Plenary Programme - Friday

This presentation will focus on current implant treatment philosophies and methodologies for papilla management for single and multiple adjacent implants in the aesthetic zone.  Emphasis will be placed on diagnosis and treatment planning, periodontal procedures, adjunctive orthodontic manoeuvers and prosthetic management for optimal anterior implant papilla esthetics.

Objectives:

• Prognostic variables for implant papilla management
• Understand factors that govern the existence of papilla
• Immediate versus delayed implant placement in papilla management

This practice-centred master lecture focuses on the fundamental elements of the aesthetics of restorations. To reach a natural looking result and harmony, the knowledge of natural relations and structures is as important as the communication between dentists and technicians. This lecture will address the entire topics of contemporary dentistry from the preparation to provisionals and the way to the final ceramic work. A comprehensive treatment planning including face examinations are just some parts you will be shown, and many clinical cases demonstrate the efforts and results of a sound planning and teamwork. An overview of the fascination of all–ceramics will be included as well.

Maxillary sinus augmentation surgery is the most predictable of the pre-prosthetic augmentation techniques as reported in the 2006 Academy of Osseointegration Sinus Consensus Conference. Eight evidence-based reviews have been published since 2003 that establish the most successful decisions that we make as surgeons performing this procedure. There are, however, intraoperative complications that may preclude the successful completion of this procedure. There are also many new grafting concepts that include growth factors, bone morphogenetic proteins and fresh frozen allografts that may lead to enhanced outcomes.

This presentation will address these issues with topics including:

• Evidence-based decision making for graft materials, implant surfaces and membranes
• Rotary and piezoelectric surgical techniques and
• State-of-the-art graft material

Bone grafting for implant site development is an important part of planning and executing treatment for the dental implant patient. From simple procedures such as socket augmentation to more complicated and extensive alveolar ridge augmentation, the final aesthetic and functional result should be the goal at all stages (1,2). In attempt to preserve alveolar bone and avoid the necessity of ridge augmentation prior to implant placement, various materials have been used immediately following tooth extraction to fill and/or cover the socket in preparation for dental implants (3). In addition, more significant anterior and posterior alveolar ridge defects often require allografts, autogenous bone harvesting, and the use of growth factors. Unfortunately, many of these procedures are quite technique sensitive, and do not have adequate literature to support their use (2). This presentation will review bone grafting techniques and materials, and their success in implant dentistry from the past and present. It will also cover new technologies that are becoming available to clinicians, which may have more applications for implant dentistry in the future.

References

1. Esposito M, Grusovin MG, Felice P, Karatzopoulos G, Worthington HV, Coulthard P 2009 The efficacy of horizontal and vertical bone augmentation procedures for dental implants - a Cochrane systematic review. Eur J Oral Implantol 2(3):167-84.
2. Aghaloo TL, Moy PK 2007 Which hard tissue augmentation techniques are the most successful in furnishing bony support for implant placement? Int J Oral Maxillofac Implants 22 Suppl:49-70.
   
3. Block MS, Jackson WC 2006 Techniques for grafting the extraction site in preparation for dental implant placement. Atlas Oral Maxillofac Surg Clin North Am 14(1):1-25.

It is more than 45 years ago since the first patient was treated with osseointegrated implants in the edentulous jaw by Dr Brånemark. Besides the introduction of the principles of osseointegration, Dr Brånemark was also a pioneer in using clinical follow-up studies to report clinical function and long-term performance of the rehabilitation in dentistry. Biological as well as mechanical problems and complications have been reported during the years, which have initiated modifications of techniques and components. Furthermore, new applications have been introduced, and modified implant treatment protocols have been tested.

This presentation will discuss how treatment protocols have changed during the years and also discuss long-term observations with regard to mechanical and biological results in situations from the edentulous patient to the single implant restoration. The presentation will focus on the process of how the protocol has changed over time and the problem how to try to predict long-term results, based on preliminary examination and early biological observations.