Roadmap of periodontal and peri-implant tissue reconstruction: What do we need for clinical success? by Prof. Serhat Aslan
Periodontal treatments involving cause-related therapy, resective and regenerative periodontal surgeries have been well documented over the last 30 years. In the era of aesthetics, clinicians are seeking for optimal results by avoiding invasive treatments. Recent developments in regenerative techniques and adoption of microsurgery in periodontal and peri-implant tissue reconstruction minimize the tissue trauma/loss, and this led to an increase in the expectations of the patients. However, the clinical excellence does not only depend on the clinical skills or practice settings. Treatment outcome is influenced by combination of many factors. For clinical success, treatment steps and protocols should be embraced by patient and clinician. In this lecture, the requirements for periodontal/peri-implant tissue reconstruction and health will be discussed in greater details.
Paradigm shift in sinus grafting procedure: The era of immediacy by Dr. Alain Abi Sleiman
The loss of maxillary posterior teeth is often associated with reduction in the residual ridge height, and this is partly resulting from pneumatization in the maxillary sinus. In some cases, it is contraindicated to place implants of certain length where the residual ridge height is not sufficient (≤4 mm). For that reason, short fixtures have been suggested to overcome this problem. Nevertheless, the lateral sinus floor elevation remains the gold standard if compared to the crestal approach, which is a blind technique even though it is a minimally invasive method.
However, the lateral sinus lift approach has certain disadvantages such as additional morbidity and extended healing time that varies from six to nine months prior to the implant placement. As a result, the entire implantation procedure can take as long as twelve months and lead to unsatisfied edentulous patients. Therefore, our team has many years of focus and experience in modified lateral sinus lift elevation procedure that shortens the healing period. This procedure also reduces the patients’ morbidity and avoids the second or implant placement surgery. We achieve that by immediate implant placement and simultaneous sinus grafting with high temperature treated xenograft/autogenous bone mix, followed by GBR supported via use of long-lasting barrier such as pericardium collagen membrane. The rationale of the approach will be explained in detail during the lecture.
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