PROGRAM CONTENT
TEACHING CONTENT FOR ORAL IMPLANTOLOGY BASIC COURSE
INTRODUCTION
(Dates will be published on our website)
– Listening to patients’ demands.
– Morphology of Dental Implants in the history of Implantology
(rationale – terminology – designs – geometry – biomechanical principles – biomaterials – surfaces).
– Improving elderly patients’ quality of life with implant overdentures.
– Patient selection / Patient education.
– Informed Consent / Legal issues / record keeping preop and postop.
– The SAC (simple / advanced / complexed) classification System:
- Biological factors
- Technical factors (restorations and lab issues)
- Esthetic factors
- Patient factors (compliance)
- Process (number of steps, scheduling).
1. Basic Principles of Osseointegration
Characteristics of the boney tissue – metabolism of osseous cells
Remodeling phases – healing process
Types of bone grafts
Use of combined bone grafts
High torque and its effects on implants’ clinical results
Different times for loading dental implants (delayed and immediate)
Reconstruction of 3D alveolar ridge defects (effectiveness of autogenous bone corticocancellous grafts vs titanium mesh technique)
The reconstructed maxilla and mandible (partially and totally edentulous)
The facial bones (anatomy and physiology / vascularization and neural structure)
• Masticatory dysfunction
• Aesthetic compromise
• Speech impairment
• Behavioral and psychological impairment
• Soft tissue irritation / nerve compression
• Intolerance / inability to accommodate prostheses
• Reaction to materials
Remodeling phases – healing process
Types of bone grafts
Use of combined bone grafts
High torque and its effects on implants’ clinical results
Different times for loading dental implants (delayed and immediate)
Reconstruction of 3D alveolar ridge defects (effectiveness of autogenous bone corticocancellous grafts vs titanium mesh technique)
The reconstructed maxilla and mandible (partially and totally edentulous)
The facial bones (anatomy and physiology / vascularization and neural structure)
• Masticatory dysfunction
• Aesthetic compromise
• Speech impairment
• Behavioral and psychological impairment
• Soft tissue irritation / nerve compression
• Intolerance / inability to accommodate prostheses
• Reaction to materials
2. Guided Bone and Soft Tissue Regeneration techniques
Cawood – Howel categories
Bone densities (I-IV)
Use of different types of membranes (resorbable vs non resorbable)
Hardware (screws and plates)
Flap designs
Suture types and suturing techniques
Peri-implant soft tissue deficiencies
• Etiology
• Diagnosis
• Management – treatment options
• Improving the volume
• Improving the width of the keratinized mucosa
Bone densities (I-IV)
Use of different types of membranes (resorbable vs non resorbable)
Hardware (screws and plates)
Flap designs
Suture types and suturing techniques
Peri-implant soft tissue deficiencies
• Etiology
• Diagnosis
• Management – treatment options
• Improving the volume
• Improving the width of the keratinized mucosa
3. Surgical Protocols
Instruments
Equipment
Consumables
Disinfection / sterilization
Clinical techniques for predictable results
Short implants as a reliable option
Is immediate implant placement worth the risk?
The role of socket preservation
The transalveolar approach in sinus augmentation
The lateral osteotomy approach in sinus augmentation
Equipment
Consumables
Disinfection / sterilization
Clinical techniques for predictable results
Short implants as a reliable option
Is immediate implant placement worth the risk?
The role of socket preservation
The transalveolar approach in sinus augmentation
The lateral osteotomy approach in sinus augmentation
4. Complications of the surgical phase in Implant dentistry
Systemic and local risk factors
Periimplantitis (PI) – is there a treatment? / can it be prevented?
IAN injuries caused by implant placement in the mandible
Rethinking implants as foreign bodies
Peri-implant mucositis
• Etiology
• Risk indicators
Bone loss related to cement and screw-retained prostheses
Can soft tissue augmentation minimize the risk of PI?
Does mechanical loading affect implant prognosis?
Bisphosphonate therapy and implant surgery
Is smoking still a risk factor?
Periimplantitis (PI) – is there a treatment? / can it be prevented?
IAN injuries caused by implant placement in the mandible
Rethinking implants as foreign bodies
Peri-implant mucositis
• Etiology
• Risk indicators
Bone loss related to cement and screw-retained prostheses
Can soft tissue augmentation minimize the risk of PI?
Does mechanical loading affect implant prognosis?
Bisphosphonate therapy and implant surgery
Is smoking still a risk factor?
Hard tissue complications from Peri-implantitis
• History of periodontal disease
• Lack of maintenance
• ETOH use, DM and Genetic factors IL-1 polymorphisms
• Occlusal overload
• Iatrogenic factors
• Disease progression
• Management: removal of aetiologic factors / surgical vs non-surgical treatment
5. The Surgical Approach
Different Implant systems analysis
Placement by handpiece
Placement by hand (ratchet assisted)
Guidelines for surgical placements
Placement by handpiece
Placement by hand (ratchet assisted)
Guidelines for surgical placements
6. Radiographic Diagnosis
Radiographic examination (OPG, CBCT)
Surgical splints
Digital Planning and CAD CAM materials in Implant Prostheses
Developments in digital implant impressions
Emerging development in 3D imaging and 3D printing technologies
Surgical splints
Digital Planning and CAD CAM materials in Implant Prostheses
Developments in digital implant impressions
Emerging development in 3D imaging and 3D printing technologies
7. Prosthodontic Solutions in Implant Dentistry and Multiple Complications
Efficiency and accuracy of digital vs conventional impressions in implant rehabilitation
Abutment interface in different connections
Accuracy of intraoral scanning vs lab scanning
Single crowns supported by short implants in the posterior region
Immediate loading of implants in edentulous mandibles with locators or Dolder bars or fixed prostheses
Restorative options for the posterior maxilla – possibilities and limitations
Restorative options for aesthetic defects
Soft tissue comps
Maintenance related Issues
Failure of the retentive system
Fracture of the dental prostheses
Bone loss due to overload or absence of a passive fit
Implant fractures
Complications due to insufficient planning
Abutment interface in different connections
Accuracy of intraoral scanning vs lab scanning
Single crowns supported by short implants in the posterior region
Immediate loading of implants in edentulous mandibles with locators or Dolder bars or fixed prostheses
Restorative options for the posterior maxilla – possibilities and limitations
Restorative options for aesthetic defects
Soft tissue comps
Maintenance related Issues
Failure of the retentive system
Fracture of the dental prostheses
Bone loss due to overload or absence of a passive fit
Implant fractures
Complications due to insufficient planning
8. How to proceed with compromised patients
Systemic health diagnoses
Respiratory diseases
Cardiovascular diseases
Neurological diseases
Muscular diseases
Endocrinological diseases and hormone levels which affect bone metabolism
The communication with the attending physician
Structural history of the implant site (local factors compromising the success rates)
Respiratory diseases
Cardiovascular diseases
Neurological diseases
Muscular diseases
Endocrinological diseases and hormone levels which affect bone metabolism
The communication with the attending physician
Structural history of the implant site (local factors compromising the success rates)
9. Treatment Planning
Scope of therapy
Which jaw should be restored first?
When should the implants be loaded?
General biomechanical considerations in treatment planning
Cementing vs screwing stability
Reducing functional loads by drug treatment
Dosage – adverse effects of muscle relaxants
Pharmacokinetics and pharmacodynamics of antibiotics preop and postop
Analgesia for all purposes preop and postop
Extraction and preservation of natural teeth structures preop / intraop / postop
The patient’s treatment expectations
Height of the lip line of smiling
Gingival biotype in the treatment area
Shape of missing and surrounding teeth
Esthetic risk profile
Decision Trees in the Prosthetic options
Which jaw should be restored first?
When should the implants be loaded?
General biomechanical considerations in treatment planning
Cementing vs screwing stability
Reducing functional loads by drug treatment
Dosage – adverse effects of muscle relaxants
Pharmacokinetics and pharmacodynamics of antibiotics preop and postop
Analgesia for all purposes preop and postop
Extraction and preservation of natural teeth structures preop / intraop / postop
The patient’s treatment expectations
Height of the lip line of smiling
Gingival biotype in the treatment area
Shape of missing and surrounding teeth
Esthetic risk profile
Decision Trees in the Prosthetic options
10. 4-dimensional considerations of bone morphology and mechanics
“Teeth and Implants are nutshells in the waves of the evolving bone”
Bone multicellular units (BMU): osteoclasts and osteoblasts
Why does BMU activation occur?
Interactions between Joints and Bone changes
Hormonal and Mechanical influences during growth and aging
“Pressure creates Bone”
Force, deformation, pressure and flow
Self-trabeculation and micromodeling
Form follows function
Bone multicellular units (BMU): osteoclasts and osteoblasts
Why does BMU activation occur?
Interactions between Joints and Bone changes
Hormonal and Mechanical influences during growth and aging
“Pressure creates Bone”
Force, deformation, pressure and flow
Self-trabeculation and micromodeling
Form follows function
11. Tissue Engineering
Future developments in implant surfaces (can they enhance clinical outcomes?)
Recent developments in bone substitutes and membranes
Blood absorption on titanium implants as a model of osseointegration
Computer assisted – flapless implant placement: does it reduce the incidence of surgery related bacteremia?
Biologic response of osteoblastic cells on titanium surface treated with Erbium – Yag laser
12. Prosthetic phase in Oral Implantology
Digital workflow for fabrication of dentures and full arch implant prostheses for edentulous patients
Intraoral digital impressions of complete arches
Digital recording of jaw relationships in edentulous subjects
Digital denture fabrication
Fabrication of surgical guide
Computer guided implant surgery
Cement and screw retained full arch fixed prostheses
Intraoral digital impressions of complete arches
Digital recording of jaw relationships in edentulous subjects
Digital denture fabrication
Fabrication of surgical guide
Computer guided implant surgery
Cement and screw retained full arch fixed prostheses