implants international No. 1, 2023
Cover
/ Editorial
/ Content
/ Guided maxillary arch implant restoration: Language and cross-border collaboration are no barrier with hybrid workflow
/ Peri-implantitis: Can it be treated without surgery?
/ Dual-wavelength laser treatment of osteotomy site to increase the success rate of implant placement
/ Immediate implant placement and bone grafting of a maxillary central incisor: A seven-year follow-up
/ Screw-retained restoration of a maxillary first premolar
/ The quest for safe and sterile implants
/ Acting against the silo effect
/ Industry
/ Manufacturer news
/ Events
/ News
/ Imprint
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[1] =>
issn 1868-3207 • Vol. 24 • Issue 1/2023
implants
international magazine of oral implantology
case report
Guided maxillary arch implant restoration
Peri-implantitis: Can it be treated without surgery?
interview
The quest for safe and sterile implants
1/23
[2] =>
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[3] =>
editorial
|
Dr Rolf Vollmer
First Vice President
and Treasurer of DGZI
Looking ahead
in 2023
Dear colleagues and friends,
The past few years have presented significant challenges for the dental community, particularly with the
pandemic and the shift to virtual events. However, despite
these challenges, the demand for dental implants continues to grow, reflecting their value as a solution for missing
teeth. This growth has led to an increased focus on research and development in the field, and new techniques
and technologies are being developed all the time. This is
a testament to the dedication and innovation of the professionals in our discipline.
I am especially looking forward to the upcoming International Dental Show in Cologne in Germany. This event, the
world’s largest trade fair for the dental industry, offers an
unparalleled opportunity for us to come together as a
community, meet old friends and partners, and explore
the latest innovations in dentistry. I would like to invite you
to visit the German Association of Dental Implantology
(DGZI) in Hall 11.2 at Booth S010/T011. Our members will
be in attendance, ready to share their experiences and insights with you. At the DGZI, we have a strong commitment
to advancing research in implantology. Our society is
dedicated to fostering and promoting ongoing research in
order to improve patient outcomes and advance our understanding of this complex and dynamic area of dentistry.
This includes exploring new materials, surgical techniques and ways to optimise the integration of implants
with the surrounding tissue.
Although there is still some time to go, I would also like to
use this as an opportunity to announce the DGZI congress in Hamburg in Germany on 6 and 7 October. This
international event is a great chance for implantologists to
come together and share their experiences, insights and
perspectives on the latest advancements in our field. I
encourage all of you to attend and contribute to the discussions, as we work together to further the progress of
implantology.
In conclusion, I am proud to be a part of this community
and to work alongside so many dedicated and talented
professionals. I look forward to continuing to support the
growth and development in implantology and to the opportunities for learning and networking that lie ahead.
Yours,
Dr Rolf Vollmer
First Vice President and Treasurer of DGZI
1 2023
03
[4] =>
| content
editorial
Looking ahead in 2023
03
Dr Rolf Vollmer
case report
page 06
Guided maxillary arch implant restoration: Language and cross-border 06
collaboration are no barrier with hybrid workflow
Dr Florian Obadan & Jorge Reyes Minguillán
Peri-implantitis: Can it be treated without surgery?
14
Prof. Hady Haririan
Dual-wavelength laser treatment of osteotomy site to increase the
success rate of implant placement
20
Dr Sean Chiu
page 14
Immediate implant placement and bone grafting of a maxillary
central incisor: A seven-year follow-up
26
Prof. Su Yucheng
Screw-retained restoration of maxillary first premolar
30
Dr Anthony Bendkowski
interview
The quest for safe and sterile implants
34
Dr Dirk Duddeck
Acting against the silo effect
36
Dr Tiziano Testori
page 42
industry
Neodent celebrates 30 years of history
38
news
manufacturer news
news
40
48
events
High-tech in a unique setting
42
about the publisher
Cover image courtesy of bredent
medical, www.bredent-group.com
implants
international magazine of oral implantology
case report
Guided maxillary arch implant restoration
Peri-implantitis: Can it be treated without surgery?
interview
The quest for safe and sterile implants
04
1/23
Background: © STILLFX/Shutterstock.com
issn 1868-3207 • Vol. 24 • Issue 1/2023
1 2023
imprint
50
[5] =>
Athens, Greece
June 8–10, 2023
Where history, future
and science meet
Are you passionate about implant dentistry?
Are you committed to science, innovation
and education?
Do you want to provide your patients with
optimized treatment solutions?
Then join Dentsply Sirona, the world-leading expert
in implant dentistry, for an exclusive, state-of-the-art
congress in Athens, Greece, on June 8–10, 2023.
At Implant Solutions World Summit, you’ll discover
cutting-edge science, the latest innovations in digital
dentistry, bone regeneration, and optimized implant
treatment solutions for your patients—and enjoy the
company of world-renowned speakers, colleagues
and friends from around the world.
dentsplysirona.com/worldsummit
#ImplantSolutionsWorldSummit
Follow Dentsply Sirona for
the latest in implant dentistry
dentsplysirona.com/implants
[6] =>
| case report
Guided maxillary arch implant
restoration: Language and
cross-border collaboration are
no barrier with hybrid workflow
Dr Florian Obadan & Jorge Reyes Minguillán, Romania & Spain
The rehabilitation of a failing maxillary dentition requires comprehensive planning and appropriate tools to
execute a treatment which will meet the patient’s expectations and accomplish the biological principles for longterm successful restoration. Nowadays, digital workflows
aid clinicians in achieving this accuracy with holistic treatment planning. Digitisation in implant dentistry has ensured that the dental technician and the clinician are in
sync at every step of planning and execution, as the exchange of data between them can be done remotely with
the click of a button. Guided implant placement ascertains
the precise transfer of the virtually planned implant positions to the surgical site. This pre-planned implant positioning facilitates immediate loading, as the provisional
prosthesis can be milled and kept ready prior to the surgery, requiring only minor relining and adjustments after
the surgery. Guided implant placement with immediate
loading not only restores function, aesthetics and the patient’s confidence instantly, but also has high patient ac-
2
06
1 2023
1
ceptability owing to the minimised surgical trauma, postoperative discomfort and reduced treatment duration.
The following case report showcases the planning and execution of the SKY fast & fixed full-arch protocol (bredent
[7] =>
case report
3
4
5
medical) with synchronisation of a complete digital workflow between a dental technician in Spain and a clinician
in Romania who do not speak a common language.
laboratory 3D scanner, and the STL files, radiographs
and images were transferred to the dental technician in
Madrid in Spain.
Case presentation
The dental technician used exocad for the digital mock-up
and e-mailed it to the clinic. The CAD was printed (the
model without the teeth, the model with the new tooth
set-up and the teeth detached from the model) using a 3D
printer. The STL files were used for planning the ideal prosthetic positions of the implants (six 4 × 14 mm copaSKY
implants, bredent medical). CoDiagnostiX (Dental Wings)
was used for planning the implant positions, as well as the
appropriate abutments (Figs. 6–8). The surgical guide was
fabricated based on the virtually planned ideal positions of
the six implants (Figs. 9 & 10). The provisional prosthesis
was designed in Madrid by the dental technician, but
milled and kept ready prior to surgery in Romania.
A middle-aged woman presented to the dentist’s clinic in
Alexandria in Romania with a mobile central incisor, seeking a long-term highly aesthetic solution. A full-mouth
clinical assessment and radiographic examination with a
dental panoramic tomogram and CBCT scan (Figs. 1 & 2)
were carried out. Based on the severity, complexity of
management and extent of distribution, a diagnosis of
generalised severe periodontitis with potential loss of
dentition was made, and the patient was advised to undergo total extraction of the maxillary teeth (other than the
terminal molars) and immediate placement of implants
and their immediate loading using the SKY fast & fixed
treatment protocol.1–4
Preoperative phase
High-resolution intra-oral images and profile pictures
were taken (Figs. 3–5). Preliminary impressions were
made with irreversible hydrocolloid (alginate), as there
was a possibility of tooth loss (owing to severe tooth mobility) with the use of silicone-based materials for impression taking. The resulting models were scanned using the
6
7
|
Surgical phase
The procedure was done under local anaesthesia with articaine with 1:100,000 adrenaline. Atraumatic extraction of
all the maxillary teeth except the terminal second molars
(as they served as a vertical stop for maintaining occlusal
height) was done, and the extraction sockets were thoroughly curetted to remove the granulation tissue. After
mechanical debridement, to ensure complete disinfection
of the site, antimicrobial photodynamic therapy was per-
8
1 2023
07
[8] =>
| case report
formed. A blue photosensitiser (methylene blue) was applied inside each socket and left in situ for 60 seconds to
stain the bacteria. After rinsing off of the liquid, each
socket was then exposed to the diode laser for 1 minute.
This ensures focused antibacterial action by destruction
of the bacteria in the biofilm by singlet oxygen molecules.
The procedure was completely flapless to minimise surgical trauma, and it facilitated seamless seating of the surgical guide. The surgical guide was stabilised intra-orally
with four fixation pins placed buccally (Fig. 11). The surgical kit was used for fully shaft-guided implant placement,
which is more convenient than the sleeve-in-sleeve and
spoon systems. It is based on the principle of maximum
safety when reaching the drilling depth and angulation by
guiding the drills through the high-precision drill sleeve
(Fig. 12). Sequential drilling was done, and primary stability of more than 40 Ncm was obtained for all six implants,
facilitating predictable immediate loading. Titanium abutments were installed on all six implants, and a closed-tray
impression was taken (Fig. 13). The milled provisional
prosthesis was placed on the quickly poured model to
make the holes in the prosthesis to facilitate intra-oral relining with Qu-Resin and Qu-Connector (bredent medical)
to ensure a passive fit of the screw-retained prosthesis
(Figs. 14 & 15). The titanium copings were picked up in the
provisional prosthesis after relining, finished and polished
extra-orally, and inserted on to the implants to a torque of
18 Ncm (Figs. 16 & 17). The provisional prosthesis was
kept out of all eccentric contact, and light centric contacts
were maintained. Biomechanical principles were applied
by preventing cantilevers which could weaken and fracture the provisional prosthesis.
9
10
11
The patient was instructed to avoid hard food, and oral
hygiene instructions were reinforced. She was extremely
satisfied with her new smile and regained her confidence.
Prosthetic phase
The patient was recalled after eight months for the final
prosthetic phase. Intra-oral scans were taken for fabrication of the final prosthesis (Fig. 18), the intention being to
12
13
08
1 2023
[9] =>
case report
14
15
16
17
plan, start and finish the case completely digitally. This,
however, was not possible because there was a mismatch in fitting the components which the laboratory had
milled for verification on the printed models. The decision
was made to go the analogue route.
for the patient, and the final outcome was extremely gratifying for the surgical and prosthetic team (Figs. 25 & 26).
Titanium copings were inserted, and after confirmation of
proper seating with a panoramic radiograph, intra-oral
splinting of the copings was done to ensure accurate impression taking. Putty and light-bodied wash impressions were taken, carefully packed and sent to Madrid for
fabrication of the final prosthesis (Figs. 19a & b).
After obtaining the master model, the dental technician
made the design of the framework, milled it in PMMA and
sent it to the clinic. The provisional prosthesis, having a
passive fit, because it was fixed intra-orally, was used as a
verification key for the master model. Because there was
a passive fit, the framework was cemented on to the prefabricated copings with DTK-Adhesive (bredent medical)
on the model by the dental technician (Figs. 20 & 21).
|
Discussion
Chronic generalised periodontitis can result in insidious
loss of periodontal attachment, tooth mobility and poor
prognosis of teeth. The SKY fast & fixed treatment protocol aims for immediate restoration of function and aesthetics for management of failing dentition. A recent study
by Slutzkey et al. concluded that, if the prerequisites
for immediate loading, such as high primary stability of
≥ 30Ncm, splinting of the implants via a provisional prosthesis and the use of bone-level implants with a sandblasted and acid-etched surface, are fulfilled, then fullarch fixed restorations supported by a combination of
axial and tilted implants can be a viable treatment option
to rehabilitate the terminal dentition of patients suffering
from severe generalised periodontitis.5
The solution for the long-term restoration was determined based on the inter-arch distance and passivity of
fit, as well as protection of the implants. The choice of
material for the definitive prosthesis framework was
laser-sintered titanium with composite build-up teeth
(Figs. 22–24). The laser-sintered titanium, being produced
with an additive method, did not have undercut areas,
and it was fabricated by the dental technician in Spain.
Canine-guided occlusion was established without difficulty. Function and aesthetics were restored satisfactorily
18
1 2023
09
[10] =>
| case report
19a
19b
Immediate implant placement with the application of antimicrobial photodynamic therapy has made the procedure
more predictable. Antimicrobial photodynamic therapy
was used in the current case at the point of extraction of
the diseased and compromised teeth to ensure disinfection and better osseointegration of the implants. Antimicrobial photodynamic therapy has gained much attention as
a non-invasive and biocompatible approach that can be
employed to prevent biological complications associated
with implants.6 Histological and histo-morphometric analyses have demonstrated significantly better results for immediate implant placement in sockets decontaminated by
mechanical debridement with the adjunctive use of antimicrobial photodynamic therapy.7 The sites which received
this combined therapy led to osseointegration of the implants without evidence of inflammation; conversely, evidence of peri-implantitis was observed where antimicrobial photodynamic therapy was not used.7
The purpose of using implant software is to plan the
placement of the implants in prosthodontically driven positions.8 The advantages of guided surgery are that the
patient’s chair time is decreased, the surgery is more predictable and less stressful, the implants are placed in a
restoratively driven manner, and the case difficulty is
learned ahead of time.9–11 In other words, guided surgery
in full-mouth implant rehabilitation has also made immediate restoration of function and aesthetics easier and
more precise and has improved treatment acceptability
by the patient. However, in full-arch rehabilitation, the provisional restorations cannot be cemented to abutments
before surgery owing to passivity concerns, as seen in
the current case report.12 The pre-milled breCAM.multiCOM prosthesis (bredent medical) was relined intra-orally
to ensure passivity of the prosthesis.
Full-arch fixed rehabilitation by means of guided surgery
and immediate loading of implants placed in fresh extraction sockets appears to be a reliable and successful
procedure.13 Selection of the final prosthesis material was
done based on the inter-arch distance (from implant platform/ridge crest to incisal edge/occlusal plane of opposing dentition).14 Various materials were considered before
making the final choice.
10
1 2023
20
High-impact polymer composite teeth with a BioHPP
(ceramic-reinforced PEEK) framework was considered;
however, the amount of inter-arch space necessary to
achieve mechanical stability and fracture resistance of
the framework was not available. Porcelain Fused to
Metal was also excluded, because of the lack of adequate rigidity of the metal framework. The modulus of
elasticity of the ceramic is not optimal in this case. To protect both the implants and the antagonist arch, a titanium
framework was selected, on which the technician set up
the teeth from composite, a well-established soft-bite restorative material. The framework was made by laser sintering because of the improved qualities of the surface of
the metal compared with those of milled titanium. Cobalt–chromium was not considered because of evidence
of reactivity of this alloy in the oral environment.15 For longterm success, a passive and perfect fit was achieved using prefabricated prosthetic components.
21
22
[11] =>
© MIS Implants Technologies Ltd. All rights reserved.
NEW.
SHARP.
EVERY SINGLE TIME.
TM
FULL PROCEDURE IN EVERY IMPLANT PACKAGE. MAKE IT SIMPLE
MIS C1 or SEVEN implants are now supplied with XD Single-Use drills. These single-use drills are
designed for optimal implant-drill compatibility and high initial stability, while ensuring safe and simplified
procedures. Learn more about MIS at: www.mis-implants.com
[12] =>
| case report
23
24
25
26
Conclusion
about the author
Advances in materials science and the boom of digitisation and digital workflows in dentistry have provided an
array of options for tackling the same clinical situation.
This means that there are more treatment options for the
various clinical indications. In addition, the interoperability
of devices and software systems, the possibility of connecting over video calls and the ease of transferring a large
number of data sets over the internet make cross-border
collaboration a reality even in cases such as this one, where
the clinician and dental technician did not speak a common language, except for the language of digital dentistry.
It is clear that clinical decisions should not be solely based
on trends, but supported by thorough treatment planning
with the technical, surgical and restorative teams, based
on expertise, comfort and confidence of the clinician in
synchronisation with the dental technician to convert the
virtual planning into reality for long-term success. The comfort and safety of the patient should be in focus if increased
patient satisfaction at affordable cost is to be achieved.
Dr Florian Obadan has attended numerous courses to specialise in his techniques, practising in countries such as Romania, India, Georgia, and Armenia. In 2015, he founded
the Implant Consult clinic in the city of Alexandria, which offered a different perspective and approach to the idea of
a dental clinic. He graduated from university in Craiova in
2001, and since then he has been practising in the field of
dentistry. Supported by his family, he attended advanced
training courses, and through his perseverance and desire,
Dr Obadan realised in 2009 the first Fast and Fixed implant in
Romania, thus contributing to the innovation of a difficult field by
applying a safe, predictable treatment, which offers the possibility of recovering teeth in a single day, by implant.
Acknowledgements
We would like to acknowledge dental technician Vasile
Bacila from Slatina in Romania and dentist Dr Magdalena
Eugenia Obadan of Implant Consult in Alexandria in Romania.
12
1 2023
contact
Dr Florian Obadan
Dr Florian Obadan
+40 76 6230616
implantsconnectedtonature@gmail.com
Jorge Reyes Minguillán
+34 914 609708
dentalreyes@dentalreyes.es
Jorge Reyes Minguillán
[13] =>
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[14] =>
| case report
Peri-implantitis: Can it be
treated without surgery?
Literature
Prof. Hady Haririan, Austria
With the introduction of a uniform classification of periodontal and peri-implant disease in 2018, definitions of
health and disease have now also been established
for implants.1 Comparable evidence on peri-implantitis
should therefore be possible in the future. In recent years,
there have been enormous developments in implantology with regard to the digital workflow and materials, but
also new insights into what can lead to failure or how to
counteract peri-implant mucositis and, subsequently,
peri-implantitis.2
The proportion of patients with implants is increasing,
due to an ageing population. A study at the University
Clinic of Dentistry Vienna in Austria showed that the
proportion of older patients with implants is continuously
increasing.3 For example, the proportion of patients between 70 and 75 years of age with implants in the outpatient clinic was already 30% in 2017; in 2013, this was
only around 20%.3 Old age is linked to various dimensions, usually accompanied by various diseases, which
in turn can lead to polypharmacy and to malnutrition. In
order to maintain stable occlusion in old age, people increasingly rely on fixed prostheses, which, however, are
sometimes more difficult to clean than removable prostheses. The risk of complications also increases with age,
and peri-implantitis is almost inevitable if prophylactic
1
measures and the reduction of risk factors are not undertaken promptly and closely monitored.
Once bone resorption around the implant has begun,
there is no predictable therapy that reliably leads to cessation of the inflammation or to regeneration, as is the
case with periodontitis. The established treatment paradigm is that a conservative approach is limited and surgical intervention—resective or regenerative—is inevitable once several threads of the implant have become
exposed. However, the following patient cases are intended to demonstrate that even initially hopeless situations can be resolved by relatively simple therapeutic
measures if peri-implantitis has not yet progressed to the
point of complete mobility of the implant (which was the
situation in the first case presented).
Peri-implantitis prevalence and risk factors
On the one hand, implants as replacements for lost teeth
have a relatively high success rate over observation periods of more than ten years.4 On the other hand, it has
been shown that 10–50% of implants showed signs of
peri-implantitis after ten years. In general, the prevalence
of peri-implant mucositis is as much as 80% and that of
peri-implantitis between 28 and 56%.5 Peri-implantitis
2
Fig. 1: The patient presented because of a broken denture tooth and loose restoration. Lifting of the upper lip revealed multiple fistula exits with pus discharge.
Fig. 2: No further conservative therapy could be initiated for the maxillary implants.
14
1 2023
[15] =>
case report
3a
|
3b
Figs. 3a & b: Situation before conservative therapy (a) of peri-implantitis affecting implant #46 in the second case and six to 12 months thereafter (b).
4a
4b
Figs. 4a & b: Situation before conservative therapy (a) of peri-implantitis affecting implants #36 and 37 in the third case and six to 12 months thereafter (b).
5a
5b
Figs. 5a & b: Situation before conservative therapy (a) of peri-implantitis affecting implant #36 in the fourth case and six to 12 months thereafter (b).
1 2023
15
[16] =>
| case report
6a
6b
6c
Figs. 6a−c: Implant #36 in the fifth case was initially planned for explantation, but could ultimately be preserved only with regenerative surgical measures
(one-year follow-up).
cases are rising in daily practice, but their development
can usually be linked to known risk factors.6 These include:
· smoking;
· history of periodontitis;
· poor oral hygiene;
· irregular supportive periodontal therapy intervals; and
· systemic disease (poorly controlled diabetes, cardiovascular disease, immunosuppression).
Sometimes it is a combination of several risk factors that
drastically increase the risk of complications. Zitzmann et al.
have already noted in a review that the incidence of
peri-implantitis is almost six times higher in patients with
periodontitis compared with non-periodontitis patients.7
Patient cases
Implant loss due to poor oral hygiene and lifestyle
habits
In the following patient case, several factors led to failure.
Despite the patient smoking more than 40 cigarettes
daily, implants were placed in such a way that a fixed restoration was possible. The patient stated that she could
not tolerate any palatal coverage and wanted a fixed option. Since her smoking, abundant alcohol consumption
and poor brushing habits were not improved, peri-implantitis was not a surprise diagnosis. This usually occurs
around seven years after implantation if—like in the following case—periodontitis treatment for the remaining
dentition is ignored and the patient’s lifestyle aggravating to the periodontium. The patient presented because
of aesthetic problems, but also because the implants
were already very loose (Fig. 1). Conservative periodontal therapy with instruction on the correct use of interdental brushes could not prevent the loss of the implants
(Fig. 2).
16
1 2023
Implant preservation with the aid of subgingival cleaning by air-scaler and concomitant administration of
systemic antibiotics
Is conservative peri-implantitis therapy ever enough to
resolve advanced peri-implantitis cases? The following
cases show that a single subgingival cleaning with airscaler and adjunctive systemic antibiotics helped to regenerate the bone around the implants. A single-blind
randomised clinical trial concluded that systemic adjunctive antibiotic administration does not necessarily provide
a clinically relevant benefit when, for example, amoxicillin
and metronidazole are administered systemically in combination.8 Would the same effect have occurred in the
cases shown here even without adjunctive metronidazole
administration for seven days after subgingival cleaning?
According to a more recent randomised clinical trial, the
administration of metronidazole as an adjunct to nonsurgical peri-implantitis therapy resulted in significant improvements in clinical, radiographic and microbiological
parameters after 12 months of follow-up.9
In the second, third and fourth patient cases (Figs. 3–5),
subgingival debridement was performed once by airscaler and then metronidazole was taken at a dosage of
500 mg three times daily for seven days.
Implant retention through interdisciplinary treatment
Not all cases develop as promisingly as the second, third
and fourth cases did. The conservative approach should
always be attempted first, and if this does not lead to the
desired clinical success, further surgical measures can
be considered, including the use of methods for which
there is not yet a strong evidence base.10 The fifth case
involved an implant that was inititally thought to be lost,
but could have been finally saved after periodontitis/
peri-implantitis treatment and subsequent augmentation
and use of a membrane as well as use of the GalvoSurge
[17] =>
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[18] =>
| case report
· a backup strategy for older people so that initially fixed
restorations can be converted into removable ones—
supported on the same implants;
· cleanable design of the superstructure—no artificial
gingivae up to the alveolar ridge;
· conscientious training on using interdental brushes—
often people are still instructed on the use of dental
floss, which is usually insufficient when cleaning the implant superstructure to remove plaque from the often
wide interdental spaces.
Ageing population
7a
7b
Figs. 7a & b: Situation of a removable prosthesis in the upper jaw and a
screw-retained prosthesis in the lower jaw in a patient.
implant cleaning system (Fig. 6). Such interventions are
relatively costly and the corresponding costs for augmentation material and the application of the electrode in
that procedure are ultimately borne by the patients, who
have an additional financial outlay in order to save the
implant. Surgical interventions can only take place in an
operating theater or clinic—a challenge that older people
are usually no longer able to cope with, as they are largely
no longer able to attend an appointment on their own.11
Ultimately, the best peri-implantitis therapy is prevention
and control of risk factors, ideally before implant placement begins. In my view, the most common mistake is
inadequate peri-implantitis prevention and inadequate
therapy, which usually consists only of oral hygiene by
the prophylaxis assistant. Sometimes patients are also
instructed to attend oral hygiene sessions every few
weeks—but this will not stop already existing periimplantitis, and further bone loss will occur.
The following scheme can help to prevent complications
with implants:
· regular checks using a conventional periodontal probe
(a special plastic implant probe is not necessary, but
can make access for probing a little easier);
· annual close-up check of implants to detect incipient
bone loss as soon as possible;
· screw-retained implants to make it easier to deal with
complications;
18
1 2023
According to the United Nations, the global proportion of
people over the age of 65 will rise to over 1.5 billion by
2050, and this population group will account for 25–40%
of the total population in the EU. As the population ages,
so does the proportion in need of care. According to the
Austrian Federal Statistical Office, for example, 70% of
women older than 90 and around 50% men in this age
group require care, most of which is provided at home by
relatives. How do complex and possibly even fixed implant restorations fit into the care regime? Even with patients who are institutionalised, the nursing staff seem to
be incapacitated (for example, the sixth case is that of a
patient from a Viennese nursing home; Fig. 7). It is therefore of crucial importance to also offer regular recall to the
older generation, especially to those who can no longer
visit the dental office on their own. Mobile units are used
for this purpose, which unfortunately currently only take
place on a project basis and have not yet become established for the general public in Austria.12
about the author
Prof. Hady Haririan is head of the Department of Periodontology at the dental clinic of the Sigmund Freud University in Vienna in
Austria. He studied dentistry at the Medical University of Graz in
Austria and the Paris Descartes University in Paris in France. He
completed postgraduate training in periodontics at the Medical
University of Vienna, graduating with an MSc in periodontology
in 2012. In 2017, he finished his doctoral studies in the regeneration of bones and joints programme at the same university.
In 2019, he completed his habilitation in the field of periodontology. He has been a board member of the Österreichische Gesellschaft für Parodontologie (Austrian Society of Periodontology)
since 2013 and its secretary general since 2019.
Prof. Hady Haririan
contact
Prof. Hady Haririan
+43 1 7201966
hady.haririan@med.sfu.ac.at
[19] =>
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[20] =>
| case report
Dual-wavelength laser treatment
of osteotomy site to increase the
success rate of implant placement
Dr Sean Chiu, USA
The focus of this case report is to demonstrate the
efficacy of the dual-wavelength (2,940 nm Er:YAG and
1,064 nm Nd:YAG) laser protocol used in our office and
its role in increasing the success rate of implant placement. Success is defined as the decreased risk of periimplantitis and of resulting infections around the implant,
the decreased risk of implant failure and of postoperative
complications of implant placement, and the increased
stability of implants placed into the surrounding bone.
It has previously been shown that the Er:YAG laser can
be used for removal of granulation tissue in both the soft
tissue and bone and for superficial disinfection of the implantation site. Furthermore, it can be used to roughen
the osteotomy surface for surface modification and
hence better cell attachment, as well as to stimulate healing. Decortication using the Er:YAG laser has been shown
to increase blood supply to the bone surrounding the im-
1
Fig. 1: Pre-op radiograph.
20
1 2023
plant for increased healing capabilities and to support
overlying grafts. The Er:YAG laser has a low risk of heating
the bone and of carbonisation owing to its very nature of
superficial ablation as well as owing to the use of water
spray, which cools the site. This laser has also been found
to have a superficial photo-biomodulation effect.
The Nd:YAG laser is used for deep disinfection inside the
osteotomy by reducing the periopathogen load in the
cortical bone after extraction of teeth and inadequate curettage or degranulation of the bone and socket. Multiple
studies have reported comparisons with conventional
drills and burs, which, when used alone without Er:YAG
and Nd:YAG lasers, generate more thermal heat, increasing the risk of bone necrosis, decreasing the healing rate
of the bone and osseointegration with the titanium implant surface, increasing inflammation, and decreasing
the mechanical and biological stability of the implant.
[21] =>
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[22] =>
| case report
2
3
Fig. 2: Pre-op image of the treatment area. Fig. 3: During Er:YAG laser degranulation of the osteotomy site.
Patient description
The patient had mild hypertension and used antihypertensive medications such as ramipril (angiotensinconverting enzyme inhibitor), propranolol (beta-blocker)
and amlodipine (calcium channel blocker). He also was
taking levodopa/carbidopa for Parkinson’s disease. He
had an extensive history of previous dental work (Fig. 1).
His oral hygiene was fair, as he brushed his teeth twice a
day, but only flossed once or twice a week. He had general chronic moderate periodontitis. The TwinLight periodontal laser-assisted cleaning procedure using both
Er:YAG and Nd:YAG lasers (Fotona) was completed on
the patient to improve the clinical attachment of the teeth,
reduce the pocket depths and improve periodontal bone
regeneration.
22
day before the surgery, and a 0.12% chlorhexidine rinse
was given to the patient to rinse with before surgery. One
carpule of 4% articaine and 1:200,000 adrenaline was
administered for the left inferior alveolar nerve block and
two carpules of 2% lidocaine and 1:100,000 adrenaline
were administered for buccal and lingual infiltration all
around the areas of the buccal and lingual mucosa of
sites #35 and 36. Three tubes of leucocyte- and plateletrich fibrin (L-PRF; 12-minute centrifuging at 2,700 rpm;
EBA 200, Hettich) and one white tube of F-PRF (folded
platelet-rich fibrin; 3-minute centrifuging at 1,500 rpm) resulted from blood drawn from the patient’s arm.
The patient had had a bridge extending from tooth #34
to tooth #37 for over ten years (Fig. 2), but there had been
extensive decay underneath the mesial surface of tooth
#37 in the past. The patient wished to have implants
placed in sites #35 and 36, to cut the bridge distally at
tooth #34 to preserve the crown, to remove the old
crown on tooth #37, to remove decay from mesial aspect
of tooth #37 and to place a new complete gold crown.
The treatment plan was to perform Er:YAG and Nd:YAG
laser-supported degranulation, surface modification and
disinfection of the osteotomy sites before implant placement in sites #35 and 36.
A #15 scalpel was used to raise a full-thickness envelope
flap along the gingival crest from the distal aspect of tooth
#34 to the mesial aspect of tooth #37. A guided surgery
kit with a fabricated surgical guide was used for preparation of the osteotomies with a sequence of osteotomy
drills before placement of the implants. Specifically, for
site #35, we used an initial regular-diameter osteotomy
drill to mark the osteotomy site and then a 3.5 × 7.0 mm
drill and a 4.0 × 7.0 mm drill. The osteotomy site was left
for laser treatment before implant placement. For site
#36, we used an initial wide-diameter osteotomy drill to
mark the osteotomy site and then a 3.5 × 7.0 mm drill and
a 4.5 × 7.0 mm drill. The osteotomy site was left for laser
treatment before implant placement. The osteotomy drills
were used at a setting of 800 rpm with saline water turned
on at a medium setting.
Treatment
Laser parameters
On the day of surgery, the patient was prepared on the
surgical chair with a bib and facial cover. The patient had
already taken two capsules of amoxicillin (1,000 mg) a
The following sets out the steps of using the Er:YAG and
Nd:YAG laser system (LightWalker AT S, Fotona) on the
osteotomy site. An Er:YAG H14 handpiece was used with
1 2023
[23] =>
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case report
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Fig. 4: Osteotomy site immediately after laser treatment.
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a cylindrical 12/1.3 fibre tip at 160 mJ and 20 Hz, in SP
(short pulse) mode and with a 5:4 water–air spray to degranulate the tissue, as well as provide superficial disinfection and ablation on both the bone surface and the soft
tissue overlying the osteotomy site (Fig. 3). Degranulation
mode removed all remaining soft tissue in and around the
bone. An Er:YAG H14 handpiece with a cylindrical 12/1.3
fibre tip at 50 mJ and 30 Hz, in MSP (micro-short pulse)
mode and with a 5:4 water–air spray was then used for
superficial disinfection along the osteotomy socket and
to conservatively open up the bone marrow spaces along
the socket walls. Choosing this setting is gentler on the
osteotomy site without removing more bone, which is critical for the stability of the implant and placement. This in
effect will increase the speed of healing, decrease inflammation, increase bone–implant contact, increase mechanical stability, increase biological stability and increase surface modification for better cell attachment. An
Nd:YAG 300 µm fibre tip non-contact with the bone at 2 W
and 20 Hz and in MSP mode was then used for deep disinfection of the osteotomy site (Fig. 4). This allows for increased removal of any periopathogens that may contribute to the failure of implant osseointegration. Care was
taken to ensure that blood in the socket site was removed
with high speed and that it did not interfere with the
Nd:YAG laser. No decortication of bone was required in
this case, as there was ample bleeding from inside the
osteotomy site. These steps allowed us to skip physical
curetting, making it more comfortable for the patient and
less time-consuming.
Second European
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Guided maxillary arch implantImplant
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case report
Peri-implantitis: Can it be treated without surgery?
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Using a surgical guide, a 4.5 × 7.0 mm Hiossen ETIII SA
implant (Osstem Implant) was placed in site #35 with a
regular no-mount driver and a 5.0 × 7.0 mm implant was
placed in site #36 with a wide-diameter driver. L-PRF was
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[24] =>
| case report
Observations and results
The patient was comfortable throughout the implant surgery and did not feel any pain. Mild bleeding was observed during the soft-tissue incision for the envelope
flap. Moderate bleeding was observed after osteotomy
preparation with the conventional osteotomy drills. The
Er:YAG degranulation mode produced some increased
bleeding on the bone surface. Surface modification of
the socket site with Er:YAG also produced more bleeding.
Ultimately, after the implants had been placed, the bleeding subsided. Moreover, placing membranous L-PRF underneath the healing abutments ultimately contained the
bleeding.
The patient had mild chronic pain and mild localised
oedema around the implant sites for two days after the
surgery, and these symptoms resolved over time. Photobiomodulation was performed for a second time two
days after the surgery, and this further decreased the inflammation and pain. By this time, primary closure of the
tissue had begun. Three weeks later, the patient returned
for removal of the PTFE sutures. There was no more
bleeding or oedema. The soft tissue was still in the process of healing, but the patient was asymptomatic, and
there was almost complete primary closure of the tissue
after 45 days of follow-up (Figs. 5 & 6).
5
Conclusion
The dual-wavelength approach using Er:YAG and Nd:YAG
lasers for degranulation, surface modification, disinfection and photo-biomodulation of osteotomy sites is
indispensable for the long-term success of implant
placement.
6
Fig. 5: Radiograph after 45 days of follow-up. Fig. 6: Almost complete primary closure of the tissue after 45 days of follow-up.
about the author
Dr Sean Chiu completed his BS in molecular biology in 2002 and his DDS at
New York University in the US in 2009.
He was a BITES Institute implantology
member from 2012 to 2018 and completed the Laser and Health Academy
master’s programme in laser dentistry
between 2019 and 2021. He has been
practising dentistry since 2009.
placed on top of each implant and then a 5 × 5 mm Hiossen
long-necked healing abutment was hand tightened on
to implant #35 and a 6 × 5 mm healing abutment on to
implant #36. Cytoplast PTFE sutures were placed.
Postoperative instructions and
pain management
Photo-biomodulation was performed twice, two days
apart, with the Genova Nd:YAG handpiece in noncontact mode at 0.5 W/cm2 and 10 Hz in MSP mode for
1 minute per spot at the implant sites for pain management and better regeneration of the tissue.
The patient was prescribed amoxicillin (500 mg) for one
week and a 0.12% chlorhexidine rinse for one week. He
only took ibuprofen (400 mg) twice for the first two days
for pain management.
24
1 2023
Dr Sean Chiu
contact
Dr Sean Chiu
contact@loft19dental.com
www.loft19dental.com
[25] =>
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[26] =>
| case report
Immediate implant placement
and bone grafting of a maxillary
central incisor: A seven-year
follow-up
Prof. Su Yucheng, China
Dental implant therapy aims to provide a long-term,
successful aesthetic and functional result that meets the
patient’s expectations and demands. A patient has the
best chance of a favourable outcome when there is a
sound understanding of his or her chief complaint and a
correct diagnosis is made. In addition, clinical decisionmaking should be based on the patient’s condition and
needs. Therefore, these must be accurately assessed.
Clinical history and interview, extra-oral and intra-oral
examination, additional investigation methods, risk
assessment, and referral to or consultation with other
specialists are all ways to collect data that could be
helpful in diagnosis. In our daily practice, this information
helps us establish an effective and practical individual
treatment plan for each patient. There are no shortcuts
to achieving long-term successful aesthetic effects. The
only way clinicians can achieve successful implantation
and restorative treatment is to strictly adhere to the
treatment plan and discuss with the patient the possible
scenarios that may be encountered during the implant
treatment journey. Moreover, despite the high success
rate for dental implants, complications are still possible.
Therefore, maintenance therapy should always be part of
1
26
2a
1 2023
2b
treatment, and its goal is to prevent peri-implant disease
and, consequently, ensure long-term implant stability.
The following clinical case describes a successful immediate implant placement with bone augmentation in the aesthetic zone of a young patient. The patient showed no clinical or radiographic complications throughout seven years
of clinical and radiographic follow-up and maintenance
therapy. The outcome met all the patient’s expectations.
Initial situation
A 25-year-old, systemically healthy female patient, a nonsmoker on no medication and with no allergies, presented to our clinic. Her chief complaint was that the
crown of an anterior tooth had been lost a few days before, having been loose for some time. She was eager for
a natural-looking replacement but was concerned about
damage to the adjacent teeth. In addition, she expressed
her desire for a quick and fixed definitive restoration of the
maxillary central incisor and to obtain a bright smile with
uniform, even teeth and a smoother look. Moreover, she
stated that she did not want to be left with a gap in her
anterior teeth during the treatment.
3
[27] =>
case report
4
5
6
7
8
9
During the extra-oral examination, her smile revealed a
medium smile line and showed the cervical margins of
the crowns of teeth #14–24. The intra-oral examination
revealed mild gingivitis and regular plaque control. After
the crown of tooth #11 had been completely removed, a
pigmented stump was found, and it was positive for the
vertical percussion test (Fig. 1). The radiographic evaluation showed thin facial bone, failed root canal therapy and
a post, periodontal ligament widening and root resorption
of tooth #11. Otherwise, no local infection was observed
(Figs. 2a & b). The SAC Assessment Tool classified this
clinical scenario as surgically complex but straightforward in terms of prosthodontics (Fig. 3).
Treatment planning
Immediate implant placement with bone augmentation
and delayed loading was decided on after a detailed discussion of the various treatment options with the patient.
The main steps of the treatment workflow included:
1. clinical and radiographic assessment;
2. preparation of the surgical guide;
3. extraction of hopeless tooth #11;
4. immediate placement of a Straumann Bone Level implant with flap elevation to ensure facial bone integrity;
5. filling of the gap between the bone and implant with
autogenous bone and a xenograft material;
6. placement of a collagen membrane to cover the grafting materials;
7. splinting of the provisional crown to teeth #12 and 21;
8. placement of a healing abutment six months after surgery (second-stage surgery); and
9. delivery of a definitive cement-retained crown two
weeks after second-stage surgery.
|
Surgical procedure
The surgical guide was first tested on the patient’s dental
arch to ensure a proper fit. The area to be operated on
was anaesthetised with local anaesthesia (2% lidocaine
with 1:100,000 adrenaline). An open-flap technique for
preserving the papilla was performed to gain adequate
access to the future implant site (Fig. 4). Tooth #11 was
extracted with minimal trauma to the surrounding tissue
and the palatal flap fixated with suture (Fig. 5).
The surgical guide was placed in the mouth to ensure
insertion of the implant in the optimal 3D position and
to visualise the future soft-tissue margin, which would
ideally be located 3 mm coronal to the implant shoulder.
The Straumann surgical cassette was used for preparing the implant bed, strictly following the drilling
protocol (Fig. 6). The osteotomy was prepared to a diameter of 2.2 mm, which was then widened to 2.8 mm and
finally to 3.5 mm. The preparation depth was checked
with the 3.5 mm diameter depth gauge. The final implant
bed preparation included profile drilling and subsequent
tapping. An implant (Straumann Bone Level, SLActive,
4.1 × 10.0 mm) was inserted at a speed of 15 rpm and
torqued to 35 Ncm. The implant was placed in its ideal
prosthetically driven position with a gap distance of 2 mm
between the facial bone and the implant surface (Fig. 7).
The gap around the implant shoulder was filled with a
mix of autogenous bone and xenograft and covered
with a collagen membrane.
The provisional restoration, an ovate pontic, was immediately placed in position #11 and splinted to teeth #12
and 21 to allow for proper healing, to shape the under-
1 2023
27
[28] =>
| case report
10
11a
lying peri-implant tissue and to enable assessment of
any necessary phonetic or aesthetic adjustments. Instructions on oral hygiene were given, and the occlusion
was checked.
After the final restoration, it was critical that the patient
understood the need for regular monitoring and maintenance to ensure long-term implant stability. Scheduled
annual follow-up visits included oral hygiene control and,
if appropriate, a dental radiograph. At the seven-year
control, the patient presented with healthy peri-implant
and periodontal tissue, and the CBCT images showed
adequate peri-implant bone levels (Figs. 11a & b).
After the implant placement, the patient underwent
routine check-ups, and no signs of pain or infection were
found. After the sutures were removed, the soft- and
hard-tissue preservation seemed uneventful.
Prosthetic procedure
Six months after implant placement, the intra-oral examination showed healthy soft tissue around the implant.
The implant had osseointegrated. A healing abutment
was placed in second-stage surgery.
Two weeks later the healing abutment was removed.
The soft-tissue profile showed optimal healing (Fig. 8).
The implant site was irrigated with 0.12% chlorhexidine,
the impression coping was placed and hand torqued,
and a radiograph was taken to verify adequate placement of the impression coping. An alginate impression
was taken of the mandibular arch, and a conventional
impression with a closed-tray transfer technique using
polyvinylsiloxane was taken of the maxillary arch (Fig. 9).
A cement-retained ceramic crown was delivered by the
laboratory. A satisfactory aesthetic outcome with a natural bone contour was achieved. Furthermore, the patient’s smile revealed a medium smile line with pleasing
aesthetics (Fig. 10).
A Straumann Center of Dental Education
(CoDE) is part of a group of independent
dental centres all over the world that offer
excellence in oral healthcare by providing the
most advanced treatment procedures based
on the best available literature and the latest
technology. CoDEs are where science meets
practice in a real-world clinical environment.
28
1 2023
CoDE Lead
11b
Treatment outcomes
The patient had been afraid of losing her anterior teeth.
She assumed that the treatment would be painful and
complicated owing to the necessary bone augmentation
procedure and the aesthetic location. We treated her with
a dental implant seven years ago, and she told us at the
most recent consultation that she was still highly pleased
with the results.
about the author
Prof. Su Yucheng works at the Peking
Union Medical College Hospital and Chinese Academy of Medical Sciences and
is the chairman of the Beijing dental implant training college, which has been a
Straumann Center of Dental Education
since 2022, all in Beijing in China. He
is a fellow of the International Team for
Implantology and of the International
College of Dentists. He is a member of the academic committee
of the Chinese Academy of Medical Sciences, a special member
of the Chinese association of oral implantology and chairman of
the subsociety of oral implantology of the Chinese Stomatological Association.
contact
Prof. Su Yucheng
Beijing, China
yuchengsu@163.com
Prof. Su Yucheng
[29] =>
[30] =>
| case report
Screw-retained restoration of a
maxillary first premolar
Dr Anthony Bendkowski, UK
Dental implants are widely accepted as a successful
method for replacing missing teeth. The success of dental implant treatment depends on many factors, such as
implant design, surgical technique, bone quality and patient factors. The aim of this case report is to present a
step-by-step description of the implant treatment and
restoration of a patient who had lost a maxillary first premolar, from the initial osteotomy preparation to the final
restoration.
Case presentation
A 71-year-old female patient presented to our practice
with a heavily restored dentition. She had lost her
crowned maxillary right first premolar due to root fracture
three months before (Fig. 1) and wanted a fixed restoration. Pre-op radiographic assessment confirmed that
there were no anticipated issues (Fig. 2). After a detailed
examination, a treatment plan was drawn up. We decided to place a screw-retained crown supported by an
OmniTaper EV implant (Dentsply Sirona).
A full-thickness envelope flap was raised with relieving
incisions, and the initial small round guide drill was used
to mark the implant position. The site was enlarged with
OmniTaper drills of different diameters, following the recommended drilling protocol. The initial osteotomy preparation was performed with a 2 mm diameter OmniTaper
drill at no more than 1,500 rpm and with copious external
irrigation with saline according to the surgical protocol.
The site was then enlarged with a 3 mm diameter OmniTaper drill and next with a 3.4 mm diameter OmniTaper
drill. Final enlargement was performed with a 3.8 mm
diameter OmniTaper drill (Fig. 3).
An OmniTaper try-in implant was then inserted to verify
the insertion path and appropriate depth of 13.0 mm
(Fig. 4). Cortical preparation was performed with a
3.8 mm diameter OmniTaper crestal drill as appropriate
for bone density. The crestal drill was used up to the first
mark, representing a 2 mm countersink appropriate for
the bone density encountered (Fig. 5).
An OmniTaper EV OsseoSpeed implant with a premounted TempBase EV was then inserted into the site
(Fig. 6). The TempBase EV was removed, and a cover
screw EV was placed (Figs. 7 & 8). The wound was
1
2
Fig. 1: Situation before surgery. Fig. 2: Pre-op radiographic assessment confirming a well-healed situation.
30
1 2023
[31] =>
case report
3
|
4
Fig. 3: Final enlargement performed with a 3.8 mm diameter OmniTaper drill. Fig. 4: Insertion of an OmniTaper try-in implant with a diameter of 3.8 mm to
verify the insertion path and appropriate depth.
5
6
Fig. 5: Cortical preparation with a 3.8 mm diameter OmniTaper crestal drill. Fig. 6: OmniTaper EV OsseoSpeed implant with pre-mounted TempBase EV.
7
8
Fig. 7: Implant (3.8 × 13.0 mm) in site #14 and the TempBase EV removed. Fig. 8: Cover screw EV (M) in situ.
9
10
Fig. 9: HealDesign EV (M) abutment placed. Fig. 10: Atlantis IO FLO inserted for capture of a digital impression with Primescan.
1 2023
31
[32] =>
| case report
11
12
Fig. 11: Atlantis CustomBase solution, consisting of an Atlantis crown, an Atlantis abutment and an Atlantis abutment screw, supported on an implant analogue
on the model. Fig. 12: Radiographic evaluation verifying the final restoration.
closed with PGA sutures. Three months later, secondstage surgery was performed, and a HealDesign EV
abutment was placed (Fig. 9).
placement of the implant, while the Atlantis CustomBase
solution provided a customised restorative option for the
patient.
A digital impression using an intra-oral scanner (Primescan, Dentsply Sirona) was then captured using the
Atlantis IO FLO for a digital restorative workflow (Fig. 10).
An Atlantis CustomBase solution, consisting of an Atlantis crown, an Atlantis abutment and an Atlantis abutment
screw, was fabricated (Fig. 11). After seating, a radiographic evaluation was performed to verify the final restoration (Fig. 12). The final restoration showed excellent
soft-tissue adaptation and an aesthetic outcome (Fig. 14).
The patient was extremely satisfied with the outcome of
the treatment and the fixed restoration.
The success of this case is a testament to the importance of careful treatment planning, precise execution of
the surgical protocol and the use of advanced digital
technology in implant dentistry. Like with any implant
case, close collaboration between the surgical and restorative teams is critical to ensuring a successful outcome for the patient.
Conclusion
Dr Anthony Bendkowski is an oral
surgery specialist in practice limited to
implant reconstructive surgery with two
clinics in London and the south-east of
England. He has over 30 years of experience in both the surgical and restorative management of implant cases. He
is a past president of the Association of
Dental Implantology, an examiner for
the Royal College of Surgeons of Edinburgh Diploma in Implant
Dentistry and a contributor to the postgraduate dental implant
programme at Brighton and Sussex Medical School in the UK.
He is co-chair of Bromley, Bexley and Greenwich LDC and an
honorary consultant at King’s College Hospital NHS Foundation
Trust in London in the UK.
This case report highlights the successful placement of
an OmniTaper EV implant in a patient with a heavily
restored dentition. The use of an intra-oral scanner and
impression components for the prosthodontic and technical digital workflow allowed for precise planning and
execution of the treatment plan. The use of the OmniTaper drill system allowed for efficient and predictable
about the author
Dr Anthony Bendkowski
contact
13
Fig. 13: Excellent soft-tissue adaptation and an aesthetic outcome.
32
1 2023
Dr Anthony Bendkowski
enquiries@theimplantexperts.com
+44 1622 751553
[33] =>
52
ND
INTERNATIONAL
ANNUAL CONGRESS
OF DGZI
IMPLANTOLOGY
IN TEAM
IMPLANTOLOGY IS TEAM
REGISTER
NOW!
www.dgzi-
jahreskongre
6 TH/7 TH OCTOBER 2023
HAMBURG
ss.de
[34] =>
| interview
The quest for safe and sterile
implants
An interview with Dr Dirk Duddeck, Germany
Dental implants have revolutionised the way we treat
missing or damaged teeth, giving patients a permanent
and natural-looking solution. However, reports of substandard and contaminated implants have brought the
quality of these devices under intense scrutiny. In this interview, we will be speaking with Dr Dirk Duddeck, the
founder of the CleanImplant Foundation, a non-profit organisation dedicated to promoting high-quality, clean
and safe dental implants for patients. Through its extensive research and advocacy efforts, the CleanImplant
Foundation is leading the charge in ensuring that dental
implants are not just safe but also effective in providing
the desired results. Join implants—international
magazine of oral implantology as we get a closer look at
the work of the CleanImplant Foundation and learn about
its efforts in ensuring the highest quality and safety for
patients receiving dental implants.
“It becomes particularly
interesting when colleagues
report to us inexplicable early
implant failures or periimplantitis shortly after
placement.”
Dr Duddeck, as a non-profit organisation, the CleanImplant Foundation is dedicated to increasing the
safety of medical devices and evaluating the factory
cleanliness of dental implants. How many implant
systems have you inspected or, to put it more precisely, analysed in the scanning electron microscope
(SEM)?
From the inception of quality assessment tests on sterilepackaged implants, we have evaluated the surface cleanliness of over 300 implant systems from approximately
250 manufacturers. Every two to three years, we undertake a comprehensive study of the implants in the marketplace. Current batch samples are supplied by manufacturers on request, or if they choose not to participate
in the study, the samples are blind purchased.
34
1 2023
Fig. 1: Dr Dirk Duddeck, founder and head of research at the CleanImplant
Foundation. (© CleanImplant Foundation)
[35] =>
interview
|
2 3
Fig. 2: Sterile implants mounted on a sample holder waiting for SEM analysis. (© CleanImplant Foundation)
Fig. 3: Organic contaminants on the entire implant shoulder–identified as silicone-containing plastic residues (polysiloxanes) by ToF-SIMS.
How can dentists and clinics with a focus on implantology benefit from the work of the CleanImplant
Foundation?
On our website (www.cleanimplant.com) dentists can
find implant systems that have proven their cleanliness
every two years across various batches and have been
awarded the Trusted Quality Seal. However, every practitioner can contact us directly. It becomes particularly
interesting when colleagues report to us inexplicable
early implant failures or peri-implantitis shortly after
placement. In these cases, we have found implant samples from the same batch typically demonstrate clinically
relevant amounts of plastic particles, residues from manufacturing or packaging, cell-toxic residues of aggressive cleaning substances such as dodecylbenzene sulphonic acid or lubricants such as perfluoropolyether.
How can you identify these contaminants so accurately? The SEM is not suitable for this, right?
Yes, you are correct. We combine two spectrometric
methods to analyse unknown substances. In the SEM,
we can see where high-carbon particles collect on the
implant. With information about the localisation or accumulation of the foreign particles, subsequent time-offlight secondary ion mass spectrometry can be used to
determine the composition of the substances. In several
cases, these essential findings enabled manufacturers to
eliminate the cause of contamination and deliver residuefree implants after the corresponding quality management improvement.
Do these substances have any effect on healing after
the placement of the implant?
It can be assumed that these substances significantly interfere with osseointegration or completely prevent it in
contaminated areas. After phagocytosis by macrophages, those contaminants can trigger a storm of pro-inflammatory cytokines, resulting in bone resorption and soft
tissue degradation. This year, the CleanImplant Foundation
will conduct an elaborate study on this matter with the
University of Zurich. Given the increasingly high reported
levels of peri-implantitis, it is likely that the effect of particulate and thin-layered dirt particles on sterilepackaged implants is under-estimated as a contributing
factor.
How have companies reacted to your analyses?
Our mandate is to encourage manufacturers and suppliers to engage in a constructive dialogue. Sadly, some
companies have not yet cooperated with our efforts, as
they have chosen not to believe that foreign particles are
clinically relevant, despite evidence to the contrary.
The CleanImplant Foundation will once again be exhibiting at the International Dental Show in Cologne
in Germany in March. What can users and manufacturers expect?
At this year’s show, we will have an SEM at our booth in
collaboration with Thermo Fisher Scientific. Those colleagues who bring sterile-packaged samples of their implant systems of choice for assessment will be able to
view the level of surface cleanliness under the SEM. Manufacturers will be shown the nature and scope of our
analyses as well as the results from a European-funded
project that enables us to count and identify particles using artificial intelligence. On Thursday, 16 March, all manufacturers are invited to the fifth group and expert meeting. We look forward to sharing insights into the
micrometre universe and unknown surface views of implants that colleagues will bring to our IDS booth (Hall
14.2, Booth O042).
contact
CleanImplant Foundation
Dr Dirk U. Duddeck
Dr Dirk U. Duddeck
+49 30 200030190
duddeck@cleanimplant.org
www.cleanimplant.org
1 2023
35
[36] =>
| interview
Acting against the silo effect
An interview with Dr Tiziano Testori, Italy
Dr Tiziano Testori is the founder and director of Lake
Como Institute, a leading institution in dental education
located in Italy. With extensive experience in the field of
dentistry, Dr Testori is recognised for his expertise and
insights on the latest trends and developments in dental
education. As a lecturer at Lake Como Institute, he has
played a key role in shaping the curriculum and delivering
high-quality dental education to students. In this interview with implants—international magazine of oral implantology, he discusses the importance of considering
the scientific evidence and reputation of presenters in
evaluating courses, as well as the benefits of taking a holistic approach to patient care.
What’s your view of the exponential growth of
extra-clinical educational courses in dentistry?
Increasingly, I am receiving information regarding courses, basic training sessions and webinars that cover
extra-clinical topics. After some initial reticence, I
started to pay attention to some of these programmes
and found myself bewildered by the huge range of topics
on offer; I had no idea that there were all these things
36
1 2023
that we needed to know in order to carry out our jobs.
I come from a generation of dentists who had the opportunity to deal with their own clinical training and apply it directly to patients in their own practices, and we
never perceived that we needed anything more. I remember though that even clinical training in recent
years has seen a multiplication in techniques to be
learned and modifications of techniques that are difficult to take in and master.
What has guided your decision-making on what
educational courses to take?
I long ago adopted a method for finding my way around
clinical research findings and education, and I have adopted it for extra-clinical topics as well: the scientific evidence on the topics discussed and the reputation of
those communicating on them. The world is rapidly
evolving, and our profession is not exempt from it. The
risk of the silo effect, that is, being focused on a single
aspect and impervious to everything else, is real, and we
can no longer afford to ignore it. Our education must also
extend to fields beyond dentistry.
[37] =>
interview
Continuing with this reflection on what training areas to
devote attention to, I wondered, how much do we know
beyond our profession as dentists? Do we retain sufficient recollection of our studies in anatomy, general pathology, physiology and pharmacology or are we locked
up in our daily silos? Do we have room only for dental
knowledge?
How do patients benefit from this new extraclinical knowledge?
Patients do not hand us their teeth to repair as one would
a smartphone or an appliance; teeth are part of biologically and physiologically complex systems that are
strongly interrelated. Patients’ oral health is a continuous
sequence of causes and effects to be investigated beyond their mouths too.
What would you recommend to your peers?
I think that the time has come to break down the walls
of our silos and build a system of knowledge that targets
the whole patient. We should propose a therapeutic alliance that goes beyond dental issues for which we are
approached. We should anticipate that moment by
communicating with our patients and providing all the
necessary tools for their awareness. We should estab-
|
lish a relationship with and communicate with other
specialists, including practitioners involved in dental
disease-related pathologies. We should expand our responsibility to patients’ experience before, during and
after their visit to our practices.
All this is possible today. The important thing, in my
opinion, is positioning ourselves correctly without ever
abandoning the method of evaluation that I have always
followed: the scientific evidence on the topics under
scrutiny and the reputation of those communicating on
them.
Dr Tiziano Testori
contact
Lake Como Institute
+39 031 2759092
info@lakecomoinstitute.com
1 2023
37
[38] =>
| industry
Neodent celebrates 30 years of
history
A global player in dental solutions that restore
smiles and confidence
As 2023 begins, Neodent is ready to celebrate what it
does best: creating new smiles every day. This year
marks the 30th anniversary of the brand, which has been
providing immediate treatment protocols and changing
lives of patients with millions of smiles worldwide since
1993. Founded by a dentist, for dentists, Neodent is now
present in over 80 countries, thanks to its commitment
to maximising predictability and enabling long-lasting
results through its unique features designed based on
key biological principles. To celebrate this milestone,
Neodent is hosting the 30 Year World Tour in the five regions where it has a presence. These in-person events
will bring together customers and experts to strengthen
relationships.
The 30 Year World Tour will feature Neodent founder
Dr Geninho Thomé and CEO Matthias Schupp, who will
The Neodent Grand Morse system feature the Acqua hydrophilic surface.
38
1 2023
celebrate the brand’s history and philosophy and promote its innovative portfolio.
Throughout its 30-year history, Neodent has learned that
celebrating is a choice, and as long as it exists, it will
choose to bring smiles to people’s lives. The manufacturer provides direct, progressive and affordable dental
solutions that bring innovative and reliable solutions to the
community.
Next-level implant surface treatment
Patients’ increasing expectations for shortened treatment duration represent a significant challenge for dental
professionals. Enjoy more treatment flexibility to create
the optimal tooth replacement outcomes for all indications, from single tooth to fully edentulous. The Neodent
[39] =>
industry
|
“I am proud to see how much we have grown over time
since our foundation, in 1993, until our first ceramic
implant system, in 2022. I just see reasons to smile. In
2015, with the full acquisition by the Straumann Group,
we started to spread our philosophy around the
world and the gratitude to see Neodent present in over 80 countries with great results
makes me happy and excited for the next
30 years. I would like to thank everybody
who was been part of our history until now
and I invite you to celebrate with us the
evolution of implantology, technology, the
dentistry market, aesthetics, patients and
Neodent.”
Dr Geninho Thomé, founder of Neodent.
Grand Morse system offers a helix implant design featuring the innovative Acqua hydrophilic surface designed
to maximise primary stability and predictability in immediate protocols for all bone types. The Helix Grand Morse
implant allows for tailored treatment options according
to the specific clinical situation, considering the biological
principles and respecting the fundamentals of implant
dentistry.
The implant–abutment interface is crucial for a successful long-term functional and aesthetic result. The Neodent
Grand Morse connection offers a unique combination
based on proven concepts: platform switching and an
internal hexagon and deep 16° Morse taper connection
for a strong and stable connection designed to achieve
long-lasting results.
The Neodent Acqua surface is an improvement on the
successful NeoPoros surface designed for high treatment predictability and developed to achieve successful
outcomes even in challenging situations, such as soft
bone or immediate protocols.1–4 The NeoPoros surface is
made using abrasive sandblasting with controlled grain
oxides, followed by acid etching, creating uniform cavities
in the implant surface. The hydrophilic Acqua surface
presents a smaller contact angle than the NeoPoros surface when in contact with liquids, providing greater accessibility of bodily fluids to the implant surface.2
With a strong focus on research and development,
Neodent is constantly pushing the boundaries of what is
possible in dental technology. Its products are backed by
rigorous clinical testing and real-world results, and the
company has a proven track record of success in helping
dental professionals deliver high-quality, affordable dental care. With its commitment to innovation, quality and
customer satisfaction, Neodent pursues the best possible care for patients. The company’s mission is simple: to
improve lives through better oral health. Join Neodent’s
mission to change the world, one smile at a time.
Literature
contact
Neodent (Straumann Group brand)
+55 800 7072526
www.straumann.com/neodent
1 2023
39
[40] =>
| manufacturer news
bredent medical
The all-round solution package for implantology
With ALL-IN-ONE, the bredent group presents itself as a all-round
solution provider for dental therapy forms. Under the motto “360°
Implantology”, the company offers a complete package for
implant care.
Whether treatment planning, the correct choice of materials and
gentle insertion of the implant or the prosthetic care—bredent
accompanies users from start to finish.
360° Implantology is an open system that offers its users maximum flexibility. The bredent group has optimised its CAD/CAM
systems so that, for example, the prefabs for making individual
abutments function smoothly.
For a successful immediate treatment, the position of the implant
is of great importance, which is why all bredent implants have
great primary stability in all bone qualities. For over 15 years,
bredent has been successfully on the market with its SKY fast &
fixed therapy and has been able to bring a smile to more than
100,000 patients in this time. With the help of
sophisticated, standardised procedures,
edentulous patients can be fully
treated with a small number of
implants. And in just one day
and with a success rate of over
98 per cent.
All bredent implants also have a back taper according to the “Bone Growth Concept”, which
means they have a crestal bevel. This leaves more room for bone
and soft tissue to support the growth of bone.
Get to know ALL-IN-ONE live at IDS 2023!
If you want to be convinced by bredent’s ALL-IN-ONE solutions in
person, visit the International Dental Show (IDS) from 14 to
18 March 2023 in Cologne in Hall 4.2, Booth J080/K081. The
team at the booth is looking forward to meet you!
bredent medical GmbH & Co. KG, Germany
info-medical@bredent.com
www.bredent-medical.com
Fotona
A multiwavelength laser approach to successful implantology
Fotona’s award-winning LightWalker® and SkyPulse® dental lasers are widely recognised as uniquely versatile tools in dentistry
and implantology. With high-precision Er:YAG lasers, they are perfect for the treatment of peri-implantitis, including the removal of
granulomatous tissue from inflamed surfaces and direct implant
decontamination. They are also highly suitable for fast and safe
de‐epithelialisation of the gingiva surrounding the extraction
socket, which prevents the ingrowth of epithelium into the socket
and produces a rough surface that enhances retention of the blood
clot. In addition, LightWalker’s pulsed Nd:YAG and SkyPulse’s highperformance diode lasers allow for highly effective soft-tissue
procedures with simultaneous coagulation and disinfection, as
well as tissue regeneration, making them ideal for applications in
implant surgery. Fotona’s comprehensive laser peri-implantitis
and post‐extraction treatment protocol utilising a multiwavelength
approach for degranulation, disinfection, de‐epithelialisation, clot
stabilisation and photo-biomodulation, has proven to be a safe and
effective solution for facilitating optimal treatment outcomes.
LA&HA, Laser and Health Academy, Slovenia
journal@laserandhealth.com
www.laserandhealthacademy.com
40
1 2023
[41] =>
manufacturer news
|
Straumann
Taking immediacy to the next level
Patients’ increasing demand for shorter
treatment times, the growing evidence
for predictable success, and the positive effects on productivity and
growth have made immediate treatment protocols a popular choice in
implant dentistry. With Immedia-XyTM,
Straumann offers an ecosystem of
solutions that are designed to enable
dental professionals to provide their
patients confidently and efficiently
with immediate temporisation—whenever possible and clinically sensible,
whether in single tooth, multiple teeth,
or full-arch cases. The Straumann®
BLX and TLX implant systems come
both with Dynamic Bone Management
and have been developed to make immediate protocols achievable, predictable and minimally invasive in all bone
types. They are featuring the same
endosteal design which means the
same drill set is shared for both systems.
Thanks to the high mechanical strength
properties offered by Straumann’s Roxolid®
alloy, the BLX and TLX lines allow for reduced invasiveness and the Ø3.75 mm is
suitable for all tooth positions. BLX is the
new generation of bone-level implants offering a simple yet versatile portfolio with
under-contoured prosthetics for excellent
soft-tissue management. With TLX, the
proven benefits of tissue level are now available as well for immediate workflows.
Throughout Straumann’s wide portfolio of
solutions for immediate treatment protocols, clinicians are genuinely empowered to
treat a wide range of clinical indications,
from the straightforward to the most challenging cases.
Institut Straumann AG, Switzerland
+41 61 9651111
www.straumann.com/immediaxy
3Shape
Wireless intra-oral scanner
TRIOS 5 Wireless is recognised for its innovative performance and
design. A double winner at the UK’s Dental Industry Awards, Dental Products Report also named TRIOS 5 one of the Top Game
Changers of 2022. In an interview, Dr Sundeep Rawal, Senior Vice
President of Implant Support Services at Aspen Dental, stated:
“TRIOS 5 nails it.”
TRIOS 5 provides excellent performance in a redesigned compact
body. The scanner is 30% smaller than the previous 3Shape models, and delivers next-level ergonomics, effortless scanning, and
improved hygiene.
The intra-oral scanner achieves an unique level of scanning simplicity with its groundbreaking ScanAssist technology that minimises misalignment and distortion in 3D models. With TRIOS 5,
professionals can create a scan path they prefer. Furthermore, it has received clearance from the U.S. Food
and Drug Administration. The scanner
features all-day battery life
with Smart Power Management. Its closed autoclavable scanner tip is
protected by scratch-
free sapphire glass. The new enclosed tip means TRIOS 5 never
needs calibration.
For availability of 3Shape products in your country or region, please
contact your reseller.
3Shape Germany GmbH, Germany
Contactus.de@3Shape.com
www.3shape.com/de-de
1 2023
41
[42] =>
| events
High-tech in a unique setting
DGZI has announced a training partnership
with Ritter Academy
On 14 and 15 October 2022, Motorworld Munich played
host to the first training presented jointly by the German
Association of Dental Implantology (DGZI) and Ritter
Academy as part of the DGZI’s implantology curriculum.
Under the motto of “Learning by doing” of the Ritter
Academy and Ritter Implants, the DGZI offered participants an unparalleled training experience using the latest
technology in simulators for hard- and soft-tissue management with high-tech phantom heads.
With experienced DGZI lecturers and specialists leading
the way, the weekend was dedicated to practical training
at the highest level. The simulators were specifically developed and manufactured for implantology courses by
Ritter Academy, allowing for a practice-oriented treatment process with the guidance of skilled professional
staff.
The goal of this mandatory module within the implantology curriculum of the DGZI is to empower dentists to excel in everyday implant practice. Ustomed, a globally established manufacturer of surgical precision instruments,
supports the course with surgical instruments and kits for
bone grafting and processing.
A prerequisite for the course is mastery of the corresponding e-learning modules to ensure the requisite
foundational knowledge and avoid hindrances during
practical training. Under the guidance of DGZI specialists, the entire spectrum of dental implantology, including
hard- and soft-tissue manipulation, is taught and participants are trained on duplicates of real patient cases, using these to plan, simulate and practise various situations
from everyday implantology practice. The workstations
are equipped with the instruments and materials (such as
implantology kits—in this case those of Ritter Implants) of
42
1 2023
an implant dentistry practice. Models with artificial mucosa and periosteum are available, as well as radiographic units, CBCT devices and surgical guides for navigation surgery, specifically designed for the case in
question. The maxillary sinus and the course of the inferior alveolar nerve are depicted and marked.
More time and emphasis are given to the practical part of
the course. After a brief theoretical introduction by the
speakers and the Ritter Academy, the individual steps are
shown in a live demonstration and transferred to the
workstations so that each step can be practised by the
participants. Work is done in teams of two to strengthen
the teamwork concept and demonstrate its advantages.
[43] =>
events
|
Learning outcomes
Through the surgical practice, participants learn how to plan and execute complex treatment cases. Areas covered include:
· applied anatomy;
· surgical procedure and incision guidance;
· implantation techniques such as bone spreading, bone splitting and
bone condensing;
· principles of soft-tissue surgery (primary wound closure, various techniques for implant exposure, papilla formation);
· knowledge of advanced soft-tissue surgery in implantology and augmentation surgery or correction of soft-tissue deficiencies;
· principles and pathophysiology of bone transplants and intra-oral
bone harvesting techniques;
· augmentation procedures and onlay bone block grafting, and membrane and shell techniques for stabilising bone replacement materials;
· sinus lift techniques (open and closed); and
· complication management.
Do not miss out on this unique opportunity to enhance
your skills and stay ahead in the field of implantology. Join
the event on 20 and 21 October at the dental training institute of the Ritter Academy in Biberach an der Riß in
Germany. This special training experience will also be offered in English if there are a sufficient number of participants. For further information, please contact the DGZI
secretariat.
contact
DGZI
+49 211 1697077
sekretariat@dgzi-info.de
www.dgzi.de
DGZI
Ritter Implants
+49 7351 5292566
info@ritterimplants.de
www.ritterimplants.com
1 2023
43
[44] =>
| events
Implant Solutions World Summit
2023—cutting-edge implant
science and innovation
Dentsply Sirona
Dental professionals join world-leading experts in implant dentistry for this exclusive, state-of-the-art congress in Athens, Greece, on 8–10 June. Together, they
will discover cutting-edge science, the latest innovations
in digital dentistry, bone regeneration, and optimised
implant treatment solutions, including EV implant family,
for their patients—and enjoy the company of colleagues
and friends from around the world.
The Implant Solutions World Summit brings together
professionals who are passionate about elevating the
dental industry and improving the quality of implant treatments and care for patients. The congress will take place
at the InterContinental Athenaeum Athens hotel, close to
Greece’s famous Acropolis.
The Implant Solutions World Summit will feature presentations from more than 40 world-renowned experts in implant dentistry, who will share best practices, expertise,
and insights. Dental professionals will learn about managing implant complications, the connections between
systemic and oral health, maximising aesthetics, controlling
risk factors, maintaining peri-implant health, and more.
The programme is developed together with the Scientific
Chairs—Dr Tara Aghaloo, USA, and Dr Michael Norton,
UK—and the Programme Chairs—Steve Campbell, UK;
Dr Malene Hallund, Denmark; Dr Mark Ludlow, USA;
Dr Stijn Vervaeke, Belgium; and Dr Martin Wanendeya, UK.
“Peer-to-peer education is vitally important for our implant solutions community, and we are thrilled to bring
implant professionals together from around the world to
explore the latest innovations and science transforming
implant dentistry” says Tony Susino, Vice President,
Global Implant Solutions at Dentsply Sirona. “The event
promises to be an inspirational opportunity for learning
and networking as we glimpse into the future of implant
dentistry and optimised patient care.”
44
1 2023
Innovative implant solutions and digital
workflows
The Implant Solutions World Summit 2023, will also feature an interactive exhibition and sign up for exciting
master class workshops to learn more about Dentsply
Sirona’s products, solutions, and workflows, including
Dentsply Sirona’s premium implant portfolio—DS PrimeTaper Implant System, DS OmniTaper Implant System
and Astra Tech Implant System—OSSIX regenerative
solutions, DS Signature Workflows for single-tooth, partial and full-arch restorations, the cloud-based DS Core
platform for improved practice efficiency, and practice
building.
The innovative, comprehensive implant solutions portfolio from Dentsply Sirona is designed to help practices
grow their implant dentistry business and get the best results for their patients.
contact
Dentsply Sirona
www.dentsplysirona.com/worldsummit
© Viacheslav Lopatin/Shutterstock.com
Scientific programme
[45] =>
ceramic
implants
is ONLINE!
e-paper · news · articles · community · newsletter
OEMUS MEDIA AG
Check out the
new website!
Subscribe to
the newsletter!
ceramic-implants.info
ceramic-implants.info/subscribe
Holbeinstraße 29 · 04229 Leipzig · Germany
Phone: +49 341 48474-0 · info@oemus-media.de
[46] =>
| events
ITI International Team for Implantology
All about the patient: The ITI World Symposium 2024
The ITI World Symposium is back and better than ever: More than 50 world
renowned speakers will present at the world’s largest scientific implant dentistry event in Singapore from 9–11 May 2024. Building on its previous highly
successful online edition, the ITI World Symposium 2024 once again puts
patients at the centre of the action. Over three days, the more than 4,000
participants will experience real patients and their stories on stage. The
speakers will discuss various treatment options based on the latest scientific
evidence. But it does not stop there: world class clinicians will provide commentary on exclusively recorded clinical procedures live on stage.
“With our unique, patient-centred programme structure, we aim to combine
practical, clinical insights with the discussion of scientific findings”, explains
ITI President Charlotte Stilwell. “We ran a survey in our community last year
to identify the topics of currently greatest relevance, and these form the core
of our scientific programme: soft tissue management, GBR/bone augmentation, immediate implants, peri-implantitis and the digital workflow.”
Registration for the ITI World Symposium opens early April. ITI members as
well as early registrations will benefit from significant discounts.
ITI International Team for Implantology
worldsymposium.iti.org
DGZI and Ritter Implants
Continued education and professional development
The German Association of Dental Implantology (DGZI) is proud to
announce its collaboration with Ritter Implants Company, in which
they participated in the recent AEEDC Dubai dental conference
exhibition. At the event, the DGZI presented its renowned Curriculum of the German Board of Oral Implantology (GBOI) through its
representative in the Arabian Gulf Countries, Dr Hisham Y. Abueljebain.
For the past 16 years, Dr Abueljebain has been successfully managing the implementation of the GBOI curriculum in Kuwait, and
the e-learning platform designed by the DGZI has received great
feedback from colleagues who have participated in the programme. The DGZI is now taking a step forward and offering a new
curriculum for dental technicians for the first time. This programme
will be available starting in September 2023 and will be delivered
through the same e-learning platform as the dentist’s curriculum,
albeit with a limited number of modules for technicians. This exciting new course for technicians will be comprised of five modules,
three of which will be conducted online, while the fourth and fifth
modules will be face-to-face, providing technicians with hands-on
experience in fabricating prosthetic crowns, bridges, and full
mouth rehabilitation over implants. In addition to this new programme, the 10th batch of the GBOI curriculum for dentists will also
begin in September 2023, and registration is now open for both
dentists and technicians through the DGZI’s website at www.gboikuwait.net.
46
1 2023
The DGZI is thrilled to be offering these opportunities for continued
education and professional development and wishes all participants a bright future and a challenging educational experience.
DGZI e.V.
+49 211 1697077 · sekretariat@dgzi-info.de
www.dgzi.de
[47] =>
DGZI
„Implant Dentistry
Award“ 2023
CALL FOR POSTERS!
On the occasion of the 52nd International Annual
Congress of the DGZI on October 6 and 7, 2023 in
Hamburg, the DGZI will again present its "Implant
Dentistry Award". Prizes will be awarded for scientific
work in the form of posters, which will be published internet-based in a Digital Poster Presentation.
DGZI will pay the congress fee and the conference
fee for the obligatory participation in the congress. The posters will be presented digitally only, no
other form of submission is possible.
Scan QR code now or visit
dgzi-2023.dpp.online/landing
and submit abstract digitally!
CLOSING DAT
E:
15. 08. 2023
[48] =>
| news
FDI supports WHO
New WHO antibiotic book addresses oral and dental infections
Launched during World Antimicrobial Awareness Week in November 2022, the publication provides evidence-based guidance on
antibiotic use in healthcare settings to combat resistance.
According to the World Health Organization (WHO), by 2050
around 10 million deaths could take place each year due to antibiotic resistance. Members of the dental profession have an important responsibility to raise awareness to this imminent issue, as
about 10 per cent of antibiotic prescriptions are issued by dentists.
During the World Antimicrobial Awareness Week 2022, WHO
launched the WHO AWaRe (Access, Watch, Reserve) antibiotic
book aimed at providing evidence-based guidance on antibiotic use in primary healthcare
and hospital settings.
Oral and dental infections chapter
considers comprehensive input from FDI
FDI’s Antimicrobial
Resistance (AMR)
Working Group
led by Dr Wendy Thompson provided significant inputat the drafting stages of WHO’s antibiotic book. In particular, the AMR Working Group held meetings with WHO to provide feedback and input
on the chapter focused on oral and dental infections to ensure that
it was coherent with the other chapters. FDI is pleased to report
that many of its suggestions were taken into consideration in the
final publication, including changing the name of the chapter from
“dental infections” to “oral and dental infections” as well as consulting local and national guidelines for the use of antibiotic prophylaxis before dental procedures. Guidance on which dental
conditions and infections are appropriate for antibiotic treatment
was also provided. Additionally, two articles written by FDI experts
were cited in WHO’s publication.
FDI commends WHO for highlighting the very important topic of
antibiotic resistance and stands ready to support further efforts to
tackle this issue. Health professionals around the globe are encouraged to share this publication as widely as possible to counter
antibiotic resistance and ensure a healthy future for all.
Source: FDI World Dental Federation
© Inna Dodor/Shutterstock.com
Research about non-surgical treatment protocols
© vgstudio – stock.adobe.com
Guided periodontal infection control is “more time-efficient than
conventional therapy”
Both conventional section-wise nonsurgical therapy (CNST) and a guided
approach to infection control where
patients receive full-mouth debridement preceded by oral-hygiene
education (GPIC) are effective nonsurgical treatment protocols for
periodontitis. A recent study, now
summarised as JCP digest 107,
sought to evaluate the relative effectiveness of the two approaches
in terms of clinical and patientcentred outcomes in the general
population, under conditions
found in practice.
48
1 2023
The research, performed in Gothenburg in Sweden, involved
95 dental hygienists randomly assigned to perform either CNST
or GPIC on patients, who were given a clinical examination at
the six-month follow-up at which they were also questioned about
their self-perceived oral health. Periodontal pocket closure was
the primary outcome. The researchers found that pocket closure
at six months amounted to 70% with both treatment modalities.
However, GPIC was more time-efficient, which provided benefits
both to patients and clinicians.
The research was summarised for JCP digest by postgraduate
students at the EFP-accredited programme in periodontology at
Ghent University in Belgium.
Source: EFP
[49] =>
news
|
Researchers found evidence for connection between diseases
Even though previous research has suggested a link between periodontitis and inflammatory bowel disease (IBD), the relationship and
its impacts have not been fully explored. In a large-scale study—the
first of its kind in a European population—researchers from Malmö
University, in collaboration with other Europe-based researchers,
have found evidence for a strong connection between the two diseases. IBD is a group of inflammatory disorders of the gastrointestinal
tract, principally Crohn’s disease and ulcerative colitis. The incidence
of IBD is increasing worldwide, and more than 1.3 million people in
Europe suffer from it. Its cause remains unknown, but an inappropriate immune response is considered to be involved. Periodontitis and
IBD are chronic inflammatory diseases with similarly complex pathogeneses. “Both diseases can be described as a strong overreaction
of the immune system against a theoretically relatively mild bacterial
trigger. You can say that the immune system attacks one’s own
body,” explained co-author Prof. Andreas Stavropoulos from the Faculty of Odontology in a university press release.
The study was conducted in Denmark and the data collected via
an online questionnaire answered by around 1,100 patients with
IBD (of whom approximately half had Crohn’s disease and the rest
ulcerative colitis) and around 3,400 matched controls without it.
The evaluation of the survey responses showed that patients with
IBD had a higher probability of perceiving the overall health of their
teeth and gingivae as worse
and of having severe periodontitis. Those patients diagnosed with Crohn’s disease reported
worse oral health than those diagnosed with ulcerative colitis and
had higher odds of having lost more teeth than the control group.
“The study shows that patients with IBD have more periodontitis
and fewer teeth compared to people without IBD. We also see that
patients with IBD and periodontitis have an aggravated intestinal
disease with a higher activity than patients with IBD who have no
oral health issues,” commented Prof. Stavropoulos.
© valiantsin – stock.adobe.com
Large-scale study links periodontitis and inflammatory
bowel disease
Based on the study results, the research team concluded that patients with IBD should be kept under close surveillance in order to
prevent the development of periodontitis and/or to slow down its
progression. “Similarly important, it may be that treatment of periodontitis has a positive impact on the management of IBD,” emphasised Prof. Stavropoulos. The study, titled “Periodontitis prevalence in patients with ulcerative colitis and Crohn’s disease—
PPCC: A case–control study”, was published in the December
2022 issue of the Journal of Clinical Periodontology.
Source: Dental Tribune International
Tylman research award
Prof. Burak Yilmaz awarded
for outstanding research
Prof. Burak Yilmaz was the principal investigator on a project selected by the American Academy of Fixed Prosthodontics as the
recipient of a Stanley D. Tylman Research Grant. Tylman grants are
highly competitive awards given to researchers conducting “outstanding research” in the field of fixed prosthodontics.
The work of Prof. Yilmaz and his Master’s student Dr Brandon
Yeager was again recognised by the Tylman Research Committee
this year. They received first prize in the 2022 Tylman Research
Award Programme for the report titled “Error analysis of stages
involved in CBCT-guided implant placement with surgical guides
when different printing technologies are used”. The outstanding
research award will be presented at the annual meeting of the
American Academy of Fixed Prosthodontics in Chicago in 2023.
“Error analysis of stages involved in
CBCT-guided implant placement
with surgical guides when different
printing technologies are used.”
Source: University of Bern
1 2023
49
[50] =>
| about the publisher
Congresses, courses
and symposia
implants
Imprint
IDS – International
Dental Show 2023
14–18 March 2023
Cologne, Germany
www.ids-cologne.de
Publisher
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oemus@oemus-media.de
CEO
Ingolf Döbbecke
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hiller@oemus-media.de
Chairman Science & BD
Jürgen Isbaner
isbaner@oemus-media.de
EFP International
Perio Master Clinic
5–6 May 2023
León, Mexico
www.efp.org
Chief Editorial Manager
Dr Torsten Hartmann
(V. i. S. d. P.)
hartmann@dentalnet.de
Editorial Council
Dr Rolf Vollmer
info.vollmer@t-online.de
Dr Georg Bach
doc.bach@t-online.de
Dr Suheil Boutros
SMBoutros@aol.com
EAO Congress
28–30 September 2023
Berlin, Germany
www.eao.org
Editorial Management
Janine Conzato
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implants
international magazine of oral
implantology is published in cooperation
with the German Association of Dental
Implantology (DGZI).
DGZI
DGZI Central Office
Paulusstraße 1
40237 Düsseldorf, Germany
Tel.: +49 211 16970-77
Fax: +49 211 16970-66
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Product Manager
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Copyright Regulations
52ND INTERNATIONAL
ANNUAL MEETING
OF DGZI
IMPLANTOLOGY
IN TEAM
IMPLANTOLOGY IS TEAM
© FleischiPixel–stock.adobe.co
m
52nd International Annual
Meeting of DGZI
50
6/7 TH OCTOBER 2023
HAMBURG
1 2023
6–7 October 2023
Hamburg, Germany
www.dgzi-jahreskongress.de
implants international magazine of oral implantology is published by OEMUS MEDIA AG
and will appear with one issue every quarter in 2023. The magazine and all articles and illustrations
therein are protected by copyright. Any utilisation without the prior consent of editor and publisher
is inadmissible and liable to prosecution. This applies in particular to duplicate copies, translations,
microfilms, and storage and processing in electronic systems.
Reproductions, including extracts, may only be made with the permission of the publisher. Given
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right to check all submitted articles for formal errors and factual authority, and to make amendments
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commercial markets. All cases of consequential liability arising from inaccurate or faulty representation
are excluded. General terms and conditions apply, legal venue is Leipzig, Germany.
[51] =>
Are you a writer?
Do you have clinical cases and a profound knowledge about a special treatment method? Then
become part of implants—international magazine of oral implantology. Share your experience
and knowledge and benefit from a global reach and high level of awareness.
We are always on the lookout for new faces to increase our clinical and scientific network.
Submission checklist
Send us a text with length of 10,000 to 15,000 characters. We do not want to limit you in terms of article
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Most important: we would like to introduce you/the
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OEMUS MEDIA AG
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+49 341 48474-147
Holbeinstraße 29 · 04229 Leipzig · Germany
Phone: +49 341 48474-0 · info@oemus-media.de
[52] =>
simply.TRIOS 5
Intraoral scanning that simply makes sense
Hygienic by design for minimal risk of
cross-contamination. Smaller and lighter
than ever for next-level ergonomics. And
a ScanAssist engine with intelligent-alignment
technology that makes precision scanning
effortless, every time.
)
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/ Immediate implant placement and bone grafting of a maxillary central incisor: A seven-year follow-up
/ Screw-retained restoration of a maxillary first premolar
/ The quest for safe and sterile implants
/ Acting against the silo effect
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