Mis Global Conference 2013 – Main Topic



The New Esthetic Concepts & Solutions with Latest Technology

Effective communication is a primary skill in any business endeavor, and never more important than in the practice of Esthetic and Implant Dentistry. This presentation will address more effective methods of communicating esthetic smile design solutions through Trial Smiles and CAD/CAM temporary restorations.

In addition, the follow-up process of selecting the best and latest technology and solutions with FC Zirconium in implant esthetics as well as all-ceramic system for that individual patient in your chair will be discussed in detail. Patient management for esthetic therapy will also be outlined along practice management pearls to enhance your effectiveness and profit.


The Essence of Beauty

At a time that anterior dental aesthetics is undergoing a paradigm shift, this article by Dr Zhu et al is both timely and appropriate. Whereas in the eighties and nineties the emphasis was providing contrived smiles primarily based on geometric perfection, in the last decade there has been a gradual shift towards more individual rather than a ‘one fits all’ approach to anterior dental aesthetics.

In addition, cosmetic dentistry based on spurious geometric smile design involved destructive, irreversible procedures for indirect porcelain laminate veneers or full coverage crowns. Nowadays the trend is shifting towards a minimally invasive approach involving modalities such as direct resin-based composite restorations, orthodontics and implant therapy.

However, similar to dental aesthetics, minimal invasive dentistry means different things to different people. For some clinicians, a minimal invasive approach is simply applying palliative varnishes and monitoring the clinical situation; while for others minimal intervention is any treatment short of extracting a tooth. Combined with more restrained treatment options, the last few decades have also witnessed a burgeoning of dental implants for replacing missing teeth.

Rather than being an esoteric, specialist therapy, dental implants are entering the realm of mainstream dental practices, offering a variety of both removable and fixed prosthetic options. In many circumstances placing implant fixtures obviates the need for preparing sound teeth as abutments for supporting fixed bridges, and provide stability for removable dentures for totally edentulous ridges.

Although the conclusions of the research by Dr Zhu may seem obvious, it does nevertheless, emphasise that for many the impetus for seeking dental care is primarily aesthetics, even more than functional needs. Therefore, this study endorses the view that dental aesthetics is an integral part of prosthodontics.

However, there is a moral and ethical obligation by dentists to sufficiently inform and educate patients, and not to sensitises them about minor aesthetic anomalies, to which they are oblivious, for the sake of accepting the so called ‘cosmetic make-over’ treatment plan. It should be remembered that a thin exists between marketing and coercion.

Also, patients are have the responsibility not be to swayed by peer, social or media pressure for seeking cosmetic treatment for ephemeral satisfaction at the expense of irreversible damage to their dentition. Hopefully, this message is filtering through to cosmetic dental spas that still promote an ‘ideal smile’ and the promise of eternal youthfulness.


Management of the posterior atrophied mandible

Atrophy at the posterior mandible constitutes one of the most intensive challenges for the implant surgeon. Most medico-legal problems in modern implantology are derived from surgical invasion of the mandibular nerve and associated neurological morbidity.On the other hand posterior mandibular edentulism, leading to bone resorption due to removable dentures is a frequent problem in our practices.

Our presentation will deal with our management protocol at this critical area, reviewing techniques such as: vertical and horizontal reconstruction, nerve mobilization and use of short implants.Indications and drawbacks of different procedures will be addresed.


Predictable Crestal Sinus Augmentation with less than 5mm of native bone utilizing the MIS SEVEN Implant

As implants have become the standard of care and their usage increases, the trend in dental implantology is moving towards minimally invasive surgical techniques which involve decreased healing times and surgical morbidity. These improved procedures should encourage more patients to become candidates for treatment.

In addition, improved bone grafting augmentation materials are resulting in decreased healing times. This lecture describes a modification to the classic osteotome sinus augmentation procedure, having the advantages of requiring less than 5mm of native bone. The technique using demineralized freeze-dried bone (DFDBA) and BondBone® calcium sulfate as part of a composite graft is described and its advantages discussed. CBCT scans are also presented.


Global Implant Dentistry: From Science to Practice through Education

Implant Dentistry has evolved into an important field of dental therapy. Evidenced based knowledge of basic science, diagnostic and therapeutic options with dental implant therapy is, therefore, mandatory for dental students, general practitioners and specialists.

All of them require a solid basic knowledge of biological prerequisites and clinical procedures leading to successful implant treatment and, in particular, an understanding of the importance of embedding implants into the overall treatment concept. Among others this includes aspects of materials that are used in Implant Dentistry.

The practitioners should be able to differentiate risk situations, which implies that they have enough knowledge within an ethic frame to transfer science to practice through education to manage a proper clinical examination and dental treatment. World Experiences of a systematic approach to enhancing the knowledge of dentists in the field of Implant Dentistry in Dental Schools and Implant Training Centers will be reviewed and presented.


Implants – shape and function: Are specific implant designs more suitable for specific indications?

The hundreds of different implant designs creates a confusing dilemma for the practitioner, in trying to decide which design is best for a particular clinical situation. This seminar will compare and critique many of the different manufacturers and designs that the presenter has utilized over the last 24 years. Short term and long term results will show the good, the bad and the ugly with many different designs.

The presenter has documented over 12,000 implants to date and utilized a customized Dental Implant Management System, to allow sophisticated analysis that is rarely seen especially from a private practice setting. This statistical information will complement the many clinical cases that will be shown, and will add scientific validity above and beyond just clinical opinion. Seminar objectives for the participants will include imparting knowledge of what works and what doesn’t as specifically related to implant design.


The shortened Drilling Protocol-Does it work?

The aim of this study was to determinate whether a reduced number of drills can prepare correctly the bone bed for implant insertion.During the last 20 years many implant manufacturers relied on the classic drilling protocol developed in the 80-ies for the Branemark implants. Nowadays, surgeons and patients look for a reduced surgical time in order to minimize trauma and pain.

The use of only 3 drills in order to insert implants with diameters from 3,3 to 4,2mm reduces treatment time to about half compared to the classical protocol.X-ray follow up showed no significant differences between the two protocols.


Histological and Histomorphometric Evaluation of C1 Implants New Prototype Surfaces to Increase the Osseointegration with Melatonin and Vitamin D. – Experimental Study in Dogs.

The aim of this study was to evaluate the effect of the topical application of melatonin compared with Vitamin D to accelerate the osteointegration on the C1 SLA surface implants in Beagle dogs three months after their insertion.

In preparation for subsequent insertion of dental implants, lower premolars and molars were extracted from 12 Beagle dogs. Each mandible received three C1 ( MIS) implants with SLA surface of 4 mm in diameter and 10 mm in length. The implants were randomly assigned to the distal sites on each side of the mandible in three groups: group I C1 implants alone, group II implants with melatonin and group III implants with Vitamin D. Prior to implanting, lyophylized liquid melatonin and Vitamin D were applied on top of implant surface None was applied at the control sites. Ten histological sections per implant were obtained for histomorphometric studies.

After a 4-weeks treatment period, melatonin significantly increased the perimeter of bone that was in direct contact with the treated implants (P<0.0001), bone density (P<0.0001), new bone formation (P<0.0001) than Vitamin D in comparison with control implants. Topical application of melatonin and Vitamin D on SLA surface may act as a biomimetic agent in the placement of endo-osseous dental implants and enhace the osteointegration. Melatonin combined with on C1 implants reveals more bone to implant contact at 12 weeks (84.5±1.5 %) compared with Vitamin D treated (75.1±1.4 %) and non-melatonin treated surface implants (64±1.4 %).


In the quest for the periimplant papilla

In the era of biomimetic implant dentistry, teeth replaced by implants should look exactly like natural teeth. However, achieving perfect soft tissue esthetics remains elusive. In particular, predictably obtaining   a papilla adjacent to an implant is probably the most  challenging goal.

This lecture will discuss the scientific and clinical nature of the difficulties clinicians encounter in preserving or reconstructing the papilla adjacent to dental implants. Topics in the lecture, will include issues related to predictable periimplant soft tissue dimensions, preservation of the periimplant bone crest, and the intimate relationship between them predictable periimplant. Additionally examples will be presented on surgical techniques aimed to augment perimplant papilla, and a complete surgical prosthetic treatment protocol to achieve a stable papilla between adjacent implants.


The advantages utilizing UNO Implants in immediate rehabilitation of complete maxillary cases

Immediate rehabilitation of complete maxillary cases, combined with immediate placement of implants, present significant risks to the integration process of newly placed dental implants.

In order to ensure osseointegration in extraction sites, our team has developed a technique for immediate temporization that does not compromise the Osseointegration: a complete temporary bridge, fixed immediately to UNO implants, used as temporary implants. 100 patients were treated based on this protocol. The clinical use of this specific protocol as well as obtained results will be presented.


Success Criteria for Implant-Prosthodontic Rehabilitations in the Esthetic Zone

Success in implant dentistry should ideally evaluate the long‐term primary outcome of an implant‐prosthetic complex as a whole. During this lecture, clinical considerations for dental implants will be analyzed in the context of their application to esthetic implant rehabilitations. Risk assessment, treatment planning, surgical protocols and esthetic/prosthodontic rehabilitations will be discussed in detail according to different clinical situations.

In particular, this presentation will examine the most frequently used criteria to define treatment success for implant rehabilitations in the esthetic zone. Parameters at the implant level, peri‐implant soft tissue, prosthetics, and patient satisfaction level will be discussed as indicators of treatment success. Objectives: upon completion of this lecture participant should be able to: – Familiarize with current trends in esthetic implant dentistry. – Assess associated risk factor for suitable treatment planning – Widen treatment options using a selective approach.


Advances in and the Socioeconomics of Implant Dentistry

Advances in the science of implantology has allow implant dentistry to become more efficiency and cost effective. This has brought an entire new population that is now able to afford this fabulous service. Implant dentistry was previously limited to the top 5% of the population.

With this affordability factor the top 25% of the population is now in the position to have implant dentistry performed. Dr.Gelbart will present some of his techniques and advances that he has evolved in his 25 years of dentistry.


Immediate Implant Placement: Clinical Decisions,Advantages and Disadvantages

Implant placement in fresh extraction sockets in conjunction with appropriate guided bone regeneration is well documented. Immediate implant placement techniques report survival rates of 94 to 100% over a varying healing period of 3 months to 7 years. The decision to extract teeth and replace them with immediate implants is determined by many factors, which ultimately affect the total treatment plan.

Advanced periodontal attachment loss, teeth restored with crowns, loosened endodontic posts, advanced caries, unfavourable crown-to-root ratios, and various combinations of these factors contribute to a final decision to remove teeth. Successful immediate implant placement may be possible in all regions of the jaws, although replacement of molars is more challenging. Chronic infection is not an absolute contraindication for immediate implant placement.

It is controversial whether immediate placement of implants may preserve the alveolar bone. Small gaps between implant surface and socket wall have a potential for spontaneous healing. No consensus exists on the need for bone augmentation in these situations.The goal of this lecture is to review some of the important clinical considerations when selecting patients for immediate implant placement, and to discuss the advantages and disadvantages of this mode of therapy. In addition, presentation of studies’ results regarding immediate placement of SEVEN® implants will take place.


The Palatal Bone Block : A Novel Place to Harvest Gold Standard Bone

Autogenous bone is the gold standard of guided bone regeneration. Autogenous bone blocks allow us to build more bone more predictably with less complications. Harvesting of bone blocks from the traditional sites like the ramus or symphysis has a high rate of morbidity and the need for second surgical entry often reduces the patients acceptance of treatment.

The Maxillary Palate is an area which has excellent cortical bone which if harvested correctly can often produce substantial autogenous bone from same area and incision as the placement of the implant. It is also a site with very little morbidity due to the overlying thick mucoperiosteal flap as well as the lack of muscle pull in the area. It also provides a one site surgery which is a far more attractive treatment option for many patients. This lecture will take you through the step by step technique of harvesting and fixing the bone blocks harvested from the palate. Flap design and suturing techniques will also be covered.


Implants in the Esthetic Zone – Surgical Options at the Prosthetic Phase

An implant supported restoration is a multi-phase process that begins before the placement of the implant and continues with the surgical phase of implant insertion, through the implant exposure and ends with the prosthesis preparation. An outcome that meets the functional and esthetic expectations of the patient requires meticulous performance at each of these stages.

Sometimes, mishaps during the surgical stages present the restorative team with anatomical situations that, due to soft tissue or bone defects, make the preparation of a satisfactory restoration impossible. Sometimes, anatomical complications occur after the finalization of the prosthesis. The aim of this presentation is to present some of these situations, try to learn how to evaluate them, and discuss the optional surgical procedures for coping with, at least, part of them.


Simplifying the Bone Grafting for Implant Surgery

The presentation aims to illustrate the methods used in practice to simplify the bone grafting procedures, either for socket grafting or for the alveolar ridge augmentation procedures . Sinus lift grafting is also included in the presentation. The method is based on the use of purely synthetic materials for grafting in order to minimize the trauma to patient, reduce the operating time, avoid creation of another operative site for graft harvesting and to reduce the risks associated with grafting.

When synthetic grafting materials are used in combination with autografts, they reduce the risk of infection and contribute to the success. The materials used for this are Beta-tricalcium phosphate and Calcium Sulphate respectively, or in combination or combined with autogenous bone obtained from the same operative site. The need for a barrier membrane(whether synthetic or collagen) for graft protection is greatly avoided, with further minimization of the potential for complications. The ethical dilemmas associated with grafting also are avoided, like implantation of animal products which are not acceptable by patient either on religious or the life style basis.


Novel Approaches for Simple and Predictable Socket Regeneration

There are many key factors for successful implant dentistry. Patients must first understand the value of ideal therapy from bone regeneration through implant placement to tissue maintenance and aesthetic restorations. To optimize placement of dental implants in the shortest time period after extraction, a few criteria must be met. When the tooth is removed, bone replacement therapy should be instituted at that visit.

The materials used must be biologically active and lead to preservation of alveolar volume, replacement of the missing hard tissue with vital bone and allow maintenance and/or augmentation of the soft tissue that will cover the site. The use of a biphasic calcium sulfate material alone and in combination with other graft materials will be shown to meet these criteria. The results will be analyzed clinically, radiographically and histologically validating these materials as ideal for use in extraction socket defects. Additionally, the latest tools for digital photography and software to educate your patients to increase case acceptance will be shown.


Designing bone and soft tissue around modern Implants: A systematic approach.

Implant dentistry is a symbiosis between Art and Science. The art and the highest target in Implant dentistry is a high aesthetical outcome in terms of micro and macro esthetics. At the same time we aim a most minimally invasive and shortest treatment way.

Implant designs, Graft materials and Membranes, new hard and soft tissue grafting techniques offer us the possibility to fulfill this target in most situations. A systematic thinking approach will be the guideline for a decision in planning and treatment.


Periodontal and Peri-Implant Disease: Similarities and Differences

Dental implants have radically changed the clinical practice in the last 30 years in dentistry. Partially or fully edentulous patients can now benefit from fixed implant-supported restorations. Unfortunately, complications can occur in a percentage of cases. Some complications are easy to correct, but others are more serious, sometimes leading to the implant failure.

Peri-implant infective pathology has been classified as “mucositis” when a reversible inflammatory soft tissues reaction is present, and as “peri-implantitis” when there is loss of supporting bone in the tissues surrounding an in function dental implant. Risk factors for implantitis include poor oral hygiene, history of periodontitis, cigarettes smoking, and some characteristics related to the implant design, as the roughness of the implant surface and the type of the implant–abutment connection. In case of of two parts implant systems, where the shoulder of the implant is positioned at the level of the bone, a non-perfect correspondence between the abutment and the implant components may lead to the presence of a gap, which, acting as a bacterial reservoir, might perpetuate the bacterial challenge where effective cleaning is difficult or impossible.

Subsequently, specific characteristics related to the implant surface might favour the accumulation of bacteria along the implant’s surface, deepening the infective process into the bone. On the basis of anatomical and physiological differences existing between periodontal and peri-implant tissues, the disease progression around implants is different from around teeth. Similarly, the respective preventive and therapeutic approach is different. On the basis of the literature and the personal experience of the author, the presentation aims to be a valid support for clinicians in the prevention and treatment of peri-implant disease.


To augment or not to augment: this is the question

Dental implants are often required to restore missing teeth in sites with significant alveolar bone loss. With this being the case, clinicians are using a variety of implantable materials and surgical techniques to augment the missing alveolus in order to allow for standard implant placement. These procedures are at times performed prior to implant placement or in other cases simultaneously with implant insertion.

However the predictability of all these procedures and materials is yet to be improved.The use of shorter implants allows the clinicians to avoid extensive bone regeneration, thus improving predictability while reducing the complexity of therapy in these sites. This presentation will focus on the available scientific data pertaining to short dental implants and offer some insight to the path that implant dentistry is taking today vis-à-vis this dilemma


New Approach for Immediate Implant Placement after Extraction

Immediate implant placement after extraction is a well codified surgical technique.This technique seems to lead to a faster osseous healing due to a better vascularization provoked by the tooth extraction, to the opening of the medullary spaces and to the slightest heating of drilling.

The aesthetic result is exceptional because the implant is located in the original position of the natural tooth.This technique gives a significant psychological advantage by replacing immediately the lost tooth and shortening the treatment time.The simplicity of the technique of immediate implant placement should be used in our daily practice when extraction should be done, every time the indication is well performed. This technique gives significant advantages to enhances esthetic results.


Soft Tissue Management to Optimize Esthetics of Implant Supported Restorations

Soft tissue attachment protects the zone of integration from plaque and infection. Gingiva at teeth and mucosa at
implants differ:
a. Connective tissue
b. Alignment of the collagen fiber bundles
c. Distribution of vascular structures in the compartment apical to the JE

Esthetics has become a key factor for success of implant-supported oral rehabilitation, especially in the partially edentulous patient. Implant-supporting bone volume, implant position, peri-implant soft tissues and submarginal emergence profile, are main factors for esthetically successful implant-supported reconstruction. An adequate zone of keratinized leads to enhanced esthetics and BIC, easier restorative manipulation, less gingival recession, easier plaque control, and regular maintenance.

Six potential opportunities for soft and/or hard tissue management intended to enhance esthetics and enlarge the keratinized mucosa zone are available: at time of tooth extraction, before implant placement, at time of placement, during the implant healing phase, at time of implant uncovering, and after second-stage surgery.


Prosthetic considerations and implications of extraction site preservation for implant-supported restoration

The extraction of a tooth normally results in the loss of ridge height and width. Often, clinicians are faced with the management of edentulous sites that are less than optimal for prosthetic rehabilitation and implant restoration due to considerable alveolar ridge collapse after tooth removal.

Site preservation using bone substitutes without a membrane may maintain ridge dimensions and contours. The presentation reviews the concepts and indications for site preservation following tooth extraction for the purpose of facilitating implant placement and conventional prosthetic restoration. Clinical cases and histological and studies will demonstrate the possibilities of extraction site preservation for implant-supported restoration. Advantages, disadvantages and potential complications and solutions will be emphasized.


Sinus Lifting: What’s the fine tuning

Dental implants offers healthy, comfortable, extremely aesthetic and long-lasting results in all types of edentulism cases. However, one of the most common and struggling situations in dentistry is the partial or complete edentulism of the posterior maxilla. As we all know, in such conditions, implant surgery would be a good treatment option but sometimes available bone volume doesn’t allow us to do this surgery directly.

Following the loss of teeth, together with a cortical and marginal resorption due to the osteoclastic activity of the Schneiderian Membrane, a resorption occurs in the alveolar bone height. Augmentation of the maxillary sinus provides adequate bone height and makes possible to insert implants to the area. A few years ago, there were two main techniques of sinus floor elevation: direct and indirect. But nowadays, numerous types of approaches came in to the picture. Special rotary instruments were invented, balloon technique was brought forward and the list goes on.

As the list lengthens continuously, we come up with new questions: Which technique gives us the most affective and successful results? Which technique should we prefer? It should always be remembered that, no matter which technique is preferred, sinus floor elevation is a very delicate surgical process and the practitioner must be fully qualified both theoretically and practically. Therefore, in this conference, sinus floor elevation techniques, their advantages and disadvantages to each other, will be discussed particularly.


Crib Selection for bone and rhBMP-2 combination graft utilization in alveolar bone reconstraction

The objective of this lecture is to clinically evaluate the freeze-dried bone allograf in a particulate form or as bone block and the titanium metallic mesh as the space maintainers in the utilization of rhBMP-2 for alveolar bone defect reconstruction. The reconstruction of the original bone volume is essential in the placement of dental implants.

The placement of Titanium mesh over the particulated graft is essential, because particulate bone would collapse without the rigidity of the mesh and the bone regeneration might be deficient. Advantage of a titanium mesh is less technical sensitive and favorable three dimensional new bone formations and creates favorable shape of the alveolar process.

The main disadvantage is the process of removal of the mesh and possible early exposure of the mesh and compromised bone formation.The bone blocks are much more technical sensitive in term of placement and reshaping, however the removal of the rigid fixation is much less invasive. In addition the process of revascularizations is longer and in the presens of cortical bone soft tissue dehiscence and exposure of the bone graft might lead to compromised bone formation. This lecture will discuss the advantage and disadvantage of each technique, the surgical procedure and the potential complications.


Augmentation procedures of the severely atrophic mandible and maxilla with human allografts and subsequent implant placements.

In this lecture the focus is based on three dimensional augmentation procedures with human allografts and subsequent implant placements. Different technical approaches with corresponding advantages and disadvantages are being presented.

Furthermore pre, immediate and post surgical soft tissue procedures are being discussed. Especially the importance of progressive, self cutting and conical threading is underlined in this lecture. The different types of drilling techniques and insertion torques for immediate respectively delayed loading protocols are being shown. The importance of bone level respectively minimally below bone level implant in reference to the soft tissue in the anterior maxilla is presented. The advantages of the morphology of the MIS implant Seven, C1 and Uno in respect to different bone types (class I – IV, Leckholm and Zarb) are emphasized throughout the whole lecture.


Choice of materials for augmentation procedures :Autogenous bone versus allograft

Bone grafting procedures allow the surgeon to overcome the clinical situation. Autologous bone has always been considered as the gold standard. Various bones grafts of different origins are commonly used to increase the bone volume in vertical and horizontal dimensions. We present a literature reviewed and report our experience.


Evolving Trends,Technologies and Techniques in Esthetic and Implant Dentistry. What you MUST
know to succeed

The predictability of osseo-intregration coupled with the ability of implant supported restorations to cosmetically equal that of conventional crown and bridge has made implants a viable treatment choice even in the demanding partially edentulous environment..

However, to be a practical choice in day to day practice the focus must move towards expediting the process with simplification and predictability. Fortunately, evolving 3D cone imaging and computer technologies, innovative products, and new techniques allow for ever increasing efficiencies and maintenance of crestal bone and tissue stability. Preservation of the extraction site is a clinical key in expediting the process and updated and creative techniques for tooth removal allow for maximal preservation of the ridge anatomy.

Definitive and prognostic diagnostic guidelines allow today’s practitioner to effectively forecast the esthetic outcome based on a specific classification of the potential implant sites. A remaining issue in implant esthetics remains Augmentation and the creation of an “esthetic framework” in the previously compromised soft tissue “restorative site”. The three- dimensional reconstruction of the alveolar ridge comprises two deliberate aspects:
1. Development of the hard tissue
2. Reconstruction of the soft tissue

Today, surgical plastic “layering” techniques include soft tissue enhancement, bone regeneration, bioactive modifiers and a plethora of osseous graft materials which can be combined with orthodontic tooth movement to effectively establish an optimal foundation for the functional and esthetic implant restoration. This program will address the evolving issues beyond the implant itself.


Innovations


The Future of Guided Implantology: Simplified Approach in 3D Implant Planning and Guided Surgery

Necessity of 3D implant planning and guided placement Requirements of the practitioner Most advanced possibilities Step by step Scientific evaluation Outlook and future developments we can expect. 3D implant planning and surgical guides are becoming more and more important in implant dentistry.

What scientific evidence is there to support 3-dimensional diagnostics and guided surgery? What are the requirements from a dentist’s and lab technician’s view? A new approach using innovative technologies and an outlook to future developments will be presented.


From Science to Practice –Sinus Floor Augmentation – how to Make It Simple?

The maxillary posterior ridge presents challenges for the implant surgeon due to the proximity of the sinus floor. In an effort to avoid violation of the maxillary sinus space while maintaining integrity of the Schneiderian membrane, several approaches to sinus floor augmentation (“Sinus Lift”) have been developed in the past three decades to facilitate implant placement procedures, and these techniques had modified through the years.

In the 1980 Boyen and James had started to place implants in the augmented sinus floor. Although their original technique of lateral access undergoes various modifications, it remains an highly invasive in nature.In 1994 Summers described a less invasive surgical protocol using a crestal approach. Later, Summers’ technique was modified and osteotomes were replaced by special drills and ultraonic devices – aiming to control sinus floor perforation while leaving an intact Schneiderian membrane. These changes were also accompanied by innovative approaches of membrane elevation and direct visual control of the membrane. This presentation will focus on the current minimally-invasive lateral and crestal sinus floor elevation techniques with sub-antral bone augmentation for implant placement. In addition, the use of the new C1 implant during minimally invasive sinus lift procedure will be presented.


Old questions. New Answers

In this lecture Dr Stanley, founder of the WHITE ™ Medical Group and of the No Half Smiles™ philosophy, shares his thoughts on new trends in cosmetic implant surgery. A veteran lecturer, having shared his experience all over the world, Dr Stanley has seen that many times there are more questions than answers following a symposium.

Here he will address the most common questions with some practical answers from a clinical level, including new trends in the field. After placing many types of implants Dr Stanley and his team are exclusive MIS users. Find out why. This is a global gathering of like minded people. Dr Stanley hopes to unite with insights into our common day-to-day practice to overcome and become a leader in the field of implant dentistry.


Immediate occlusal loading of 100 SEVEN MIS Implants. A report of prospective study after 1 year of function with final restorations.

The purpose of this lecture is to analyze the results of prospective center clinical study on immediate full occlusal loading, full-arch screw-retained or cemented prostheses , with distal extensions supported by SEVEN® ( M.I.S implants) inserted in edentulous upper or lower jaws.

Materials and Methods:twelve patients were enrolled in one clinical center. Fourty seven implants were inserted and occlusally loaded according to an immediate loading protocol. The temporary prosthesis was delivered 4 h from surgery. The final prosthesis was delivered after 4 months. Marginal bone loss was monitored from radiovisiography and panoramic radiographs.

Results: Zero implants failed. Acumulative implant success rate of 100% was achieved for a period of one postplacement. Crestal bone loss around the immediately loaded implants was similar to that reported for standard delayed loading protocols. Conclusion: The results of this study suggest that the rehabilitation of the partially edentolous maxillary and mandible by an immediate implant and immediate occlusally loaded prosthesis supported by five to six M.I.S. implants (mandible) and eight to ten M.I.S. implants (maxillary) represents a viable alternative treatment to classic delayed loading protocols.


Optimising Aesthetic Implant Placement: From Surgery to Restoration and Beyond

In the early years of modern implantology, the chief concern was tissue health and implant survival. Over the last decade, there has been an increasing appreciation that aesthetics is just as important to the success of the final restoration as health.

Implant placement and restoration to replace single or multiple teeth in the aesthetic zone is an especially challenging area for the clinician, particularly in sites with multiple missing teeth and with deficiencies in soft tissue or bone. Preservation or creation of a soft tissue scaffold needed to create the illusion of a natural tooth is often challenging and difficult to achieve. Placement of a dental implant in the aesthetic zone is a technique sensitive procedure with little room for error.

A subtle mistake in the positioning of the implant or the mishandling of soft or hard tissue can lead to aesthetic failure and patient dissatisfaction. The aim of this lecture is to present guidelines for ideal implant positioning and for a variety of therapeutic modalities that can be implemented for addressing different clinical situations involving replacement of missing teeth, soft tissue management & bone augmentation procedures in the aesthetic zone.

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