Dental Education
Online Dental Education Dental education lectures and videos Online dental ce Dental education articles Expert dental educators Dental products education Dental Community
 
Video Details
Regenerative Procedures for Implant Site Optimization: Establishing the Perio-Implant Interface

Description:
Emerging concepts in implant dentistry have allowed bone preservation to become a reality, thus reducing the need for extensive augmentation procedures. Nevertheless, clinicians are still confronted with atrophic defects that require complex regenerative strategies for dental implant rehabilitation. This presentation will focus on some of the essential elements for a predictable regenerative protocol in implant site development. A discussion will include the use of defect topography as a guide in choosing a suitable augmentation technique. Several considerations that allow for tension free wound closure will be reviewed. Furthermore, an evidence based approach in graft material selection will be presented. Clinical cases will then be reviewed, to demonstrate how to integrate the presented principles into daily clinical practice.

Date Added:
6/29/2016

Author(s):

Ehab Moussa, DDS Ehab Moussa, DDS
Dr Ehab Moussa graduated with a bachelors degree of dental surgery (BDS) in 2009 from faculty of dentistry, Alexandria university, Egypt. He then completed a ...
[read more]






Online Videos / Surgery / Bone Grafting / Regenerative Procedures for Implant Site Optimization: Establishing the Perio-Implant Interface




Questions & Comments
Ehab Moussa - (9/2/2016 8:21 PM)

Thank you dear Figen.

FİGEN ÖZÇELEBİ - (8/15/2016 10:21 AM)

One of the best presentations I have seen Dr Moussa thank you

Robin Tran - (7/12/2016 11:27 AM)

Dr Moussa,
thank you very much for your reply.
RT

Ehab Moussa - (7/11/2016 11:45 PM)

Snjezana, I am honored you enjoyed the presentation. I am sure with your outstanding skills, you will achieve great results with Ti mesh !! Best regards, Ehab

Ehab Moussa - (7/11/2016 11:43 PM)

Dear Dr Tran, Thank you for your kind comment. I have seen your post in the forum. Obviously having some clinical photographs would help more, however these are my thoughts. Patient 1: It appears as though the implant might not be deep enough. If you are set on keeping the implant in place, you can attempt submerging the implant with a rotated palatal pedicle and then uncovering after soft tissue has been augmented, don't think bone grafting will be much help here. Again, very difficult to tell without clinical photographs. If the entire implant surface is exposed 360 degrees all around through the gingiva, I would remove the implant and start all over. The fact that you are faced with a tissue deficiency and implant exposure (even if just on the buccal aspect), still compels me to remove the implant. Perhaps removal, followed by soft and hard tissue augmentation and implant placement would be most predictable for the long term. I would not recommend any bone augmentation if soft tissue quality is poor. Case 2: Perhaps bone augmentation with delayed implant placement would be a predictable plan. The sausage technique with a collagen membrane seems like a good alternative here. Non resorbable barriers and Ti-mesh would also work well, however do have a higher chance of complications and may not be needed (Again difficult to tell just from scans). Difficult to determine whether simultaneous implant placement is possible here, it appears as though the ridge has also a large buccal concavity. Personally I do not disturb the pseudoperiosteum layer. However I measure the thickness, and attempt to place my implants 1-2mm subcrestal to account for any future remodeling that may occur. Perhaps adding some clinical images and posting the case in the forum will allow you to also get extremely valuable input from the members. I do this quiet often, and it has SAVED me several times. I do hope that this helps, and I thank you for your kind interest. Best regards, Ehab

Robin Tran - (7/11/2016 3:55 AM)

Dr, you mentioned , upon removing titanium membrane, there was a layer of pseudoperiotium . should I scrape it off before placing implant. thanks RT

Robin Tran - (7/11/2016 3:26 AM)

Dr Moussa:Ifind this video very informative. I need your advice on 2 cases: 1st case. 29 yo male heavy smoker,healthy individual.he stopped smooking cold turkey when #8 was extracted and implant was placed. bone graft and membrane was placed right after. 1 week later, bone graft failed due to smoking again. I removed the graft, cleaned with saline and tetracycline powder, placed new graft again(using nonresorbable PTFE membrane without primary closure) and left implant in tag. Area healed, but buccal surface bone loss is significantly and about 1mm of implant is showed above gum. I have to go in and graft again. I wont be able to get primary closure even full flap is lifted up high due to small area of mucosa. I am using Hiossen. Should i: 1. use titanium membrane with PTFE nonresorbable membrane on the outside 2. leave the area with PTFE see through.
What kind and brand of titamium membrane are you using? what tools did you use to cut titanium membrane and to tag the screws in?
2. 2nd case: 50 yo male, smoker and healthy. He stopped smooking 2months before procedure. He had a bridge 9to 11. #11 had cavity and unrestorabe. I did removed #11 and grafted bone on #10 and #11 using nonresorbable memebrane PTFE without primary closure. #9 has temporary. My plan is to place implant on #11 later and canteliver #10 from #11 because spaces 10 and 11 is about 9mm only. this guy have issues: a. scar tissue(?) around 10 and 11 to the upper inside lip is hard and immobile.It's been like this for years. b. bone graft at alveolar crest is around 4 to 5mm at most. How can I overcome placing implant and graft more bone from here. I will find ways to post ctscans ad xrays. thank you. RT. Please look for my scans and xrays under implant dental forum Attn Dr Moussa. thank you

snjezana pohl - (7/10/2016 3:09 PM)

Thank you for very informative and didactically well structured presentation! Literature overview and results with Ti mesh are really encouraging,you convinced me to try it. Best regards Snjezana

Ehab Moussa - (7/8/2016 5:38 PM)

Dear Dr Mirna; Thank you for your kind comment. Really the key for adequate primary closure is RELEASE OF THE FLAPS. For the labial flap I use a sharp 15 or 15c blade for a periosteal scoring incision preferably apical to the MGJ. The incision does not have to be very deep, just has to be continuos from one end of the flap to the other. Following that, depending on the amount of release required, I can go back and deepen the incision with a blade. Releasing the lingual flap really simplifies the closure so much, and increases our chances of maintaining a closed healing environment (same technique as described in presentation). For the palatal flap, adequate reflection in both a mesio-distal and apico-coronal dimension is essential for double layer closure. As for the closure, I use deep horizontal mattress sutures about 4-5 mm from the flap margin on both labial and lingual flaps, this increases the area of CT contact between both flaps. Then a continuos interlocking or interrupted sutures to approximate the flap margins together. I hope this helps. Best regards, Ehab

Related Videos
The Role of Piezo-Surgical Ridge Split Technique in the Reconstruction of Ridge Deficiencies - Part 2 of 2 Premium Member Content

The Role of Piezo-Surgical Ridge Split Technique in the Reconstruction of Ridge Deficiencies - Part 2 of 2
This 2 part lecture demonstrates the piezoelectric hinge assisted ridge split (PHARS) technique for reconstruction of ridge deficiencies to facilitate the placement of dental implants. A review of multiple ridge augmentation techniques is provided along with advantages and unique challenges of the PHARS technique.

Presented By:: Dan Holtzclaw, DDS, MS
Presentation Style: Lecture
Community Rating:
 
Watch Now>>
Controlled Ridge Splitting (CRS) Premium Member Content

Controlled Ridge Splitting (CRS)
To demonstrate a new technique of controlled ridge splitting (CRS) in severely atrophied maxillary cases as an alternative to autogenous block graft. Twenty cases were completed using a controlled ridge splitting (CRS) technique with a total of 65 implants were placed in severely atrophied Maxillae and followed after the implants were loaded.

Presented By:: Suheil M. Boutros, DDS, MS
Presentation Style: Video
Community Rating:
 
Watch Now>>
The Next Challenge in Implant Dentistry: The Rise in Peri-implantitis and What Can We do About It? Premium Member Content

The Next Challenge in Implant Dentistry: The Rise in Peri-implantitis and What Can We do About It?
In this presentation, Dr. H. Ryan Kazemi will discuss etiologies for implant failure due to peri-implantitis, its preventive measures, and what treatment modalities work best. He will also describe a new classification to help clinicians choose the optimal treatment approach.

Presented By:: H. Ryan Kazemi, DMD
Presentation Style: Video
Community Rating:
 
Watch Now>>
Related Courses
Regenerative Procedures for Implant Site Optimization: Establishing the Perio-Implant Interface Premium Member Content

Regenerative Procedures for Implant Site Optimization: Establishing the Perio-Implant Interface
Emerging concepts in implant dentistry have allowed bone preservation to become a reality, thus reducing the need for extensive augmentation procedures. Nevertheless, clinicians are still confronted with atrophic defects that require complex regenerative strategies for dental implant rehabilitation. This presentation will focus on some of the essential elements for a predictable regenerative protocol in implant site development. A discussion will include the use of defect topography as a guide in choosing a suitable augmentation technique. Several considerations that allow for tension free wound closure will be reviewed. Furthermore, an evidence based approach in graft material selection will be presented. Clinical cases will then be reviewed, to demonstrate how to integrate the presented principles into daily clinical practice.

Presented By:: Ehab Moussa, DDS
Presentation Style: Online Self-Study Course
CE Hours: 1 CEU (Continuing Education Unit)
Watch Now>>
Site Preparation & Osseodensification in Bone Management Premium Member Content

Site Preparation & Osseodensification in Bone Management
Today's implant arena involves not only the understanding of procedures but also the science behind wound healing. Often new technologies and instrumentation evolves that have a significant impact on what we are able to do clinically. Piezosurgical devices, periotomes, osteotomes, hydraulic sinus devices, neurosurgical drills, and the "PET" (Partial Extraction Therapies) system are just a short list of those that have made surgery more efficient and less traumatic for our patients. Osseodensification is another concept that can be added to this long list. This lecture will speak about new age bone management concepts and how these technologies may be able to assist us. Potential issues and focus on use will be touched upon as well.

Presented By:: Maurice Salama, DMD
Presentation Style: Online Self-Study Course
CE Hours: 1 CEU (Continuing Education Credit)
Watch Now>>
Partners in Synergy - The Webinar Event; Augmentation Strategies in Implant Dentistry Premium Member Content

Partners in Synergy - The Webinar Event; Augmentation Strategies in Implant Dentistry
This course will highlight the current available regenerative techniques and protocols to maximize the esthetic results of tooth replacement therapy. Extraction site management, labial bone enhancement as well as current gingival augmentation techniques will be featured. These highly acclaimed clinicians and educators will team up to provide a glimpse of their upcoming LIVE Synergy VI conference June 27th - 30th, 2013 in Orlando, Florida

Presented By:: Michael A Pikos, DDS;Maurice Salama, DMD
Presentation Style: Online Self-Study Course
CE Hours: 1 CEU (Continuing Education Unit)
Watch Now>>
The Use of SonicWeld® Ultrasonically Fabricated Barriers for Enhanced Outcomes in Guided Bone Regeneration Premium Member Content

The Use of SonicWeld® Ultrasonically Fabricated Barriers for Enhanced Outcomes in Guided Bone Regeneration
KLS Martin has developed a unique bioresorbable guided bone regeneration barrier which can be molded into any desired three-dimensional form. Using a combination of thermoplastic and ultrasonic energies, these barriers have been successfully used to create the proper environment for both large lateral and vertical ridge augmentations for situations previously only treated with block grafting or distraction. This course will outline the basic science, clinical techniques and outcomes of the SonicWeld technique.

Presented By:: Kevin George Murphy, DDS, MS
Presentation Style: Online Self-Study Course
CE Hours: 1 CEU (Continuing Education Unit)
Watch Now>>
Related Articles
Long-Term Block Graft Stability in Thin Periodontal Biotype Patients - A Clinical and Tomographic Study

Long-Term Block Graft Stability in Thin Periodontal Biotype Patients - A Clinical and Tomographic Study
Autogenous block grafting seems to be a predictable treatment modality to reconstruct alveolar ridge defects in the long term. A thin periodontal biotype did not seem to affect the volume of transplanted bone for the population studied.

Author(s): Fernando Verdugo, DDS;Krikor Simonian, DDS;Alon Frydman, DDS;Antonio D'Addona, DDS;José Pontón, PhD
View Article>>
The safety of bone allografts used in dentistry

The safety of bone allografts used in dentistry
Recent media reports concerning “stolen body parts” have shaken the public’s trust in the safety of and the use of ethical practices involving human allografts. The authors provide a comprehensive review of the safety aspects of human bone allografts.

Author(s): Dan Holtzclaw, DDS, MS;Nicholas Toscano, DDS, MS;Lisa Eisenlohr, PhD; Don Callan, DDS
View Article>>
"Sandwich" Bone Augmentation Technique - Rationale and Report of Pilot Cases

"Sandwich" Bone Augmentation Technique - Rationale and Report of Pilot Cases
The aim of this article is to present a new technique for augmentation of deficient alveolar ridges and/or correction of osseous defects around dental implants.

Author(s): Hom-Lay Wang, DDS, MSD, PhD;Carl Misch, DDS, MDS; Rodrigo F. Neiva, DDS, MS
View Article>>
Contact Us | Privacy Policy | Terms of Use
©2020

Preferred Language: English Flag
Contact Us · Login ·