AGENDA

FRIDAY SEPTEMBER 13 WORKSHOP DAY

Workshops run in parallel
It is a prerequisite to attend the lecture day in order to book a workshop.

SATURDAY SEPTEMBER 14 LECTURE DAY

ABSTRACTS

LECTURE

Dr. Koray Feran: 10 years of experience in private practice with botiss biomaterials – a solution for every situation 
The botiss portfolio of hard and soft tissue augmentation materials first entered the UK at the start of 2012, Dr. Koray Feran was one of the first clinicians in the UK to adopt these biomaterials into his practice.
In that time, he has utilised both hard and soft tissue augmentation combinations to optimise results for his patients at the clinic. This presentation is to demonstrate the range of biomaterials and the way that they can be utilised for a variety of different predictable bone and tissue augmentation scenarios in private practice.

LECTURE

Prof. Sofia Aroca: Indication and limits of the use of collagen matrix in the coverage of multiple recessions. The advantage of using cerabone^® plus in a case of peri-implantitis
The techniques for surgical treatment of recession type defects, mainly derived from the coronally advanced flap, the supraperiosteal envelope technique in combination with a subepithelial connective tissue graft, or its evolution as a tunnel technique, have been developed to achieve complete root coverage with improved aesthetic outcome, but few of them can provide complete root coverage in RT2/RT3 recession, as these type of defects present loss of interproximal bone and soft tissues.
All techniques aimed at covering soft tissue defects around teeth involve the use of connective tissue grafting. However, CTG harvesting is often associated with increased patient morbidity, prolonged surgical time, and the possibility of postoperative complications such as bleeding, numbness, and sensory changes in the donor area. To overcome these inconveniences, new materials are being developed to replace connective tissue grafts, thereby improving patient acceptance and minimizing morbidity. To what extent can these biomaterials be applied with reproducibility?
Prof. Aroca will focus on a detailed description of the modified tunnel technique and all the parameters that need to be evaluated, which she is sure will make the decision-making process less complex and the results more predictable. She will also delve into the biology of the tissues to better understand their management and how to create a favorable environment where scarring can always occur in a predictable manner. Therefore, the aim of this lecture is to present different surgical protocols for the successful management of soft tissue defects and to provide clinicians with in-depth knowledge to apply in their daily clinical practice. At the end of her presentation, she will present a clinical case of peri-implantitis and its treatment using cerabone^® plus.

WORKSHOP

Prof. Sofia Aroca: Periodontal plastic surgery and treatment of multiple recessions
Theoretical background:
Periodontal plastic surgical procedures aiming to treat multiple recession defects have been extensively described in the literature. Most of them can be combined with connective tissue graft or with soft tissue substitutes in order to increase the marginal gingiva thickness which in turn ensures the long-term stability.

Hands-on parts – techniques presented:
– The surgical techniques used are very technical sensitive and need a deep knowledge on behalf of the clinician in order to obtain predictable results.
– The course will focus on presenting step by step of the tunnel technique and a comprehensive philosophy of surgical risk factors which need to be taken into account to optimize the clinical outcomes.
– Clinical cases and surgical techniques using connective tissue grafts and acellular dermal collagen matrix will be demonstrated

LECTURE

Dr. Marius Steigmann: Extraction Socket treatment in the aesthetic zone with and versus immediate implant placement – Anatomical and functional aspects
Alveolar ridge preservation (ARP) can successfully reduce volumetric ridge changes. However, there is still no consensus on what technique is the most advantageous for each specific clinical scenario. Hence, the aim of the lecture is to provide a treatment decision tree to guide the choice of predictable ARP procedures based on extraction socket buccal bone morphology, aesthetic necessity, and modified implant position. Each socket morphology can be treated with different biomaterials and membranes according to the socket anatomy for this a Treatment Decision will be presented in connection with the adequate soft tissue manipulation according to each situation. The advantages and disadvantages of immediate implant placement will be described in detail.

WORKSHOP

Dr. Marius Steigmann: Soft tissue management for Guided Bone Regeneration of horizontal bone defects – The Periosteal Pocket Flap
Alveolar bone resorption leading to knife-edge ridges is a common phenomenon in dental implantology. Guided Bone Regeneration (GBR) has been shown to be a successful technique to allow dental implant placement in these cases. However, in cases of severe or localized horizontal bone deficiencies, sufficient soft tissue mobilization to ensure primary soft tissue closure over the augmented area can be difficult to achieve. The failures in GBR include dehiscence, flap opening, flap necrosis, hematoma, and edema.
This hands-on course describes a buccal ‘Periosteal Pocket Flap’ (PPF) designed to address these situations. The flap design results in a periosteal pocket, which is filled with bone grafting material and facilitates primary, tension-free soft tissue closure by early splitting of the mucosa. This design gives stability to the augmented volume within the pocket.

The hands-on course on pig jaws, limited to 20 participants, will describe:
– Soft tissue manipulation necessary for primary closure tension free
– The incision, flap design, flap manipulation, suturing step by step
– Protection of vital structure like nerves, arteries, glands
– Bone grafting biomaterial and membrane properties necessary for PPF
– Advantage and disadvantage of this technique compared to classical GBR like ‘Sausage technique’, bone blocks or cortical plates

LECTURE

Dr. Miroslav Sikora: Importance of Vitamin D in maintaining oral health and periodontal integrity
Before the dentist decides on GBR and implantoprosthetic therapy, it is important to consider the general and local factors that can cause dental implant rejection. General factors are untreated diabetes, osteoporosis, radiotherapy, chemotherapy, smoking, malnutrition and excessive alcohol consumption. Another factor is extremely important, and that is the lack vitamin D in the blood. In dental implantology and GBR, the concentration of vitamin D in the blood is still neglected. Vitamin D is not a vitamin. It is actually a hormone that most people are unable to synthesize either because of living in areas with little sun or because of the way modern way of life, so they have to take it in food or as a supplement.
Many recent studies concluded that vitamin D has a significant impact on osseointegration of dental implants, periodontal health, and oral health in generally. Procedures for measuring concentration of vitamin D should be carried out in those patients in whom there are risks factors from the development of deficiency of this vitamin. It has already been proven that there is a large number of people in the world with a lack of vitamin D. This problem can be solved extremely easily with use of vitamin D supplementation. Longer exposure to the sun is also recommended.
The purpose of this lecture is to show dental doctors the importance of vitamin D as a pleotropic hormone, especially in maintaining oral health and periodontal integrity with reference to the possible numerous systemic manifestations in case of its deficiency. In conclusion, vitamin D significantly affects the immune system, teeth, and bones. Studies have demonstrated that vitamin D is helpful for maintaining strong teeth and bones as well as enhancing immune system functionality.

LECTURE

Dr. Daniel Palkovics: Artificial intelligence, virtual planning and a pure magnesium membrane for alveolar ridge reconstruction
The advent of digital technologies and material science is continuously affecting the field of reconstructive surgery.
A virtual patient model acquired with the combination of 3D reconstructed cone-beam computed tomography (CBCT) images and intraoral scans. With powerful artificial intelligence (AI) based tools the model acquisition process is fully automated, and no longer requires the application of manual intervention. By combining virtual patient models allow us to plan the incision, the flap elevation, and the regenerative strategy digitally prior to surgery.
Additionally, to precise planning, using resorbable barrier membranes can further reduce invasiveness and complication rates of surgical procedures. NOVAMag^® membrane, a pure magnesium membrane, combines the advantageous properties of resorbable- and nonresorbable barrier membranes. With its rigid structure it can be used in instances that otherwise would require the use of non-resorbable membranes.
Aim of this lecture is to demonstrate a computer-aided planning for alveolar ridge reconstruction utilizing NOVAMag^® membrane.

LECTURE

Dr. Giorgio Tabanella: New frontiers in bone augmentation procedures: a sophisticated and minimally invasive approach for bone reconstruction
Predictable and safe regeneration of bone defects is no longer a major obstacle in implantology. A proper selection of different grafting biomaterials is based on the volume stability, osteogenicity, origin, porosity, and ease of clinical application that they provide. Especially the new generation of sticky bone not only supports better handling, but also provides faster cells proliferation, vascularization, and better clinical outcomes. Also, the guided bone regeneration is supported by the appropriate choice of barrier membranes. The balance between timed barrier function and space maintenance properties seems to be of crucial importance. The pericardium collagen membranes are already a gold standard for long-term barrier function, but do we enjoy the removal of titanium meshes?
Luckily a new generation of biodegradable metal is already available that doesn’t need removal. Also, their barrier function is comparable to pericardium collagen membranes. Among different applications, a new technique, the “magnesium shield technique” will be presented, which allows any clinician to get the maximum out of a socket preservation in case of missing buccal bone: this approach will reduce the need of invasive surgical procedures thus increasing patient comfort during implant treatment.

WORKSHOP

Dr. Giorgio Tabanella: Socket shield technique and horizontal ridge augmentation with the use of the NOVAMag^® membrane
The NOVAMag^® portfolio includes products that are synthetic and mechanically strong, but fully bioresorbable and that are replaced by natural bone over time. It thus offers dentists completely new treatment options. The NOVAMag^® regeneration family consists of the NOVAMag^® membrane and the NOVAMag^® fixation screw and was developed for augmentation procedures in the alveolar ridge. The NOVAMag^® membrane is a magnesium membrane and the NOVAMag^® fixation screw is a set of magnesium fixation screws in different sizes that can be used for both barrier membrane and bone block fixation. Due to its unique features, the NOVAMag^® product line offers a minimally invasive approach for patients, as the implants do not need to be removed in a second procedure. Therefore, it is also a very safe technique in comparison to nonresorbable membranes. In addition, this also reduces chair time for the dentist. This is a win-win situation for everyday clinical practice.

WORKSHOP

Dr. Henriette Lerner: Avoiding complications by minimally invasive bone and soft tissue grafting 
Digital Dentistry is, among many other benefits, claiming to transform the surgery minimally invasive and predictable procedure. The surgical philosophy, bone and soft tissue grafting are living a paradigm changing in the time of digitization. In this workshop new techniques of minimally invasive bone and soft tissue surgery will be step by step presented.

LECTURE

Dr. Iulian Filipov: Simultaneous sinus lift and implant placement in cases with less than 1.5 mm subantral bone
The main goal of implant rehabilitation is masticatory function. Bone loss is a subsequent consequence of tooth extraction that may undermine the optimal condition of the alveolar bone for implant placement. In the lateral area of the maxilla, alveolar bone can lose significant volume due to maxillary sinus pneumatisation following teeth extractions. In many cases an adjunct augmentation procedure is indicated in order to restore the subantral bone volume. The goal of maxillary sinus lifting is to raise the Schneiderian membrane and augment the resulting space with a biomaterial in order to restore the subantral bone height. This preliminary study evaluated the effectiveness of a novel technique for one-stage sinus lifting and simultaneous implant placement in cases with less than 1.5 mm residual alveolar bone. The results of the study will be presented in conjunction with a literature review and technical aspects of the novel technique will be outlined.

WORKSHOP

Dr. Iulian Filipov: Bone augmentation through sinus lifting extern technique
In many cases, due to early extraction, periodontitis, trauma or oncological pathology, alveolar process suffers a significant loss and bone augmentation procedures are a prerequisite for successful dental implant treatment.
Sinus lifting is one of the most challenging procedures faced by the surgeon in dental implantology and a thorough planning and a proper surgical technique makes the difference between a favorable and unfavorable outcome. An evidenced-based approach is advisable to be used to set accurate technique for a specific clinical scenario.

LECTURE

Prof. Cristian Dinu: Implants in the aesthetic zone: protocols for successful results
High aesthetic standards and a reduced duration of the overall treatment are the overarching tendencies in aesthetic implantology nowadays. While these two concepts may appear contradictory, our main goal is to achieve the maximal aesthetic results within the shortest time frame possible.
This presentation will showcase a merger of concepts such as immediate implantation, guided implant placement, and the “socket shield” technique with simple and complex situations of hard and soft tissue reconstruction in different types of bone and tissue deficiencies.
The presentation will facilitate gaining a perspective on the extent of the therapeutic interval in relation to the complexity of the clinical situation and also how to avoid the aesthetic complications and, when they appear, how to solve them. Participants will be able to define the criteria for achieving success in implanto-prosthetic restorations, will know the areas of the emergence profile and will be able to recognize the types of deficiencies of hard and soft peri-implant tissues. They will be able to indicate and perform contour bone augmentations, connective tissue grafts and epithelial free grafts to optimize the emergence profile and volume of the alveolar process.

WORKSHOP

Prof. Cristian Dinu & Dr. Darius Tomina: Bone and tissue importance for shaping the ideal emergence profile
The quality and quantity of hard tissues are key elements in the planning of any implant surgery, being directly responsible for the long-term stability of implant therapy, a fact demonstrated and supported by the specialized literature of the last 50 years.
The gingival soft tissues surrounding the prosthetics on implants have been of major research and development interest in recent decades. Soft tissues are essential for the survival and success of prosthetic restorations on implants representing the area of maximum vulnerability. After any type of implant surgery, the appearance of the soft tissues becomes even more important because any shortcomings of the surgical procedures can lead to changes in color, contour, size, texture and last but not least the presence of scar tissue, deficits that can be really difficult or in some cases impossible to correct.
In this course, we will highlight the importance of hard and soft tissues in optimizing surgical outcome by emphasizing surgical techniques for bone augmentation, augmentation of connective tissue, management of keratinized tissue deficiency, and volume changes that can be corrected with the help of gingival tissue grafts or vestibular bone augmentations. Participants will apply a MegaGen AnyRidge dental implant to a porcine mandible/maxilla, perform a xenograft vestibular contour augmentation, fabricate a provisional crown, harvest connective and epithelial tissue using various surgical techniques, and model implantoprosthetic transition zone.