Clinical Roundtables
Sixteen Clinical Roundtables will be offered throughout the meeting so you have additional choices of topics and in-depth learning opportunities. Each Clinical Roundtable will be limited to 20 participants. Each is 90 minutes in length. Some topics delivered as Main Podium Presentations are covered more in-depth as Clinical Roundtables. This gives you the opportunity to interact on an intimate basis with a Main Podium presenter. Several topics are also offered only as Clinical Roundtables allowing you the chance to delve deeply into a subject with a world-class expert. Because these are limited to only 20 participants, reserve your spot early when you register for the Annual Meeting.
To maximize your learning experience, the suggested level of implant dentistry experience is listed for each Clinical Roundtable. In order to make the session most useful for all attending, be certain to register only for those Clinical Roundtables that suit your level of implant dentistry experience.
Level 1 – for the practitioner with a new or very early-stage implant practice or for general topics understood by all practitioners
Level 2 – for the practitioner with an established implant practice who is competent to handle common implant treatment
Level 3 – the highly experienced and expert practitioner
Thursday, October 21, 2010
1:30 pm – 3:00 pm
RT1. Graftless Solution: Immediate Loading of the Edentulous Patient with Fixed Prosthesis
LEVEL: 2
Edmund Bedrossian, DDS
A fixed, implant-supported prosthesis is the most common desire for patients with edentulous jaws. Such patients seek a permanent solution that involves minimal surgical procedures and reduced treatment time, with predictable outcome. However, successful rehabilitation with a fixed prosthesis is limited by the maxillary sinus and the mental foramina in the maxilla and the mandible respectively. To establish sufficient anchorage the systematic pretreatment evaluation of this group of patients using the tilted implant concept will be presented.
The application of the All-on-4 concept using tilted and Zygoma implants will be presented. Extensive discussion of the provisional prosthesis as well as the options available for the fabrication of the final prosthesis will be considered. Patient case presentation of the multiple application of this treatment approach will discussed.
RT2. Reconstruction of the Severely Atrophic Mandible: Guided vs. Non-Guided Surgery
LEVEL: 2
Peter K. Moy, DMD
Advance technologies and surgical techniques today permit the surgeon to handle many contour and volume defects of the alveolar ridge. Guided surgical techniques combining the advancements in computer software programs and surgical instrumentation provide the clinician with capabilities that can enhance augmentation procedures and outcome in the atrophic mandible. The key to success for clinicians is to understand the biologic implications associated with the severity of alveolar defects and the objectives of the reconstruction. To accomplish this, hard and soft tissue classifications for defects must be used to assess the extent of the defect and specific surgical procedures designed to handle certain clinical situations, depending on the severity of the defect. This presentation will show methods of classifications for both hard and soft tissues with correlating surgical procedures that aid the surgeon in achieving success and predictable results with augmentation procedures. Specifically, the presentation will address success and failures of bone grafting techniques, soft tissue augmentation procedures and alveolar distraction osteogenesis in managing specific mandibular alveolar deficiencies. Potential for long-term relapse for each of the grafting techniques will be addressed and clinical results presented.
Learning Objectives: At the completion of this presentation, participants should be able to:
1. Recognize specific alveolar deficiencies and classification
2. Have an introduction to the various augmentation techniques and materials used to gain more hard and soft tissue volumes
3. Understand the long-term efficacies of each surgical technique for managing alveolar ridge deficiencies of the mandible
4:00 pm – 5:30 pm
RT3: Techniques and Materials for Ridge Preservation and Implant Site Development
LEVEL: 1
Barry Bartee, DDS, MD
The purpose of this course is to familiarize clinicians with current techniques and materials available for ridge preservation and implant site development. With the current emphasis on esthetics in restorative dentistry, the prevention of post-extraction bone loss has never been more vital. With the current emphasis on natural esthetics in the field of implant dentistry, the importance of a properly developed implant site cannot be overstated. The scientific literature pertaining to soft and hard tissue esthetics will be reviewed, as well as the scientific basis for the use of contemporary bone replacement materials. A treatment planning approach will be presented that will enable the clinician to select the correct material for extraction site grafting and apply it in a cost-effective manner.
Learning Objectives: At the completion of this presentation, participants should be able to:
1. Develop an organized approach to the treatment planning of future extraction sites
2. Understand the materials and techniques available for grafting extraction sites
3. Understand appropriate selection of materials for use in ridge preservation or in conjunction with immediately placed implants in extraction sites
4. Understand the techniques and materials available for localized ridge augmentation
RT4: – Cone Beam Technology: “It’s Not the Scan, It’s the Plan®”
LEVEL: 1
Scott D. Ganz, DMD
There is little doubt that CT Scan technology is the pre-eminent method for viewing and understanding three-dimensional anatomy. Recent recognition of this fact has been fueled by the advent of smaller, in-office Cone Beam CT scan machines (CBCT), and a renewed focus on CT-derived planning and guided surgical techniques. As more clinicians move from two-dimensional periapical and panoramic images into three dimensional imaging offered through CBCT technology, the need to correctly decipher these scans, discover underlying anatomical landmarks, and plan cases properly for bone grafting or implant reconstruction has become apparent. However, the acquisition of the scan is only the first step on the road to discovering the world of 3D planning.
Therefore, “It’s Not the Scan, It’s the Plan®” is a concept which will lead to proper treatment recommendation. This presentation will review basic concepts which will illustrate how CBCT can be effectively used in diagnosis, treatment plan for dental implants, choose the appropriate implant type and size, and to link the implant placement with the abutment/restorative choices.
This allows clinicians to practice “restoratively driven implant dentistry” using the new tools and paradigms provided by this technology helping to take the guesswork out of what we do every day.
RT16: Immediate Replacements and Immediate Loading – Fact versus Fiction
LEVEL: 2
Jack Hahn, DDS
The emergency implant is what could be called the “office economic stimulation package.” Patients who present themselves with anterior teeth that are not restorable usually want a replacement immediately. The immediate extraction replacement can be a good option. Presented properly, the patient with the fractured anterior tooth readily accepts the immediate extraction implant replacement option. This presenter has many years of experience performing immediate replacements and will share case selection, technique and clinical data which support long term success. Like all modalities in implant dentistry, there are proven principles that must be followed for predictable results. These principles will be clearly demonstrated. Molar and pre-molar immediate replacements will also be discussed. In today’s economic environment, being able to offer and perform immediate extraction replacements can be a great financial benefit to any practice.
Learning Objectives: Attendees can expect to learn the following from the presentation:
1. Techniques for atraumatic extractions
2. Socket preparation to insure implant primary stability and predictable long term success
3. Methods and materials for grafting socket defects
4. Methods for provisional restoration fabrications creating the “wow” effect
Friday, October 22, 2010
1:30 pm – 3:00 pm
**SOLD OUT**RT5: “Tunnel Grafting Procedure” ***SOLD OUT***
LEVEL: 1
Alfred "Duke" Heller, DDS, MS
The purpose of this presentation will be to show the implant dentist the use of alternative methods of bone-block grafting procedures to obtain lateral width of mandibular thin ridges sufficient to place normal width screw implants to support fixed crowns and bridges. Bone-block grafting; autogenous from chin and lateral ramus or allograft solid bone grafting cadaver bone are not without their problems of non-union, tissue complications from opening of surgical site, or infection that can result in bone-block exposure resulting in loss of bone-block.
Each participant will learn the step-by-step procedure of utilizing a predictable “tunnel grafting procedure” that can give the patient increased ridge width up to 6-8mm of bone width in six months that is of sufficient strength to support screw-type implant placement. Hundreds of patients have benefited from the presenter’s use of this technique. Hundreds of dentists taught by the presenter presently use this predictable technique to help their patients obtain sufficient bone width to place dental implants.
The participants will be shown an overview of how to use the “tunnel grafting procedure” in the following areas:
• Comparison of bone-block graft procedures verses “tunnel grafting” procedures
• Step-by-step examples showing the development of a “tissue pocket” created by specific tissue manipulations that will allow for placement of bone grafting material
• Use of different tissue barriers which are essential to avoid tissue ingrowth into the grafted bone mixture
• Discussion of different bone grafting mixtures that have proven to be predictable to obtain sufficient bone width
• Decortications of lateral ramus of mandibular bone to allow for medullary blood supply needed for bone growth results
• Suturing techniques that assures best tissue closure
• Observation of several cases showing implant placement in previous “tunnel grafting procedures”
• Discussion of “tunnel grafting procedures” that did not produce the desired results of bone width sufficient to place implants
Evidenced-based literature will be reviewed and made available.
Learning Objectives: Attendees can expect to learn the following from the presentation:
1. Alternative to block bone grafting that is predictable
2. Step-by-step procedure to create the “tunnel” to place bone grafting material
3. Placement of bone grafting mixture onto lingual side of resorbed mandibular ridge
4. Decortication of buccal cortical bone to allow for blood supply to graft material
RT6: Lateral and Crestal Bone Planing Antrostomy: Dask™ and Implantium™ System in the Treatment of the Posterior Edentulous Maxilla
LEVEL: 2
Jaime Lozada, DDS
The DASK™ system presents an innovative crestal and lateral approach for sinus grafts used to reduce the incidence of maxillary sinus membrane perforation during subantral augmentation procedures. The Implantium™ Dental Implant System is the perfect partner for the treatment of patients with sinus grafts. The large surface area of these implants helps to provide the initial stability needed during sinus augmentation. The adequate use of these instruments will enhance the precision and accuracy in bone regeneration surgery and prosthodontic rehabilitation in the posterior maxilla. This presentation will describe the use of the DASK™ and Implantium™ systems, as well as the application of Osteon™ graft materials during treatment of the posterior edentulous maxilla.
RT7: Extraction and Ridge Preservation Versus Extraction and Immediate Implant Placement: A Treatment Plan and Procedural Blueprint
LEVEL: 2
Sonia Leziy, DDS
This session is intended for clinicians with a good understanding of the principles of straight-forward implant placement who would like to further develop their range of treatment. Cases will be presented to illustrate selection criteria and treatment techniques for successful immediate implant placement, as well as indications or clinical scenarios that influence the decision for site preservation with delayed implant placement. Well documented and emerging surgical concepts, techniques, and materials will be presented for both case scenarios.
Learning Objectives: Attendees can expect to learn the following from the presentation:
1. Review the treatment planning considerations for immediate implant placement or for ridge preservation followed by delayed implant placement
2. Ridge preservation: understand how to perform atraumatic extractions, review current bone/soft grafting materials and techniques used to preserve or enhance ridge from for future implant placement
3. Immediate implant placement: review the adjunctive surgical procedures and materials that are incorporated into an immediate placement protocol to enhance long-term tissue form and stability
4:00 pm – 5:30 pm
RT8: What is the “Standard of Care” in Implant Dentistry?
LEVEL: 1
Frank Recker, DDS, JD
What implant and diagnostic modalities constitute the “standard of care” in implant dentistry today? The phrase “standard of care” is often used, but just as often misunderstood. What may be within the “standard of care” for one clinical situation may be below the “standard of care” in another.
RT9: Bone Manipulation and Expansion
LEVEL: 1
O. Hilt Tatum, Jr., DDS
Implant treatments can be planned in simple ways by determining the desired crown positions and then placing the implants with flapless surgeries in the correct positions in one procedure without the need for bone grafts. Also, during the same operations, soft tissue inadequacies can be corrected to produce stable tissue to enhance and protect the supporting bone, implants and final restorations. These will be explained and demonstrated by using combinations of bone and soft tissue manipulations to achieve these results.
Learning Objectives: At the conclusion of this presentation, the participant should be able to:
1. Understand why most edentulous areas are bone deficient
2. Understand how to simply plan prosthetic directed implant placement
3. Understand why implant placement should be flapless
4. Understand the plastic qualities of both upper and lower alveolar bone
RT10: The Benefits of Trans-Sinus Malar Process Implants as a Minimally Invasive Alternative to Sinus Grafts for the Highly Resorbed Posterior Maxilla
LEVEL: 3
Yvan Fortin, DMD
One well-established approach for implant anchorage when confronted with extensive maxillary resorption has been sinus inlay grafting, usually done as a staged procedure with multiple implants to follow. An alternative is to provide longer trans-sinus implants anchored in the malar process without bone grafting. This approach has been evaluated on over 350 patients and has demonstrated the ability to provide anchorage for fixed or splinted bar restoration of the highly-resorbed maxilla in a minimally-invasive and costeffective manner with minimal complications. This approach has the added benefit of eliminating time required for the graft-maturation phase of treatment before restoration. The indications and rationale for this approach will be demonstrated. This program is intended for the highly experienced and expert practitioner.
Learning Objectives: At the conclusion of this presentation, the participant should be able to:
1. Recognize the possibility of trans-sinus implants anchored in the malar process as a minimally invasive alternative to sinus grafting for treatment of the highly resorbed posterior maxilla
2. Understand important aspects for routine surgical delivery of transsinus implants
3. Relate the prosthetic applications of trans-sinus implants used for full arch restoration in conjunction with supplemental anterior implants
Saturday, October 23, 2010
8:00 am – 9:30 am
RT11: Applications for Connective Tissue Grafts to Enhance Peri-implant Esthetics
LEVEL: 2
Nicholas Caplanis, DMD, MS
Achieving optimal peri-implant esthetics can be extremely challenging especially in those patient situations where compromised periodontal biotypes or pre-existing soft or hard tissue deficiencies are present. This round table discussion will present information on how to safely harvest and effectively use autologous connective tissue grafts either prior to or concomitant with implant placement in order to help maximize peri-implant esthetics.
Learning Objectives: At the conclusion of this presentation, the participant should be able to:
1. Understand indications and contraindications of connective tissue grafts to improve soft tissue esthetics
2. Understand advantages and disadvantages of various harvest techniques for tissue grafting
RT12: Understanding the Principles of Esthetics for Implant Restorations
LEVEL: 3
Howard M. Chasolen, DMD
In today’s world of implant dentistry, patients assume their dentist will provide aesthetic outcomes for implant restorations. Many times, these outcomes fall short of aesthetic expectations due to the lack of understanding of how current anatomic, biologic and physiologic conditions impact the aesthetic treatment. This lecture will give dentists the ability to understand how to assess these conditions, plan and treat the necessary modifications and communicate the path of treatment to their patients. Only then will patients have a full understanding of their existing biologic conditions and the potential modifications necessary to achieve their desired aesthetic outcomes.
The attendee will be presented with strategies to develop and manage occlusal function and parafunction to preserve esthetic implant restorations.
Learning Objectives: At the completion of this presentation, participants should be able to:
1. Understand how to evaluate, classify, diagnose and treat different stages of hard and soft tissue defects. The recognition and classification of these defects will directly impact the esthetic treatment plan from a surgical and restorative perspective
2. Understand how to integrate CT derived information in the formulation of an esthetic implant prosthetic treatment plan
3. Have a thorough understanding of what restorative materials are available for esthetic implant rehabilitations. A critical assessment of the performance of these materials will be covered and clinical dependability will be discussed
4. Understand the significance of attached, keratinized tissue, tissue architecture and be able to formulate opinions on its relevance in esthetic implant restorations to both the health and beauty of the restoration
RT13: Laser Treatment of Peri-Implantitis: State of the Art
LEVEL: 2
Robert Convissar, DDS
One of the greatest challenges in the field of implantology is successful treatment of peri-implant lesions. This seminar will detail a biologic rationale for the use of lasers for treatment of peri-implantitis and suggest a step-by-step protocol for treatment of peri-implant lesions. Emphasis will be placed on peer-reviewed literature to justify the use of lasers for periimplantitis.
Learning Objectives: At the completion of this presentation, participants should be able to:
1. Understand the different laser wave lengths and their roles in peri-implantitis
2. Understand the protocol for laser treatment of peri-implantitis
3. Understand the biologic rational based on peer-reviewed literature for laser treatment of peri-implantitis
10:30 am – Noon
RT14: Understanding How Mini Implants Work
LEVEL: 1
Victor Sendax, DDS
The inside secret as to what makes Minis predictable for long-term as well as transitional applications lies in the specialized details of the essential insertion protocol, and has far less to do with the intrinsic device itself. Small diameter implants have by now mushroomed into a plethora of commercial variations from a seemingly endless list of competitors, all trying to mimic width, length and surface treatment variations that have already proven so elusive for conventional implants. Various anchorage styles and often over-elaborate prosthodontic techniques have also typically added to the cost basis and made minis less affordable for the enormous number of the full and partially edentulous who are in great need of simplified, costeffective oral implant solutions as the population ages and funds are scarce.This presentation will attempt to de-mystify the mini implant scenarios by reviewing the core Sendax insertion protocol first developed in 1976 and then studied and evaluated during follow-up clinical trials by Balkin and Ricciardi, before being presented to the FDA’s regulatory panel on devices for long-term approval. Both Dr. Sendax’s original patent and subsequent FDA acceptance were based on a minimally invasive, virtually non-surgical method for inserting a dental implant to attain immediate functionality, as well as for recognition of the ultra-small-diameter device itself that permitted the unique insertion protocol to work and be effective.
A review of representative mini implant cases, and a preview of Dr. Sendax’s first MDI textbook, Mini Dental Implant Innovations, due to be published before the end of 2010 by Wiley-Blackwell, will precede the roundtable open forum by participants.
Learning Objectives: Attendees can expect to learn the following from the presentation:
1. Mini dental implants background and history
2. Step-by-step MDI insertion and reconstructive protocol
3. Representative fixed and removable cases
4. How to integrate MDIS into your practice to help advance patient implant acceptance in a recessionary economic environment
RT15: The Most Predictable Approach to the Totally Edentulous and Atrophied Mandible
LEVEL: 1
Leonard Linkow, DDS, DMSc
Years and years of research and numerous procedures to allow the patients to function long-term with teeth supported by various types of implants has led to disasters. Subperiosteal implants when executed correctly and when placed over severely atrophied bone have proven to last into the fifth decade with practically no bone resorption. Seeing is believing, and you will believe.