2015 Leading Edge Implant Symposium; An Empowering Educational Experience for:

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Specialists, general dentists, dental technicians and auxiliary team members striving to stay at the forefront of the implant dentistry services that today’s patients demand!
As a result of increasing patient awareness and demands for immediate function and esthetic implant procedures, our symposium topics are of great interest and importance to clinicians who desire to stay at the forefront of implant dentistry. Those clinicians who gain the knowledge will be best prepared to experience practice growth by offering the leading-edge procedures learned at this year’s symposium.
Despite the overwhelming success of the 2014 Leading Edge Implant Symposium, The Sclar Center’s educational committee found a way to further improve the educational content and interdisciplinary collaboration for a uniquely empowering educational experience for surgical and restorative specialists, general dentists, dental technicians and auxiliary team members alike. This two day cross disciplinary program will provide a wealth of scientific and clinical information related to all aspects of All-on-4® Treatment Concept for Full Arch Immediate Function and State-of-the-Art Implant Esthetics.

2015 Leading Edge Symposium’s
World Class Cross-Disciplinary Educational Team:
Anthony Sclar DMD, OMFS
Joseph Kan, DMD, MS, Prosthodontist
Juan Diego Cardenas, DDS, CAGS, Prosthodontist
Larry Grillo, DMD, Restorative Dentist,
Rafael Santrich, CDT
Chuck Genco, CDT

Do Not Miss the Opportunity to advance you knowledge at the The 2015 Leading Edge Implant Symposium, at the Ritz-Carlton Grande Lakes Resort, Orlando, Florida on Saturday and Sunday February 21-22, 2015. This is a delightful time of year in Florida and may be an ideal time to travel with your family. The Grande Lakes Ritz-Carlton is located in the heart of all the Orlando attractions—just minutes away from SeaWorld and the Walt Disney Resorts. It’s also surrounded by 500 acres of lush gardens with bass stocked lakes, a top ranked Greg Norman Golf Course and a 40,000 square foot Spa second to none; there is something for everyone. The resort offers breath taking views and a thoughtful array of amenities with world renowned Ritz hospitality. Come for the education and stay for a vacation at the special conference rate of $269 per night single or double occupancy.

Day 1 Learning Objectives: All-on-4® Full Arch Immediate Loading

• Discuss the scientific and clinical basis, case selection criteria, biomechanical concepts and diagnostically driven clinical, radiologic and model based treatment planning and methods for successful execution for All-on-4® treatment concept full arch immediate loading restorations.
• Comprehend the surgical, prosthetic and laboratory procedures and teamwork required for successful delivery of the All-on-4® full arch immediate provisional prosthesis using direct and indirect denture conversion techniques

• Grasp the steps required for fabrication and delivery of All-on-4® definitive prosthesis including: restorative and lab procedures, bar design, restorative material selection, prosthesis design options and successful occlusal schemes
• Avoid, identify and treat All-on-4® surgical, restorative and laboratory complications.
• Understand the benefits of CT Guided workflow required to minimize complications and successfully deliver CT Guided full arch immediate function

Day 2 Learning Objectives: State-of-the-Art Implant Esthetics

• Perform an esthetic patient evaluation and identify prognostic keys for predictable results and risk factors for esthetic complications
• List the indications, advantages and pitfalls of immediate, delayed and early esthetic implant placement
• Understand the indications and procedures for successful immediate implant placement and provisionalization in the esthetic zone.
• Discuss the indications and procedure details for socket gap management and soft tissue augmentation in the esthetic zone.
• Understand the etiology of Implant gingival recession and efficacy of available treatment solutions
• Fully understand conventional and CT based diagnostically driven esthetic implant treatment planning and surgical execution protocols
• Distinguish between esthetic case scenarios that are amenable to simultaneous implant placement and grafting from those that require pre-implant site development procedures.
• Select and sequence State-of-the-Art surgical and restorative site development procedures as part of interdisciplinary management of single, multiple gap and full arch esthetic implant reconstructions
• Understand restorative soft tissue site development at implant sites using interim restorations; custom healing abutments and esthetic implant provisional restorations.
• Understand the importance of restorative material selection and applications of advanced technologies and techniques to achieve seamless integration of esthetic implant restorations with adjacent virgin and/or restored natural teeth.
• Avoid, identify and treat common to complex esthetic implant complications.

Don’t wait, space is limited (this course sold out last year) and the Early Registration period expires November 1, 2014.We encourage you to make your plans to attend now!

Symposium Director,
Dr. Anthony G. Sclar DMD
Director of Education
Sclar Center for Empowered Dental Implant Learning

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Concern about Bone Graft Success

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The patient was in crisis and needed treatment. My student wondered how to handle this patient. The situation was a tough one. The patient needed a bone graft at #5 site, but there was loss of periodontal attachment on the adjacent canine.

Tooth #5 max right first premolar was fractured, decayed, with loose crown-post and significant bone loss. The implant surgeon was concerned about esthetic facial soft tissue loss after extraction and was unsure about the bone graft working due to loss of attachment on the adjacent canine tooth. The patient was in crisis and needed immediate treatment.

 

My Advice:

 

I have treated this type of situation on several occasions with good and sometimes excellent success. My advice is to do the following:

1. Extract failed tooth #5 using an open flap approach with a cosmetically concealed distal releasing incision. This will provide access for complete debridement and disinfection of the site by removal of granulation tissue, thereby reducing the risk of post grafting infection.

2. Although detoxification of the exposed root surfaces is necessary using citric acid or Straumann Pref Gel, maintenance of the PDL or remnants of the PDL in the unexposed portions of the adjacent canine tooth is important.

3. I would graft this site using Straumann Emdogain to coat the distal canine root surfaces and a particulate graft of Bio-Oss with autogenous bone harvested from the local area or preferably cancellous marrow harvested from the maxillary tuberosity. I would adapt a non-cross linked membrane such as BioGuide to isolate and protect the graft. Use of PRP in these cases provides the advantage of stabilization of the graft and the technical advantage of allowing you to sculpt the graft with a high degree of precision and “Glue” the barrier membrane in place eliminating the need for sutures or tacks. If you do not have access to PRP, you can collect blood from the local area using a syringe at the surgical site. This is facilitated by minimizing vasoconstrictor in the local anesthetic.

4. You could also consider using Gem21S growth factor enhanced matrix to graft the area. The Gem21S product provides recombinant platelet derived growth factor at a concentration 1,000 times higher than the patient’s own blood. Studies demonstrate 3 times greater bone fill in periodontal defects grafted with Gem21S.  Although off label, mixing the Gem21S with a slow substitution graft material that provides long term structural stability such as Bio-Oss is an approach that has been very successful in compromised sites such as the case you are faced with.

5. After securing the barrier membrane over the graft complex, I would then rotate and secure a VIP-CT palatal pedicle flap over the grafted site and achieve primary closure. This flap provides a vascularized periosteal-connective tissue flap that not only provides additional circulation to the area but also provides a large volume of soft tissue cover and the required mesenchymal cell pool required for maintenance of the graft volume during the remodeling phase of bone graft healing.

6. Allow up to 4-6 months healing time before reentry for implant placement or 3 months if conventional dental restoration is planned.

 

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Preparation of the Periimplant Soft Tissue Envelope…what every dental implant surgeon should know

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At the Sclar Center for Empowered Dental Implant Learning, my students frequently ask:

How do I know when soft tissue augmentation is indicated around dental implants or at sites with deficient alveolar ridges requiring bone grafting?

How should the procedures be sequenced?

 

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All-on-4® Full Arch Immediate Function Revisited

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Over five years ago, I became highly interested in helping patients who came to me crying because no one was offering them hope of an easy, fully functional solution for their terminal dentitions. Just as heart-tugging were the desires of those who were already suffering from full edentulism.

Many implant surgeons were and many continue to be skeptical about the efficacy of full arch immediate function fixed restorations supported by angled implants, but I decided to learn about them, do them, and stay in conversation with colleagues who were and are doing them.

I am happy to report we are seeing very few complications among our patients, many of whom are now five years post-operative, and these patients are reporting continued high satisfaction with quality of life improvements consistent with that reported in the literature.

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Achieving Successful Bone Grafts

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Achieving predictable results with intra-oral bone grafting and oral soft tissue grafting procedures requires advanced training and experience.

To begin with, the implant surgeon must fully comprehend:

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