Joint Meeting of the Nicosia and Limassol Study Clubs

Invited speaker: Prof Urs Belser (Switzerland)

10:00-13:30 (2 lectures, coffee break at 11:30).

Lunch 13:30-14:30

Abstract 1

“Long-term outcomes of esthetic implant restorations”

- A critical appraisal, based on 25-year clinical experience –

Various clinical approaches for the replacement of extracted teeth with implant-supported restorations have emerged in recent years. This presentation will focus on long-term data of anterior implants, specifically addressing esthetic parameters. Based on these results, the rationale for an early placement / early loading concept in conjunction with simultaneous facial contour augmentation will be discussed in detail, comprising the related preoperative analysis, decision-making process and clinical/laboratory step-by-step procedures. In particular, the fundamental differences between single tooth sites, two adjacent missing anterior maxillary teeth, and more extended edentulous segments, often accompanied by significant horizontal and vertical tissue deficiencies, will be addressed. Finally, a critical analysis of the recent evolution in implant design and novel restorative components, such as CAD/CAM derived high-strength ceramic elements will be made.

Objectives

-      Relevance of implementing objective esthetic parameters

-      Validity of the early implant placement protocol

-      Significance of simultaneous contour augmentation

-      Esthetic potential of the “platform-switching” design

-      Well-defined treatment strategies for single, multiple adjacent, as well extended edentulous spaces in the anterior maxilla

-      Integration of artificial gingiva in case of major vertical tissue deficiencies – “the pink power concept”

-      Importance of comprehensive pre-surgical esthetic risk assessment & team approach

Abstract 2

“Reconstructive Dental Medicine

in the Crossfire of Implantologists and Bondodontists”

- with special emphasis to therapy of the compromised anterior dentition, including the replacement of missing teeth and treatment of advanced dental wear-

Traditional fixed reconstructive dental medicine comprises namely cemented single full-crown coverage to restore function and appearance of severely broken-down teeth, and multi-unit fixed dental prostheses to replace missing teeth. Implementing fundamental rules such as establishment of resistance and retention form as well as respecting biologic width often requires invasive perio-surgical crown-lengthening procedures and / or endodontic therapy.

Nowadays, thanks to improved and predictable adhesive techniques, the indications for full-coverage single crowns have considerably decreased and a clearly more conservative approach termed “Additive Prosthodontics” following the concept of minimally invasive biomimetic restorations may frequently be proposed. Likewise dental implants have significantly contributed to reduce indications for long-span tooth-supported FDPs.

Even though adhesive treatments simplify both the clinical and laboratory procedures, restoring dentitions suffering from advanced tooth wear remains a major challenge due to the advanced degree of loss of mineralized dental tissue. To facilitate the clinician’s task during the planning and execution of a full-mouth adhesive rehabilitation, an innovative concept has been developed: “the 3STEP technique”. Three laboratory steps are alternated with three clinical steps allowing the clinician and the laboratory technician to constantly interact in order to achieve the most predictable esthetic and functional outcome. Using the 3STEP technique, the clinician can break down a full-mouth rehabilitation into several well-defined stages and subsequently carry out the final restorations in a quadrant-wise manner. The described approach allows to considerably reduce both the length and the complexity of the various chair-side sessions.

This presentation will describe step-by-step how various kinds of severely worn-down dentitions are optimally rehabilitated in terms of function and esthetics, while systematically preserving as much as possible tooth vitality and the remaining mineralized tooth structure. Finally, medium to long-term follow-up of numerous patients treated with this novel concept, will be presented and critically discussed.