinDent MRD RSCEd
Lecture: Implants - My fallback position: But endo-microsurgery really works
The advent of predictable implant technology is a great back-up for the endodontist. Endodontics enjoys equally successful outcomes as implants according to systematic reviews. It is preferable to save a natural tooth when possible. I will discuss the indications for endodontic microsurgery and how it has evolved, and will present some cases (with video) where it may be appropriate to consider an endodontic surgical approach.
As endodontists we need to be able to provide consistent high quality predictable treatments. Gone are the days of the clumsy apicectomy and amalgam retrograde fillings. Like all other aspects of endodontics, endodontic surgery has now evolved to become a technically accurate, highly predictable procedure. It has changed so radically that we no longer call the procedure an apicectomy, rather endodontic microsurgery. We use small volume CBCT scans for planning, microscopes, micromirrors, ultrasonic retrograde tips and MTA to optimise success. It is a shame that it is considered so infrequently in treatment planning as a option as the success rates are remarkable, greater than 90% in long term studies.
When: Forum B: Restorative & General - 11:40
Shiraz Gulamali qualified in 1980 from Guy’s Hospital Dental School. He returned to Guy’s in 1983 to do a Masters in Periodontology. He was Hospital based full time till 1988, after which he entered part time practice.
He has been involved with both undergraduate and postgraduate education, and has presented numerous papers to professional bodies and Societies. He is currently a Mentor on the ADI list, and now has a full time practice exclusive to Periodontics and Implants.
Qualifications: BDS LDSRCS MSc FDSRCPS
Lecture: Good morning Mrs Tissue, how nice to see you……….
The scope of this oral presentation will be to follow a case history spanning 19 years, with the specific aim of focusing on the preservation of both and soft tissues after trauma, root fracture, immediate implant placement and immediate implant restoration.
This is a case involving a fit and well male patient, aged 37 at initial presentation, having suffered trauma to the upper anterior region. The sequence of treatment that followed will demonstrate the following:
- Connective tissue grafting to facilitate root burial.
- Maintenance of tissue profile.
- Immediate implant placement, and the critical relevance of both bucco-palatal and mesio-distal implant positioning.
- Immediate implant restoration and the importance of correct emergence profile.
- The contact points and their relevance to papillae.
- Final restoration in a stable environment.
As the title suggests, the goal of delivery of care in the more complex case is to perhaps finish with a statement like: "Good night Mrs Tissue, we trust we shall be seeing you again tomorrow!" thus requiring a multitude of treatment modalities to achieve the desired outcome.
The presentation will, in conclusion, look briefly at the the use of platelet-rich growth factor as one of the predicable ways forward to to facilitate tissue augmentation, and to support the use of this technique in our day to day practices.
When: Forum B: Restorative & General - 11:20
James Invest is a partner in full-time private practice in Harley Street, London. He is a part-time Honorary Clinical Lecturer at the Eastman Dental Hospital, UCL.
He qualified from Guy’s Dental Hospital in 1995 with a distinction in restorative dentistry, attainted FDSRCS (Eng) in 1999 and completed specialist training in Prosthodontics in 2004 from the Eastman Dental Hosptial, London and was awarded the UCL Dental School Commemorative Prize in Fixed and Removable Prosthodontics.
He teaches prosthodontic and implant dentistry to postgraduate students, and lectures nationally.
Qualifications: BDS (Lond) FDSRCS (Eng) MClinDent (Prosth) MRDRCS (Eng) Specialist in Prosthodontics
Lecture: Acrylic, composite or ceramic – some considerations for full arch prostheses
This lecture will discuss the three materials available to be used as the veneering material for full arch implant retained prostheses. The lecture will cover the origin of the materials through to the current concepts, looking at what longevity/survival studies are out there and give some key points when to use which material and other important considerations when resorting a patient with a full arch implant retained prosthesis.
When: Forum B: Restorative & General - 13:45
Nigel Jones runs an implant referral practice in Abergavenny, South Wales. He first studied dental implants with Cemal Ucer in 2002, gaining his diploma in implant dentistry from the FGDP in 2008.
He now teaches on the implant diploma having been a tutor on cohorts 9, 12 and 14. He presents for several implant companies, and will place about 500 implants this year to meet the financial demands of his long-suffering wife and four children.
Qualifications: BDS MJDF DipImpDent RCS
Lecture: Building and marketing a referral implant practice
The presentation is a mixture of slides, film and animation on how to build and market a dental implant practice. It includes tips on how to encourage referrals from colleagues, and how to build an effective website.
The presentation begins by looking at the dental implant market. It poses and answers the question 'Should we market healthcare?'
It looks at recent shifts in marketing, and conforming with GDC regulations.
It deals with the differences between internal and external marketing; creating the right message, presence and tone in advertising; search engine optimisation; encouraging testamonials from patients; and reaching out to potential referring colleagues.
It concludes with top tips (learned from my own experience) for building a referral practice.
When: Forum B: Restorative & General - 09:10
Younes Khosroshahy qualified from Faculty of Dentistry, Tehran Medical University in 1996 with first class honours. Having worked for three years in general dental practice, he moved to the UK in 2000 for postgraduate training in Oral and Maxillofacial Surgery. He achieved the Membership of the Royal College of Surgeons of England in 2003 after working in various London hospitals for three years.
Having passed the IQE examination of the GDC in 2004, he then worked as a Staff Grade Oral Surgeon in the Queen Victoria Hospital, East Grinstead and also in a general dental practice in London for four years. During this time, he developed a keen interest in dental implants. He joined Hospital Lane Dental and Implant Clinic in 2007 and has worked there since then. He passed the rigorous examination of the Royal College of Surgeons of Edinburgh and obtained the Diploma in Implant Dentistry in 2010.
Qualifications: DDS MFDS RCS(Eng) Dip Imp Dent RCSEd
Lecture: Soft and hard tissue reconstruction of a severely deficient site prior to implant placement
This case report describes how a severe localized alveolar bone deficiency together with altered gingival contour in the site of upper left first molar was reconstructed. A sinus exposure following earlier extraction and an attempt to close it with a buccal advancement flap compromised the site even further by repositioning the buccal fraenum in an unfavourable position.
This case was managed in three stages. First, a sinus lift procedure was performed through the floor of the alveolar defect after extending the existing sinus floor perforation. This, needed minimal bone removal. This space and the alveolar defect was then reconstructed with Regenaform and Bio-guide. Six months afterwards, a free gingival graft was harvested from the left side of the palate and grafted to the UL6 site after raising a full mucoperiosteal flap incorporating the buccal fraenum and repositioning it apically. Two months later, a 13 mm, wide platform Nobel Replace Tapered implant was inserted in the healed site. After three months, a crown was fabricated and fitted.
With this technique, both sinus augmentation and alveolar reconstruction were performed simultaneously using Regenaform which was less invasive to the patient as it was carried out in one surgery. The altered gingival contour was also corrected by performing a free gingival graft on the second stage. This increased the width of keratinized gingiva around the implant which will improve the health of perimplant tissue and improve the gingival contour around UL5.
This case report was published in the 1/2013- Vol. 9 edition of EDI journal.
When: Forum A: Surgical - 16:10
Shane McCrea graduated from the Royal Dental Hospital, London University in 1979, becoming a member of the University of Dusseldorf's Work Study Groups in implantology, prosthetics and periodontology until 2001.
He gained the MFGDP examination in 2003. In 2005 he completed an MSc in Dental and Maxillofacial Radiology (Kings College, London), his research project being published in the BDJ. As a result of this project, he is now a Peer Reviewer for fourteen dental journals.
Between 2008 and 2012 he has had seventeen papers published in peer-reviewed journals. In 2010 he gained an MMedSci (Dental Implantology) from The University of Sheffield. He is presently undertaking a further MSc in Stem Cells and Regeneration at The University of Bristol. This year, he has had three papers accepted for publication. Of the eleven case studies published by the British Society of Periodontology, four are attributed to Shane's work on soft and hard tissue management. He is now Co-ordinator of Post-Graduate Education for the British Society of Oral Implantology.
Qualifications: MMedSci (Dental Implantology) MSc (Dental and Maxillofacial Radiology) BDS (Lond) LDS RCS (Eng) MFGDP (UK)
Lecture: Improving conventional periodontal subepithelial connective tissue grafting for the demands of peri-implantology
Following tooth extraction, resorption of the buccal wall of the socket will occur; this is true for both the maxilla and mandible. Where the extraction site is surrounded by natural dentition, the loss of the buccal alveolar wall can degrade the visual aesthetics of an implant-supported prosthetic rehabilitation.
To aid harmonization of hard and soft tissue morphology, both hard and soft tissue augmentation can be carried out either consecutively with an extraction/immediate implant placement or prior to an implant placement in the delayed scenario. The contemporary method of increasing soft tissue volume is to use the subepithelial connective tissue (auto) graft (the SCTG). The graft requires fixation, otherwise it can be extruded from the recipient site.
This presentation will be a step-by-step description of a collection of innovatory suturing techniques developed by the author to be specifically applied to dental implantology, for the preparation and improvement of dental implant sites; all can confidently secure the SCTG, thus resisting its dislodgement. The presentation will be illustrated by (at least) 20 cases with follow-ups ranging from a minimum of 12 months to 60 months.
When: Forum A: Surgical - 09:10
Manuel Nunez qualified from Madrid School of Dentistry in 2005. He has been involved in implant dentistry since 2005. He has done postgraduate studies in Cuba, Spain and Brazil. He is dedicated to mentoring in dental implants, sedation and dental photography. He has a passion for rehabilitating atrophic maxilla implant cases under sedation or general anaesthetic.
Qualifications: BDS DipHyp
Lecture: The treatment of atrophic maxilla: a challenging situation
The treatment of atrophic maxilla is a great challenge for the dentist today. The alveolar bone width is often lost, which complicates implant placement. Furthermore, the biggest challenge arises when insufficient alveolar bone is present: neither in width nor in height.
It is often found that full arch grafting procedures lower, the quality of life of our patients. If we could deliver quicker techniques, with immediate loading, wouldn’t it improve the quality of life and overall health of our patients? We can now give graftless techniques, with low morbidity and treatment times; but how?......by using zygomatic implants.
What are the greatest problems of graftless techniques in athropic maxilla cases? Can we do them under sedation? What about under just local anaesthetic? Do we use general anaesthetic to control the patient’s behaviour or is it pain related? Are there other techniques? What about prosthetic problems? What about load?
When: Forum B: Restorative & General - 15:30
Rishi Patel graduated from the University of Bristol Dental School in 2002. Following a year in general practice, he completed Senior House Officer posts in Oral and Maxillofacial Surgery and Restorative Dentistry at St. George’s Hospital in London and the University of Birmingham Children’s Hospital.
Following this, he undertook his graduate Prosthodontic training at Loma Linda University School of Dentistry in California. He completed a 3 year full-time training program focusing on all aspects of fixed, removable and implant prosthodontics and obtained a Master of Science (MS) degree in Prosthodontics in 2008. He then completed a one year Surgical Fellowship in Implant Dentistry at Loma Linda.
Rishi is recognised as a Specialist in Prosthodontics by the General Dental Council. His practice interests are focused on aesthetic, prosthodontic and implant dentistry. He is an Honorary Clinical Teaching Fellow at the University College London, Eastman Dental Institute and is actively involved in teaching postgraduate students and general dentists and pursuing ongoing research interests.
Qualifications: BDS MFDSRCS (Eng) MS (Loma Linda, Calif)
Lecture: Treatment planning considerations for fully edentulous maxilla
The purpose of this presentation is to provide a comprehensive overview of the treatment planning options for the completely edentate maxilla. There will be a discussion of the range of treatment planning considerations to successfully plan and manage the spectrum of completely edentulous patients.
Through a thorough review of the current literature on the outcomes of treatment, an evidence-based approach to clinical decision-making in the planning of treatment will be presented together with case-based decision-making. The rationale for fixed versus removable treatment will be presented and the advantages and disadvantages of each modality outlined in detail.
When: Forum B: Restorative & General - 14:05
Geoffrey Pullen trained at King’s College Hospital and the University of Southern California School of Dentistry. Geoff has lived and practiced in Central London since 1981.
He has lectured on the use of dental implants and treatment planning to dentists in the UK, Europe, Russia, the US and India. He has demonstrated both the restorative and surgical phase of dental implants to hundreds of dentists in his practice.
He is a member of the Association of Dental Implantology, the American Dental Society of Europe and is a Past President of the American Dental Society of London. He is on the board of the James Hull/Smiles Group and is a director of Bicon Marketing Limited.
Qualifications: BDS (Lond) DDS (U Southern California)
Lecture: Tall tales and short implants
With over 25 years of experience placing and restoring dental implants, I reckon that over 90% of projects go well, stay well and everyone stays happy. What happens when things don't go well and why? Can upset be predicted? Can upset be avoided even in the midst of failure?
Cases good and bad from my files. Protocols for planning. Degrees of complexity. Thoughts on maintenance principles. Expect the unexpected.
When: Forum B: Restorative & General - 14:25
Juliette Reeves is a dental hygienist and trained nutritionist with over thirty years’ experience. She qualified from Birmingham University School of Dental Hygiene in 1981 and the Institute for Optimum Nutrition in 1993. She is Secretary to the BSDHT Eastern Regional Group, clinical director of Perio-Nutrition and a consultant for the Wrigley Oral Healthcare Program. She has written and lectured internationally over the last ten years on the systemic associations between nutrition and oral health and is an editorial advisor to a number of dental journals.
Juliette is an active ADI Member and Certified ADIA Implant Auxiliary, receiving training in implant maintenance and therapy from academies in Geneva, Liechtenstein and the USA. She regularly provides postgraduate courses in the UK and was recently elected ADI DCP Committee Member.
Qualifications: EDH dip NMed
Lecture: Nutritional manipulation of pro-inflammatory gene expression and the prevention of peri-implantitis
Risk factors, most prominently smoking, diabetes and previous periodontal disease, are associated with the development of peri-implantitis and implant failure. Recent study demonstrates that specific genetic markers have been associated with increased expression of IL-1 and are a strong indicator of susceptibility to chronic inflammation and periodontal breakdown in adults.
Treating peri-implant diseases successfully lies in facilitating the resolution of chronic inflammation. The discovery of a new family of pro resolving lipid mediators termed resolvins has shown resolution to involve active biochemical pathways that enable inflamed tissues to return to homeostasis. These newly discovered mediators are biosynthesised from polyunsaturated fatty acids (n-3 PUFA’s) derived exclusively from the diet.
Evidence of genetic and nutritional biomechanisms in inflammation with relevance to the oral tissues is becoming clear with current research demonstrating a role for nutrition in the modulation of inflammation.
This presentation will consider the prevalence of the hyper-inflammatory genome IL1 in the population and the concept of epigenetics, review the biochemistry of nutrition and chronic inflammation of the periodontal tissues, examine new research surrounding dietary factors implicated in the resolution of chronic inflammation and ask the question:
Can we begin to draw together nutritional protocols to support the compromised implant patient?
When: Forum B: Restorative & General - 15:50
Bill Schaeffer is qualified in dentistry and medicine, has postgraduate qualifications in both dental and general surgery and is recognised as a specialist oral surgeon. He has been placing dental implants for more than 16 years and is experienced in many different implant systems.
Bill works full-time doing implant surgery in Sussex and has lectured widely on the subject both in the UK and abroad.
Qualifications: BDS MBBS FDSRCS (Eng) MRCS (Eng)
Lecture: My biggest implant disaster: How it happened, how I managed it, and how you can avoid it happening to you
If you're the kind of clinician who never makes a mistake, then this presentation is not for you - you won't learn anything useful from it and your time is better spent elsewhere.
Like most clinicians, however, I do make mistakes and here I will present a clinical case that became my biggest implant disaster. A simple, stupid mistake on my part turned into a nightmare for both the patient and me - though she suffered much, much more as a result.
I will explain the simple error that led to my negligence (for that's what this was), and how the case quickly spiralled from a relatively localised problem into a larger and larger disaster.
I will explain how I managed the case - and I do not claim that this management was in any way ideal - and discuss what I might have done better.
Finally, I will explain how some simple steps can help you can avoid the same thing happening to you and your patients.
When: Forum A: Surgical - 11:00
Ashok Sethi is a registered specialist in Oral Surgery as well as Prosthodontics and his Harley Street referral practice in the heart of London is dedicated solely to Implant Dentistry.
He conceived and has run the Diploma in Implant Dentistry at the Royal College of Surgeons of England.
The second edition of his book ‘Practical Implant Dentistry – the Science and Art’ (co-author Thomas Kaus) has just been published by Quintessence.
Qualifications: BDS DGDP (UK) MGDSRCS (Eng) DUI (Lille) FFGDP (UK)
Lecture: Immediate placement and immediate loading of implants placed into fresh extraction sockets
Immediate placement and immediate loading of implants carries a tremendous attraction because of an inherent reduction in treatment time and considerable convenience in comparison to conventional implant treatment. The goal of this study was to evaluate the clinical outcome of implants placed immediately into fresh extraction sockets and loaded immediately.
Materials and methods: Patients were considered for immediate placement after careful assessment of the failing tooth and future implant site. A detailed protocol was followed to enable a possible immediate loading of the implant with the use of prefabricated angulated abutments (0° - 37.5°) in combination with transitional restorations.
Results: As of May 2013 a total of 843 immediate implants had been placed in 400 patients and loaded immediately. The maximum observation period by May 2013 was 162 months with a mean observation period of 39 months. Six implants had been lost in function. A broad range of prefabricated angulated abutments was required in order to be able to restore the implants immediately. Angles beyond 15° were necessary in more than 50% of the cases.
Conclusion: The preliminary results of this ongoing prospective clinical study are very promising. Immediate loading of immediately placed implants is a possible treatment option that might be predictably and successfully achieved. A simple restorative protocol for chair-side fabrication of temporary restorations can be followed in order to load the implant immediately, when a broad range of prefabricated angulated abutments (0° - 37.5°) is used.
When: Forum A: Surgical - 09:50
Nilesh Shah has extensive commitment to continuing education with a special interest in Implantology and oral surgery - including visits to the Pankey Institute for Advanced Dental Education, Miami, USA. Has a Masters degree in Implantology from Sheffield University.
Nilesh is a mentor for Dentsply Implants and is on the ADI mentor list. Has lectured nationally and internationally on consent and dental implants. Provides a referral service for local GDPs requiring MOS services. Has taught on various training programs ranging from MSc to foundation training. Holds a Diploma in Clinical Education from Sheffield Hallam University. Is the principal of Gorse Covert Dental Practice Ltd.
Qualifications: BDS MFGDP MMedSci (Implantology)
Lecture: Communication - the path to Dental Enlightenment
Patient anger underlines many malpractice claims and frequently results from ineffective communication.
This talk will focus on factors that constitute effective communication, and how developing an understanding of the communication process will enhance the interaction between the clinician and the patient.
It will explore the different modes of communication, touching on body language and tone of voice as underutilised aspects.
It will explore the differences between 'listening and hearing’, and the use of techniques such as parroting and paraphrasing to enhance the communication process and reduce misunderstandings for both the clinician and patient.
I will briefly describe learning styles and what constitutes a ‘good and bad’ communicator.
Finally I will explore how communication is essential in managing patient’s expectations.
Happy patients are the first step to Dental Enlightenment.
When: Forum B: Restorative & General - 09:30
Andrew Shelley is a specialist in Prosthodontics and is in practice in Manchester, UK. Qualified in 1979, he is a Fellow of the Royal Colleges of Surgeons of Edinburgh and of England. He has held the posts of Associate Specialist in Restorative Dentistry at North Manchester General Hospital and Clinical Teacher at the School of Dentistry, University of Manchester. He is an examiner and co-lead for the Fellowship in Dental Surgery of the Royal College of Surgeons of Edinburgh.
Andrew has a special interest in imaging prior to dental implant placement and is currently researching the impact of cone beam CT technology on treatment planning and patient outcomes. Andrew is a co-author of the FGDP (UK)’s selection criteria in Dental Radiography, the UK Department of Health’s e-Den project and a forthcoming textbook, ‘The Restoration of Teeth’ published by Quintessence.
Qualifications: BDS MSc MFGDP (UK) DPDS MGDS RCSEd FDS RCSEd FFGDP (UK) Dip Rest Dent RCS Eng Specialist in Prosthodontics
Lecture: Imaging methods prior to dental implant placement in the anterior mandible
The placement of two dental implants in the anterior mandible allows methods of additional retention to be used to support complete lower dentures. Nevertheless, implant placement in the symphyseal region is not without risk. Perforation of the lingual cortical plate has the potential to traumatise lingual vessels causing severe bleeding and a life threatening upper airway obstruction. At least twenty cases are presented in the literature, some of which are reported as “potentially fatal” or “near fatal”. There are unpublished accounts of fatalities. An appreciation of the form of the mandible is required in order to avoid such complications. Pre-operative imaging methods include conventional two dimensional x-ray views and three dimensional imaging such as cone beam CT. Nevertheless, the impact of the different available imaging modalities is unclear. As a first step in understanding this problem, a survey was conducted amongst implant practitioners in the North West of England.
This survey investigated custom and practice when planning imaging methods prior to implant placement in the symphyseal region of the edentulous mandible. A radiographic phantom was used to produce a range of images and the interactive capabilities of the internet were used in an attempt to reproduce clinical decision making. An 80% response suggests that the results represent a reliable representation of the image prescription pattern of this population. The results, however, revealed a chaotic pattern of prescription of imaging methods.
When: Forum A: Surgical - 14:05
John Stowell qualified in 1966 from both London (RCS) and Durham University.
He held various SHO rotations in Newcastle Dental School and on gaining his Fellowship in Edinburgh in 1969 he held the post of Registrar in Oral & Maxillo-Facial Surgery in the North Manchester Hospital.
Subsequently he set up his own Private Clinic and lectured part time in Oral Surgery at the University of Manchester Dental School. He was the first UK dental surgeon to gain the Associate Fellowship of the American Academy of Implant Dentistry (AAID) by examination in 1992. He became an honoured fellow of the AAID in 2011.
He held the post of Associate Specialist in OMFS at Wigan & Leigh NHS Trust until his retirement from hospital work in 2010. He still maintains his private practice at Woodvale Clinic 2-3 Days a week where he mentored MSc post-graduate students in implantology from the University Dental School of Manchester.
He placed his first implant in 1969 (Downs Blade Implant) and has used many implant systems over the years (and thrown a lot away!). This lecture was presented at the AAID meeting in Washington, USA in 2012 and the AISI meeting in Bologna, Italy in 2013.
Qualifications: LDSRCS (Eng) BDS FDSRCS (Edin) Dental and Oral Surgeon
Lecture: New horizons in implantology - screwless and cementless
The first part of the paper will cover the salient facts regarding the tapered (1.5') connection of the implant that dispenses with screwed abutments. This results in a biological seal and also avoids the costly and perennial problem of loose or fractured screws as well as the potential of bone saucerisation and peri-implantitis around the neck of the implant and all its associated clinical complications.
The second part of the paper will show: a) The use of an advanced composite that is directly bonded to the titanium abutment in the laboratory to fabricate a whole crown - an integrated abutment crown that is simply tapped into the implant well with a customised jig thus avoiding conventional luting cement of an Implant crown and the potential problem of retained cement and its associated clinical complications that can lead to mucositis and peri-implantitis. b) The use of a new glass fibre reinforced resin substructure that is metal free, extremely strong, light and supports a fixed prosthesis.
Learning Objectives: 1) Understand the benefits of the locking taper connection. 2) Understand the benefits of utilising integrated abutment crowns instead of conventionally screwed and cemented implant crowns.
Aims: The paper will show that if we can reduce any potential complications in Implant Dentistry, then that is our goal. This in turn reduces costs and less stress on the implantologist.
When: Forum B: Restorative & General - 11:00
Paul Swanson qualified from the University of Liverpool in 2000. His career has mainly been based in General Dental Practice but has also combined this with part time hospital based oral surgery. He completed his MFGDP qualification in 2003 and a Post Graduate Certificate in Conscious Sedation in 2004. In 2008 he received the Diploma in Implant Dentistry from the Royal College of Surgeons of England and the Advanced Certificate in Bone Grafting. In 2011 he received a Master of Science degree in Implant Dentistry from Queen Mary University of London.
Over the last 7 years the volume and complexity of cases has naturally increased. Paul’s clinical practice is now limited to Implant Dentistry. He owns a specialist referral practice in Liverpool and contributes to the multidisciplinary cases done by his team. He mentors dentists at both entry level and advanced implantology and contributes to study clubs in his region.
Qualifications: BDS MFGDPUK PGCert (Sed) DipImpDent RCS (Eng) MSc (Impl)
Lecture: Upper right first molar tooth replacement in the site of previous oro-antral-communication
This is the case of a fit and healthy 35 year old female patient who requested the replacement of her missing upper right first molar (UR6).
Approximately three years prior to presentation the UR6 was displaced into the right antrum during a routine extraction. The patient was referred to a Maxillofacial unit to retrieve the displaced tooth and repair the resulting oral antral fistula with a buccal advancement flap.
Clinical and CT scan investigation demonstrated a grossly deficient alveolus in both width and height, and a lack of keratinised mucosa. The prosthetic space was uncompromised and had appropriate mesiodistal and interocclusal space. All fixed and removable prosthodontics options were fully discussed to allow the patient to make an informed decision. Her preference was to replace the UR6 with a single tooth implant.
A two-staged surgical approach was undertaken. The first stage involved a sinus elevation and augmentation with bio-oss with a simultaneous autogenous block graft to restore ridge width. A submerged 4.6mm x 9mm Biohorizons implant was placed at second stage. A coronal advancement flap was performed at the time of exposure to augment the buccal keratinised mucosa. A screw retained metal-ceramic crown was chosen as the definitive restoration, to aid future prosthetic maintenance.
Summary: This case is an example of a severely compromised UR6 edentulous space with respect to both bone and soft tissue. It demonstrates a complex three dimensional bone augmentation, together with soft tissue augmentation to allow for a single tooth implant in the UR6 position.
When: Forum A: Surgical - 15:50
Karen Walker qualified from Edinburgh Dental School in 1994 and immediately moved to Nottingham. She splits her working week between two Specialist Referral Practices, The Campbell Clinic in Nottingham and Refine in Derby both owned by Colin Campbell. Karen sees all the patients in both pre-op and maintenance phase. 4 years ago Karen implemented protocols based on OH status and individual risk to design a bespoke maintenance programme for each patient. This ensures optimum oral health can be achieved to ensure healthy peri-implant tissues.
Karen is a speaker for the ITI and has lectured at the International Congress and numerous ITI study clubs. She has also lectured for BSDHT regional groups. Karen has recently become a Cavitron Trainer with Dentsply. This autumn Karen will also be lecturing to the dentists at The Campbell Academy ‘Live Skills’ course. She regularly has hygienists from local practices attending for observation sessions during her clinical hours.
Qualifications: RDH Dip Dent Hyg
Lecture: Implant complications managed by the dental hygienist
This case presentation demonstrates how a dental hygienist in practice can successfully select the correct treatment modalities to treat peri-implant mucositis and to treat and effectively stabilise peri-implantitis.
Case study 1 - Peri-Implant mucositis: The patient was referred from the GDP, and therefore consent was already obtained. The patient complained of bleeding and swelling from her lower left 6 implant. The patient’s medical history was checked and no changes were noted. On clinical examination there was significant swelling, bleeding and tenderness. The oral hygiene was revised in this area and appropriate aids were again demonstrated and reiterated. The long buccal nerve was anaesthetised and non-surgical debridement was carried out with a slim line cavitron tip, the purpose being to disrupt the biofilm. Post op instructions were given and the patient asked to return 8 weeks later.
Case study 2 - Peri-implantitis: The patient was referred from the GDP, and therefore consent was already obtained. The patient complained of soreness around his 4 year old lower right 6 implant; the referring GDP had taken a radiograph which showed circumferential bone loss. The probing depths were 6 mm cirumferentially. The oral hygiene of the area was revised with the appropriate aids. The long buccal nerve was anaesthetised and a slim line cavitron tip was agian used to deride and disrupt the biofilm. Post-operative instructions were given and the patient asked to return in 8 weeks.
Both cases show maintenance is the key to implant success. Photos and radiographs will be included in the presentations.
When: Forum B: Restorative & General - 09:50
Orcan Yüksel graduated from Johan Wolfgang Goethe University in Frankfurt am Main and Istanbul University in 1987, and subsequently took a doctor degree. Since 1993 he has owned a dental clinic with education center, specialized in dental aesthetics, oral implantology and adhesive dentistry. He is running a number of education programs as a certified implantologist and implantological trainer of European Association of Dental Implantology (BDIZ/EDI) and Diplomate of ICOI, is a guest lecturer in the certified Curriculum Program of Oral Implantology and accredited supervisor in Master of Oral Implantology at Frankfurt University. He is a tutor in P3 (Personal Performance Program for young implantologists, future international speakers) groups’ development.
He has published numerous international presentations and publications in dental implantology and aesthetics, and is a member of Turkish Quintessence edition. In 2008, he joined Dr B Giesenhagen as a partner and coordinated and developed the challenging project of ‘Bone Ring Technique.’
Qualifications: Dr. Med. Dent.
Lecture: The bone ring technique: New perspectives in augmentation
A two-stage method is usually chosen for bone defect augmentations with autogenous blocks and then restored by implant placement. An alternative procedure is a bone ring technique that allows bone transplantation and implantation to be performed on large three-dimensional bone defects in a single operation.
The technique is applicable for almost all indications, including a sinus lift with minimal bone height. In cases of large bone defects or advanced jaw atrophy, extensive horizontal and/or vertical bone augmentation is required to prepare the patient’s implant treatment. This traditionally occurs in a time-consuming, painful and risky procedure – by harvesting and transplantation of the patient’s own autologous bone in a two-stage procedure (augmentation/implantation).
The bone ring technique is performed using pre-fabricated cancellous ring-shaped allograft of processed allogenic donor bone, which is placed by press-fit into a trephine drill-prepared bone bed. At the same time an implant is inserted into the ring. The bony integration of both the bone ring and the implant occurs via the surrounding vital bone. The allograft bone ring technique allows bone augmentation and implantation in a one-stage procedure.
Bone ring eliminates the need for autologous bone harvesting and manual adaptation of autologous blocks. Thereby, allograft bone ring reduces pain, risk of infection, morbidity, operation time and total procedure costs significantly. The bone ring allows for both vertical and horizontal augmentation and new bone formation, therefore simplifying the surgical treatment of three dimensional bone defects. The entire patient’s treatment period is shortened by several months and saves re-entry procedures.
When: Forum A: Surgical - 11:40