Academic Program (All times are CET)

Tuesday, November 17, 2020

 18:00-18:10 CET Welcome and introduction 
18:10-19:00 CET Immediate or early implant placement: The role of GBR
Dr. Isabella Rocchietta
Immediate implant placement is a valuable surgical approach to replace missing teeth, mainly in the aesthetic region, where the timing and the aesthetic parameters are important. However, it has been widely demonstrated that a strict and specific protocol is adamant to achieve a successful long-term outcome. The patient and site-specific indication still remains the uttermost important factor when taking a clinical decision.
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The lecture will cover these parameters and will focus on the early implant placement in conjunction to guided bone regeneration as a therapeutic approach when dealing with moderate to severe pathologies around the affected tooth or teeth. The details of performing a successful GBR procedure with or without implant placement will be covered, including an analysis of the biological principles of guided bone regeneration.
19:00-19:50 CET Management of challenging situations for immediate implantation cases in the aesthetic area
Dr. Alberto Salgado
The aim of this session is to highlight the key points regarding bone regeneration and soft tissue regeneration to achieve optimal results in complex aesthetic cases. During the session, we will discuss why the flapless approach is suitable for immediate implantation in the aesthetic area, how to fill the gap in an immediate implantation case, plus the characteristics of an ideal tunnel for a tunneling technique, not only for soft tissue grafting but also for bone regeneration through the tunnel. In addition, the session will include how to deal with a total absence of the buccal bony wall and contemplate if it is a contraindication for an immediate flapless implant case. The latest scientific protocols will be revisited and with the aid of our clinical cases, we will answer these topics.
19:50-20:40 CET Immediate implant loading in conjunction with CBCT guided implant placement, alongside the inferior alveolar nerve as an alternative to nerve transposition
Dr. Fares Kablan & Prof. Samer Srouji

Immediate implant loading in conjunction with CBCT guided implant placement, alongside the inferior alveolar nerve as an alternative to nerve transposition. In cases with extreme mandibular atrophy, Inferior Alveolar Nerve (IAN) transposition may be the only option to treat a posterior edentulous mandible with an implant-supported fixed prosthesis. When the available bone above the nerve is less than 5mm, short implants for example, can’t be an option (3). An additional scenario is when the nerve is located at a central location inside the bone, prohibiting placement of implants buccally or lingually to the nerve using a CT guide.
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This technique offers several advantages including reduced treatment time, and eliminating the need for bone grafting with immediate insertion of dental implants at the same surgery, bicortical implants anchorage, and favorable corono-radicular relationship. However the conflicting results from studies that have determined the incidence of IAN dysesthesia with this procedure have created debate as to its appropriate use.
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According to the IAN location bucco-lingually, several modifications have been reporting attempts not to disturb the nerve, including bone expansion combined with immediate loading of one-piece implants, vertical splitting of the mandibular body, and the repositioning of the buccal cortex laterally by greenstick fractures with simultaneous implants placement. Additional option in use by the author ( Fares Kablan), includes vertical osteotomy of the buccal cortex to enhance visualization of the IAN, placing the dental implants buccally and repositioning of the buccal cortex and fixation. In recent years, the timing implant loading has been challenging, and numerous practitioners now advocate immediate loading of the implants. Immediate loading requires shorter periods and allows immediate recovery of function and esthetics with reports of high success rates. The availability of virtual reality technologies, and the advent of radiographic and CBCT Guided Surgery help the practitioners to insert dental implants alongside the IAN even at the borderline bone dimensions. The technology may reduce the indication for IAN transposition surgery in atrophic mandibles, saving the integrity of the mandibular body, reducing nerve disturbance, enabling placiement of longer dental implants, and enhancing the immediate loading procedure of the dental implants.
 20:40-21:10 CET Q&A – Panel discussion with all speakers of the day

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Wednesday, November 18, 2020

 18:00-18:10 CET Welcome and introduction 
18:10-19:00 CET The art of compensating reabsorption: updated immediate implant protocol
Dr. Iñaki Gamborena
This lecture will focus on the difference of protocols when it comes to surgical and prosthetic criteria to treat anterior implants in an immediate manner using, as a volume maintainer only, soft tissue grafting procedures. We will look into the necessity of grafting, the donor site selection and the histologic background that creates the difference.
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Criteria, techniques and tools will be discussed in order to reach the best consistent results regarding anterior implant treatments. We will learn the decision of key aspects for execution, taking into account all aspects the clinician should take into consideration.
19:00-19:50 CET Immediate loading of prefabricated prosthesis using guided surgery in full-mouth post-extraction rehabilitation
Dr. Giampiero Ciabattoni & Dr. Alessandro Acocella
Digital protocols for implant placement can really change the quality of life of our patients. Tooth loss is often a traumatic experience for the patient. Patients may suffer real or perceived detrimental effects following the loss of one or more teeth. Immediate implant placement offers the most cost-effective and long-term solution for replacement of missing teeth with a higher than average life expectancy, providing the patient with the best sense of security and well-being. Prosthetic rehabilitation in post-extraction cases using dental implants, often
represents a challenge for many clinicians. Factors that are potential sources of complications are bone quality, soft tissue management and anatomical variables due to natural bone remodelling.
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In order to have long‐term outcomes and benefits for the patient, the treatment plan should consider all these difficulties and variables. Flap-less immediate post-extraction implant placement utilizing guided templates, further shortens the overall treatment time, reduces the patient chair time and offers immediate functional and aesthetic benefits. In addition, this type of procedure facilitates the clinical work by “eliminating” the need for an interim, removable prosthesis that may cause potential detrimental effect on both soft and hard tissues. The optimal positioning of the implants into the sockets and the right handling of the surgical and prosthetic phases are discussed during the lecture.

19:50-20:40 CET Immediate approach in implant dentistry
Dr. Attila Bodrogi

Implant site preservation is the concept of maintaining the volume and architecture of both the soft and hard tissues. It is critical to minimise tissue loss during extraction to conserve the natural ridge form and architecture for implant placement. Tissues should be preserved and maintained in their original forms as much as possible from the time of tooth extraction to the placement of restoration. This concept is crucial to ensure tissue healing, patient comfort, aesthetics and functionality of the final implant restoration.
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This concept is crucial to ensure tissue healing, patient comfort, esthetics and functionality of the final implant restoration. This presentation will highlight techniques and cases for Immediate Implant Placement and Provisionalisation with a special attention on Partial Extraction Therapy that facilitates a more esthetic, functional and predictable result in implant dentistry.
 20:40-21:10 CET Q&A – Panel discussion with all speakers of the day