Main Podium

THURSDAY, OCTOBER 21, 2010

Opening Remarks
8:00 am - 8:30 am

Implant Dentistry - Where Are You Now and Where Do You Want To Be in the Next 3 Years?
8:30 am - 9:00am
Gordon J. Christensen, DDS, MSD, PhD

This presentation is directed toward some very important questions. Are you satisfied with your current level of involvement with implant dentistry? What level is your goal? How do you achieve your desired proficiency? The following and other topics will be included:

Gaining optimum competency in single implant placement and restoration

Gaining optimum competency in multiple implant placement and restoration

Surgical guides—are they just desirable or necessary?

Cone beam and tomographic radiographs—are they state of the art?

Keeping up with the constant ongoing changes in implant dentistry

Anticipating and coping with surgical and prosthodontic implant complications—staying out of trouble.

Where is implant dentistry going?

Learning Objectives: At the completion of this presentation, participants should be able to:

Identify and list clinical situations where implants provide more adequate service than conventional oral therapy
Discuss and list situations in which computer guided surgical implant placement is highly desirable
List ten situations that either complicate implant placement or make implants contra-indicated
List six potential implant and other surgical situations in which cone beam radiographs are highly desirable

Graftless Solution: Immediate Loading of the Edentulous Patient with Fixed Prosthesis
9:00 – 10:00
Edmond 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.

Learning Objectives: Attendees can expect to learn the following from the presentation:

Treatment planning concepts for the edentulous maxilla
Understanding the concepts of prosthetic reconstruction of “composite defects”
Immediate load concepts: Do’s and don’ts
Identification, management and referral of complications

Reconstruction of the Severely Atrophic Mandible: Guided vs. Non-Guided Surgery
11:00 am – 12:00 noon
Peter K. Moy, DMD

Advanced 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 provides 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 aids 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. Potentials 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:

Recognize specific alveolar deficiencies and classification
Be introduced to the various augmentation techniques and materials used to gain more hard and soft tissue volumes
Understand the long-term efficacies of each surgical technique for managing alveolar ridge deficiencies of the mandible

Computer-Guided Implant Placement for the Severely Atrophic Maxilla
1:30 pm – 3:00 pm
Tomas J. Balshi, DDS
and Stephen F. Balshi, MBE

Various protocols exist for treating the severely atrophied maxilla. Many therapeutic options include sinus lifts or bone grafting to increase bone quantity for traditional implant placement. These ‘pre-treatment’ modalities have their own associated risks. In addition, implant success in native bone is reported to have higher success rates than an implant placed in grafted bone. Furthermore, with grafting, the patient’s treatment spans many months before fixed teeth can be connected to the implants with predictability.

The length of treatment time, reduced implant survival rates, and potentially invasive nature of grafting procedures leads us to search for an alternative approach for treating the severely atrophied maxilla. Using current medical imaging technologies, along with remote implant sites in native bone (zygoma and pterygomaxillary regions), allows the treatment of these patients in a single day. Implant placement in these regions, combined with the Teeth In A Day® protocol, allows the patients to have immediate function in a single office visit.
This presentation will discuss patient diagnosis and treatment of such clinical applications.

Learning Objectives: At the completion of this presentation, participants should be able to:

Determine which patients are candidates for computer guided implant placement
Learn how to avoid massive bone grafting for the several atrophic maxilla
Understand the principles of the Teeth In A Day® protocol for complete maxillary rehabilitation
Understand the evidence based data for immediate loading of zygomatic

Implant Prosthodontics Complications and Their Prevention. Some Practical Pearls
4:00 pm – 4:45 pm
Tony Daher, DDS, MSEd

Many complications related to implant prosthodontics are described in the dental literature. Some of these complications will be described and a tentative approach will be presented for their prevention. Mechanical complications include screw loosening/fracture, implant fractures, framework, resin base and veneering material fractures, opposing prosthesis fractures, and overdenture mechanical retention problems. The presentation will focus on many practical clinical pearls on how to prevent these complications from occurring.

Learning Objectives: The attendees will be able to learn how to:

Fix the retention loss of attachments used in implant overdentures
Prevent breakage of the different components of the implant overdenture during function
Retrieve restorations in easy procedures
Make accurate impressions and combine three clinical visits in one

Relocation and Rehabilitation of Integrated Implants
2009 Annual Meeting Winning Table Clinic Presentation
4:45 pm – 5:00 pm
Gilbert Tremblay, BSc, DMD

In today’s world of implant dentistry and clinical practice, one finds patients with dental implants located at severely compromised positions on the patient’s dental arch. Relocating or replacing those implants for a better functional and aesthetic outcome can be challenging and can require advanced planning protocols and technology.

Conventionally, implants in a disadvantaged position are prosthetically rehabilitated by applying adapted abutment to the compromised situation. They can also be removed, grafted at the defective bone site and inserted in a new implant at the corrected position. Finally, osteodistraction can also be used to move the implant within the bone block to a new prosthetic position.

This presentation will address this project management with digital planning for exact surgical evaluation and relocation of the implants, with innovation in implant therapy, growth factors for enhancement of bone regeneration and finally, predictable aesthetics results will be achieved.

FRIDAY, OCTOBER 22, 2010

Technical and Anatomical Considerations of the First Human Maxillo-Facial Transplant
8:00 am – 9:00 am
Daniel Alam, MD

Dr. Daniel Alam and a team from the Cleveland Clinic made history in December 2008 when they performed the first near-total face transplant to be done in the United States. Dr. Alam was the primary microvascular surgeon on the case. The operation on Connie Culp, whose face had been mutilated by a shotgun blast to the face, lasted 22 hours and involved eight surgeons. Prior to this last-resort surgery at the Cleveland Clinic, Connie had endured two dozen ineffective reconstructive surgeries of the past five years.

At the time, three previous face transplants had been done elsewhere in the world. On the other patients, only the skin and surface structures were transplanted. Dr. Alam and his team were the first to transplant the palate, sinuses, and bone structure.

Learning Objectives: At the completion of this presentation, participants should be able to:

Understand the history of composite tissue allograft reconstruction
Understand the design and execution of human face allograft transplantation
Consider the ethics and patient selection criteria

The Next Dimension in Implant Esthetics: Guidelines for Success
9:00 am – 10:00 am
Sonia Leziy, DDS

Conventional concepts in esthetic dentistry generally focus on establishing ideal tooth form and color. Often overlooked is the challenging interplay with the surrounding gingival framework. At this time, dental literature poorly addresses and references this important parameter of success, and yet this aspect of treatment continues to challenge the clinician. This lecture will focus on the esthetic outcome of implant treatment. An understanding of how to control and enhance tissue quality and contour is a crucial element to a highly successful esthetic result. Current techniques and changing treatment concepts that contribute to the long-term esthetic success of restorations supported by single and multiple implants will be presented.

Learning Objectives: Attendees can expect to learn the following from the presentation:

What can realistically be expected in terms of soft/hard tissue architecture and stability through various bone and soft tissue grafting procedures?
Understand the impact of correct implant positioning on soft tissue volume, esthetics and stability
Understand the potential impact of implant and abutment design changes on hard and soft tissue architecture
Understand the aesthetic challenges associated with multiple and adjacent implant placement

Periodontal Complications of Implant Treatment: Avoidable Problems, Emerging Challenges and Management Strategies
11:00 am – 12:00 noon
Sonia Leziy, DDS

While the predictability and long-term success rates of dental implants make them an attractive treatment option for tooth replacement, complications can arise at any stage of treatment. This lecture will provide the clinician with practical information supported by evidence-based research on recognizing the signs of iatrogenic complications and peri-implant mucositis and peri-implantitis, how to minimize surgical and restorative-related complications that affect the peri-implant tissue health, and recognize the diverse but at times limited management strategies for peri-implant tissue complications.

Learning Objectives: At the completion of this presentation, participants should be able to:

Define “peri-implant complications”: disease vs. iatrogenic outcomes
Recognize the patient at-risk for peri-implant disease from the time of diagnosis and treatment planning
Identify common surgical and restorative planning and technical errors that adversely affect the peri-implant tissue health and esthetics
Be familiar with the commonly used remedial procedures, their predictability and limitations in the management of peri-implant soft and hard-tissue complications

Optimal Facial Esthetics: Rejuvenation with Botox, Injectable Fillers, Laser and Facial Implants
1:30 pm – 3:00 pm
Joe Niamtu, III, DMD

The face is the frame for cosmetic dentistry and there needs to be equal attention to the intraoral and extraoral structures to truly rejuvenate the patient by contemporary standards. The presentation will discuss the various components of facial and periorbital aging and provide a multimedia presentation on the various contemporary rejuvenation options of cosmetic facial surgery. After this lecture, dentists should have a better understanding of facial aging and treatment options that can be applied to their practice to better benefit the delivery of contemporary patient care to their patients.Learning Objectives:The common causes of facial aging

Scientifically Driven Clinical Success: How to Master the Indispensable Basic and Medical Sciences Required for the Long-term Clinical Success of Contemporary Implant and Reconstructive Surgery

1:30 pm - 5:30 pm (In Salon G)
Manuel Chanavaz, MD, DDS, PhD

Comprehensive and multidisciplinary implantology is a prosthetically driven medico-surgical discipline. It aims to rehabilitate the oral condition of the patients presenting with partial or total tooth loss and variable degrees of residual bone atrophy, by means of dental implants with or without bone and soft tissue grafting. To this end, the principal mission of the implant surgeon is to restore or create the anatomy of each component of the impaired stomatognathic apparatus. It is only then that the overall normal function, comfort, health and aesthetical harmony can be achieved.

The aim of this presentation is to give a didactic and clinical overview of the importance of mastering the basic medical and clinical sciences required at the time of patient screening and treatment planning, while achieving surgical and prosthetic excellence in implementing the acquired interactive expertise. This expertise should also include the management of potential complications with a serene sense of urgency.

Abstract 1

Friday 10/22

01:30pm - 03:00pm

Contribution of Ct-Scan derived 3D modelization in oral and maxillofacial, plastic and advanced implant surgery

Manuel CHANAVAZ

Department of Oral and Maxillofacial Implant Surgery, Faculty of Medicine, University of Lille 2, France

Reparative and reconstructive surgeries of maxillofacial structures require easily available and interpretable medical imaging documents both for the purpose of treatment planning and the smooth running of the actual surgical phase. The advent of diagnostic quality primary scanners as from the eighties has greatly contributed to improving the predictability the surgical procedures. More recently the 3D reconstructed images and simulation techniques have further improved the therapeutic environment of complex cases. However, the most decisive progress has come form the routine use of CT-Scan derived 3D modelization of skeletal structures of the head. The preparative phase of skeletal malformations such as cleft palates have been significantly improved by this technique.

In this paper, the author will present an overview of the technology of 3D modelization and its impact on the understanding of anatomical landmarks of the head. Furthermore he will present the relevant clinical cases demonstrating the surgical preparation and management of severe atrophies of both jaw bones by means of autogenous bone grafts and screw type implants on the one hand, and advanced custom-made implant techniques on the other, facilitating meticulous occluso-prosthetic preparations.

Abstract 2

Friday 10/22

04:00pm - 05:30pm

Has the contemporary implant aesthetic trend become an irresistible fashion leading occasionally to over-treatment of patients?

Manuel CHANAVAZ

Department of Oral and Maxillofacial Implant Surgery, Faculty of Medicine, University of Lille 2, France

The diversity of contemporary implant-systems and graft techniques, requiring multiphase surgeries and the complexity of bone substitute materials have greatly enhanced the treatment options of patients suffering from advanced atrophy of jaw-bones. However, this progress, frequently time consuming, has also brought a downside with it, especially when the “aesthetic ambitions” have disproportionately dominated the functional and health needs. This “fashion” or “aesthetic trend” has occasionally lead to overtreatment of patients while producing short-lasting aesthetic results, requiring regular surgical maintenance. Two causes, among others, have been the main culprits; unpredictability of certain bone substitute materials and excessive or reiterative soft tissue manipulations over unstable osseous beds. Furthermore, a competent implant surgeon does not only rely on his own professional skill and experience, but also takes into consideration the patient’s need and personal wishes. Sometime optimal results and best service to patients are only obtained when wise or balanced therapeutic compromise has been implemented.

The aim of this presentation is to make an interactive and comparative study between ambitious complex implant treatments and less ambitious but comprehensive treatment options adapted to patient’s needs.

Understanding the Principles of Esthetics for Implant Restorations
4:00 pm – 5:30 pm
Howard M. Chasolen, DMD

In today’s world of implant dentistry, patients assume their dentist will provide esthetic outcomes for implant restorations. Many times, these outcomes fall short of esthetic expectations due to the lack of understanding of how current anatomic, biologic and physiologic conditions impact the esthetic 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 esthetic outcomes.Learning Objectives: At the completion of this presentation, participants should be able to: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.

Understand how to integrate CT derived information in the formulation of an esthetic implant prosthetic treatment plan

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.

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

The attendee will be presented with strategies to develop and manage occlusal function and parafunction to preserve esthetic implant restorations.

Immediate Loading in Partial Edentulism –An Evidence-Based Approach
4:00 pm - 5:30 pm (In Salon H - K)
Paul A. Schnitman, DDS, MSD

Immediate loading of implants has increased dramatically, especially in partial edentulism where fewer implants are used, often in poor bone quality, with higher occlusal forces, and loss of cross arch splinting. As this practice continues, failure rates can be expected to rise unless methods are developed to predict which implants can be successfully loaded immediately. This presentation will describe an evidence based protocol, for both freehand and computer guided implant placement, that clinicians can use to determine when and when not to immediate load. Rationale for immediate loading decisions will be discussed based on correlation of primary stability measurements by insertion torque, Periotest and resonance frequency analysis at insertion with each other and the preoperative CT scan and with implant outcome. Threshold values as predictors of implant outcome will be presented. Treatment planning for immediate loading in partially edentulous cases from a single to multiple missing teeth using computer guided placement will also be discussed, as well as the significance of the computer guided provisional restoration and its use in growing the inter-implant papilla.

Learning Objectives: At the completion of this presentation, participants should be able to:1. Describe the use of prognostic technologies (Insertion Torque, Periotest, Resonance Frequency Analyzer) for selection of implants to be immediately loaded, exposed or submerged based on observed thresholds 2. Understand the correlation of pre-operative bone density as measured by CT Scans with achievement of primary stability at implant insertion 3. Identify which of these technologies are sufficiently sensitive to predict outcome and how to apply this information to both free-hand and computer guided techniques4. Understand how computer guided techniques can be used to develop the tooth/implant complex in the immediate provisional restoration to influence inter-implant papilla formation

SATURDAY, OCTOBER 23, 2010

Medical Assessment of the Implant Patient
8:00 am – 9:30 am
Daniel Becker, DDS

Provides IV sedation services for dental practices throughout the Dayton-Cincinnati area
This presentation will highlight essential aspects of medical evaluation for patients undergoing dental implant surgery. Emphasis is placed on fundamental pathophysiological principles that enable the dentist to better understand and evaluate a patient’s fitness for treatment. Attention will also be given to the most commonly prescribed medications, which not only reflect the nature and severity of specific diseases, but also present potential for side effects and interactions with medications used by the dentistLearning Objectives: At the conclusion of this presentation, the participant should be able to:Describe basic principles of preoperative assessment, including protocols for medical consultation

Explain basic pathophysiological features of common disease states

Explain the rationale for medically prescribed drug classes and identify potential impacts they may have on patient management, including potential drug interactions

Key Elements of Risk Management in the Practice of Implant Dentistry
10:30 am – 12:00 noon
Frank Recker, DDS, JD

The course will address the most important, everyday, risk management issues in the clinical practice of implant dentistry, proper patient selection and patient termination (when necessary), staff selection and termination, the distinction between substandard dental care and malpractice, and informed consent issues. The program will also discuss the essential contents of patient dental records, including all underlying diagnostic information and treatment plans, including implant treatment options. The relationship between alternative treatment plans and clinical judgment, in context with the standard of care, will also be discussed.The objectives of this course are to provide the dental clinician with no-nonsense, practical risk management information relating to dental office procedures and clinical situations. The practicing dentist will appreciate the everyday scenarios and specific clinical examples presented in the program, especially as they relate to alternative treatment plans, clinical judgment, patient cooperation, dental records, and patient termination.

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