15:00 - 17:30
Guided Bone Regeneration Hands-On Workshop: Biological and Surgical Principles That Pave the Way for Success
Guided bone regeneration (GBR) is one of the best-documented and widely used methods to regenerate bone in localized alveolar defects. The clinical concept implies the use of barrier membranes that mechanically exclude soft tissues from filling the osseous defect allowing cells with an osteogenic potential to colonize the wound and reconstruct the bone. Many clinical studies and systematic reviews have documented that guided bone regeneration is a successful method for augmenting bone and for the osseointegration of subsequently placed dental implants.
This workshop will provide insight into GBR. An introduction of the biological principals, surgical principals, and step-by-step procedure will be presented, as well as current and innovative concepts. The introduction will be followed by a hands-on workshop, in which the participants will have the opportunity to try and to exercise GBR.
Soft Tissue Harvesting Techniques
The workshop will focus on soft tissue harvesting techniques:
- Free Epithelial Graft
Connective tissue graft
- Free graft de-epithelialization approach
- Trap Door approach
- Single Incision approach
The workshop will have two parts:
- A short lecture that will explain the anatomic factors relevant to soft tissue harvesting, the harvesting techniques, suturing and trouble shooting.
- Hands-on training of the different harvesting techniques.
Mastering High End Photographic Results in Everyday Practice: Why & How
The aim of the course is to highlight the importance of proper dental documentation employing a simplified and practical approach for everyday documentation. On completion of this course, participants will be able to implement the presented concepts and clinical tips, achieving a high level of clinical documentation in a predictable and reliable way.
The first part of the course is a theoretical presentation covering the below topics:
- Why dental photography?
- How dental photography is implemented clinically
- Photographic camera and its components: most recommended
- How to set up the camera and main setting characteristics: understanding the technical parameters
- Accessories and their clinical use
- Importance of light in quality & quantity of capturing detail
- Preoperative documentation: protocol
- Clinical protocol: step-by-step
The second part of the course is a practical demonstration covering the below topics:
- How to properly adjust and set the photographic camera
- Frequently-used accessories
- Full face/portrait photography: with camera + bouncers and studio photography with light modifiers: soft boxes and beauty dish
- Lip and smile images
- Intra-oral clinical images: protocols, ring flash & bouncers
- Capturing surface texture of soft tissues and teeth
- Extra-oral/models and prosthetic work documentation (shadow box)
Number of spaces is limited.
Participation in the workshops requires an additional fee.
9:15 - 11:05
Session I: The Smile Zone
Moderator: Stefen Koubi
Optimizing the Restorative-Tissue Interface in Challenging Esthetic Treatments
Mirela Feraru, Israel
In order to achieve a harmonious esthetic result of restored teeth and implants in the smile zone, not only should the material of the restoration be carefully selected, but careful analysis of the abutment type, in terms of the design and color, should be conducted. This is necessary in order to achieve integration of the whole restorative complex with the surrounding tissue; whether of a natural tooth (vital or non-vital), or an implant.
In cases where different types of adjacent abutments are to be restored, the treatment is even more challenging: one should plan ahead the different phases of the perio-restorative treatment in order to end up with a harmonious, natural-looking result, by choosing the most suitable restoration type for each site, so that the combined abutment-crown complexes will blend with each other, as well as with the adjacent dentition and with the vital periodontium, in an esthetic and healthy manner.
The concepts of Model Based Restoration and Cervical Contouring will be presented as fundamental tools when dealing with such situations, and will be thoroughly explained in a variety of esthetically challenged clinical cases.
Restoring Pink and White Aesthetics in Challenging Cases
Tommie Van de Velde, Belgium
Implants that are placed in the aesthetic zone aim to mimic a natural dentition in all its aspects. Numerous techniques are available to handle soft and hard tissues to restore the pink aesthetics. New materials, implant components and prosthodontic techniques help the dental technician and dentist to optimize the restoration of the white aesthetics. If handled properly, we can achieve beautiful implant restorations that are almost undistinguishable from the neighboring teeth.
However some challenging cases are more difficult to achieve those high aesthetic outcomes. Cases with a lot of tissue loss need extensive treatment planning, surgical and prosthodontics skills and sometimes result in compromised outcomes. This presentation aims to give an overview on the diagnosis, treatment planning, surgical and prosthodontic handling necessary to optimize the treatment of aesthetically challenging cases.
Esthetic Implant Rehabilitation
Eric Van Dooren, Belgium; Victor Clavijo, Brazil
The esthetic implant rehabilitation of patients with compromised dentition frequently involves a multidisciplinary approach. The achievement of esthetic objectives in multidisciplinary cases represents a considerable clinical challenge. During recent years, treatment modalities and options have changed. The design of implants and prosthetic components has changed in order to minimize bone resorption and soft tissue alterations. This lecture will focus on the prosthetic approach in difficult esthetic implant rehabilitations.
11:35 - 13:15
Session II: Digital Dentistry Solutions
Moderator: Tali Chackartchi
Incorporating Digital Means into Guided Bone Regeneration Workflow
Orly Nir Shapira, Israel
How can we improve our surgical skills? Until recently, the digital revolution in dentistry was incorporated into implant placement and implant restoration procedures. However, the digital technology can also be used as an aid for bone reconstruction. Using digital technology can make bone regeneration surgical procedures accurate, efficient, and predictable. Of course, the biological principals of guided bone regeneration (GBR) are fundamental for successful bone reconstruction, and digital technology should be used according to these principles. The presentation will explore several possibilities that exist using digital means to plan and perform bone regeneration for implant placement. These possibilities will be presented in a step-by-step manner.
Today’s Reality: Guided Surgery
Galip Gurel, Turkey
In the workflow of any prosthetic treatment, whether it be analog or digital, the design of a new smile is the most creative and critical part, and it starts with a direct mock up or wax up, which will be test driven in the patient's mouth.
Any aesthetic case that would need the restoration of the teeth, or in cases of missing teeth that should be restored with implants, should start with the end result in mind, and must be treatment planned accordingly. Tooth proportions, shape, and incisal edge silhouette of the restorations should be visually seen in 3D form in the patient's mouth, and the approval of the patient should be obtained at this design stage. With this smile design in mind, which should be the first step in aesthetic treatment planning, function, structure and biology should follow, in order create the optimal workflow.
This becomes even more important in cases where implant(s) needed to be placed. The vertical, horizontal or mesio-distal positioning of the implants will be dictated by the zenith points of the teeth according to this smile design. Today, this can only be planned with the help of digital technologies, i.e. creation of the 3D smile design and its correlation to the CBCT findings. The only way to transfer this information to the mouth during implant placement, is with the help of surgical guides, regardless of whether it is a single implant case, or multiple implants needed to be placed in a partially edentulous or non-edentulous mouth.
In this lecture, the importance of pre-designing the smile and utilizing surgical guides will be emphasized.
STAR Concept: A Full Digital Protocol for Full Rehabilitations
David Norre, Belgium
Guided surgery has been a hot topic for many years. One of the biggest uses of these guides, are fully edentulous cases. However, it is well known that the accuracy in such cases is less than for tooth-supported guides, and the double scanning protocol makes preparing the procedure laborious. Another hot topic in implant dentistry is the fully digital approach. Again, in edentulous cases this approach is difficult. How do we define the final shape of the teeth before implant placement and how do we transfer these shapes for immediate loading? This lecture will give you an insight into the STAR concept, and a comprehensive digital workflow to achieve a full rehabilitation using guided prosthodontics.
14:15 - 14:25
Clinical cases Competition: Announcement on the winners
Prof. Moshe Goldstein
14:25 - 16:15
Session III: Future Trends in Implant Dentistry
Moderator: Nardy Casap
Plan, Communicate, Guide - Lessons for the Smile Zone
Kyle Stanley, USA
Plan, Communicate, Guide: Dr. Stanley will show the most recent concepts in implant dentistry to connect the restorative and surgical modalities for long term success. From digital planning and guided surgery to one-abutment one-time and polished zirconia, these concepts will help any clinician to achieve long term success in any part of the mouth.
Collaborative Care: How a Team Approach Can Improve Clinical Outcomes
Andrew Matta, USA
Though members of the audience represent countries across the globe, we’re all professionals with a fundamental goal of providing the best possible care for our patients, and despite our geographic diversity, we experience many of the same challenges in our effort to offer that level of care. For too long we’ve delivered patient care through the lens of our own expertise, perspective, and experience, and though such a practice method doesn’t necessarily comprise clinical outcomes,
it could be argued that outcomes aren’t optimized, either. Through a change in mindset and with
the help of technology, we as professionals can start working collaboratively to develop our skills
and improve clinical outcomes. Throughout this program we’ll discuss the evolution of dental providers
and the way we’ve approached patient care, with an emphasis on the current landscape and how the landscape
will look in the future. We’ll explore implant dentistry and how the power of true collaboration between
doctors and industry partners allows us to deliver the best clinical results for our patients. We’ll talk candidly
about the barriers to implementing true collaborative relationships, simple tips to break through those barriers,
and the steps necessary to maintain a collaborate network using our own examples as we’ve scaled our organization
throughout the US and Europe
Tissue Management in Cases with High Aesthetic Demand
Gustavo Giordani, Brazil; Juan Arias, Spain
Today, esthetics have become one of the main motivations of patients who visit dental offices. The orofacial harmony does not depend only on the position, color, shape or size of the teeth. Its direct relationship with the position and architecture of the tissue can determine the failure or success of the case. The concept, “TISSUE” implies esthetics and function. The different mucogingival techniques are designed to correct the position, volume and characteristics of the tissue, and to obtain a perfect result in our cases regarding teeth and implants.
16:15 - 16:45
Expert Panel: How to Integrate Best Dental and Implant Solutions to Enhance Aesthetics and Function in the Anterior Maxilla
Moderator: Mariano Sanz
Panel Members: Nardy Casap, Galip Gurel, Nitzan Bichacho, Lior Shapira, Moshe Goldstein, Eric Van Dooren
9:00 - 11:40
Session I: Live Surgery: Soft Tissue around Implants
Giovanni Zucchelli, Italy
Moderators: Nitzan Bichacho and Moshe Goldstein
12:10 - 13:50
Session II: The Implant Biologic Width
Moderator: Pablo Galindo
Towards a Biologically-Oriented Esthetic Implant Restoration at the Smile Zone. Where Do We Stand?
Nitzan Bichacho, Israel
In order to achieve a natural-looking result of artificial implant restorations, we must analyze the operative site and plan for a long-term, healthy integration of the restorative complex and the implant fixture within the surrounding living tissues.
In the smile zone, our primary goal is also to obtain natural-looking peri-implant soft tissue, embracing a natural-looking functioning crown.
The accumulated insights over the last 20 years on bone and tissue response (and alterations) around implants, enable biologic-based implementation of different surgical and restorative approaches, so that the abutment-crown complex has more chances to blend in with the surrounding tissue and the dentition, in complete health and harmony. Unfortunately, this goal is not always predictable and achievable.
In this presentation, surgical and restorative approaches will be demonstrated through clinical cases, to enable a comprehensive understanding of the present limitations and the various options available today, to maximize the successful results of implants-based restorations, especially in the smile zone.
Biological Concepts in Preservation of Crestal Bone around Implants
Tomas Linkevicius, Lithuania
Biology has always been important to preserve crestal bone stability. It is connected to the idea of "1 abutment - 1 time", which has been circulating within the dental world for decades. It has been suggested that moving restorative procedures to the abutment-level allows no additional abutment disconnection, which, in turn does not disturb the peri-implant seal and produces better bone levels. To achieve this, an intermediary multiunit abutment or CONNECT abutment (MIS) is used. A positive outcome is obvious already at an early stage of the treatment, as multiple disconnections of healing abutment are inevitable. Furthermore, the 1 year follow-up provides an even better clinical picture, as no bone loss and no bone remodeling is seen. It may be concluded that the use of an intermediary multiunit abutment, significantly reduces crestal bone loss around sub-crestally positioned implants.
The “One Abutment - One Time” Concept - Revision of the Biologic Width?
Stavros Pelekanos, Greece
Biologic width around teeth is a well-established term, although still controversial sometimes regarding numbers. It gets more complicated when the same term is used around implants, since technology and human intervention add many factors which affect the transmucosal zone in quality and quantity.
The use of the “one abutment-one time” has been shown to be beneficial throughout the years, in keeping the soft and hard tissue integration as high as possible.
The aim of this presentation is to emphasize the differences between teeth and implants, to analyze and categorize different treatment modalities, focusing on the methodology and treatment workflow in aesthetic implant cases, and finally, give some guidelines to achieve optimum aesthetic results.
14:50 - 16:55
Session III: Complications: Prevention and Treatment
Moderator: Moshe Goldstein
Interdisciplinary Approach to Managing Esthetic Problem Cases
Dennis Tarnow, USA
Synopsis: The treatment planning of complex cases requires the highest level of knowledge and skill of the treating team. It is an orchestration of procedures, including proper sequencing and timing, which makes the difference. A visualization of the final case before starting is required to know where the goal of treatment will be directed. This, in conjunction with the patient’s needs and clinical situation, comprise the decision-making process for what is the best treatment for the patient.
Various problems facing the team include:
- Which teeth to save or extract?
- Should implants be placed immediately or in a delayed protocol?
- Should multiple implants be placed in the aesthetic zone?
- When and how to include orthodontics if needed for sight development?
- Should pink ceramic be used or should ridge augmentation be performed?
- Should the case be splinted or broken up into separate bridges or individual teeth?
- How to provisionalize the case throughout treatment?
- When to immediate load cases versus doing a serial extraction case?
These concerns will be addressed in this interdisciplinary approach to our most challenging cases.
Reducing Complications and Enhancing Long-Term Patient Management through Meticulous Treatment Planning and Implementation
Ariel Ragrodski, USA
With extended life expectancy and evolving advanced technologies and materials, interdisciplinary treatment planning and implementation may facilitate, now more than ever, successful treatment outcomes and simplified long-term patient care with implant-supported restorations. This presentation will address restoratively driven treatment planning and implementation designed around reducing prospective complications and allowing for simple reentry and additional contingencies. The role of CAD/CAM technology as well as the use of titanium and zirconia for custom implant abutments for cement-retained, for screw-retained, and for extensive complete arch implant-supported restorations, will all be discussed. Highlighting the restorative perspective, this presentation will apply the philosophy of “Simple is Better” in planning and implementation, to facilitate functional and esthetic, successful treatment outcomes for simple and comprehensive patient care in the everyday dental practice.
Prevention and Managing of Complications during Different Phases of Implant Therapy
Bernee Dunson, USA
The goal of the modern dentist is to restore the patient to aesthetically-pleasing, functional dental health. Complications in both the restorative phase and surgical phase are a natural reality in providing this care. This presentation will provide some common complications that occur, and the steps to manage and treat.
Palais Dar Soukkar