"Evolving Technologies in Implant Dentistry"

Prosthetic Track: Technology Disruptors – See more details

These courses were previously recorded. Join LIVE Q&A immediately following each set of presentations.

Moderator - Carlo Ercoli,DDS

10:00 - 11:00 am
What Is the Next Frontier in Prosthetic Management?
Evanthia Anadioti, DDS; Lee Culp, CDT
The recent unprecedented technological advancements in digital and implant dentistry have affected previously established treatment philosophies and modalities. This presentation illustrates the patient and prosthetic management for Maxillary Unsplinted Implant Overdentures. The evolution of this treatment option after assessment of patients' quality of life and associated complications from recent clinical cohort publication will be presented.

Upon completion of this presentation, participants should be able to: 1) discuss the quality of life of patients treated with unsplinted implant supported maxillary overdentures as well as associated complications; 2) review step-by-step the surgical and restorative process of unsplinted implant supported maxillary overdentures.

11:00 am - noon
Complex Implant - Prosthetic Rehabilitations
Dean Morton, BDS, MS; Michael Norton, BDS, FDS, RCS(Ed), MS
Dr. Dean Morton will discuss a linear thought process focusing on effective data collection and treatment planning, designed to ensure predictable outcomes for patients with complex needs. This presentation will center on team decision-making when treatment options include maintenance of the dentition, extraction of teeth and various prosthetic alternatives.

Dr. Michael Norton’s presentation will build on this theme by focusing on a rare case of a 19-year-old man suffering from Tricho-Dento-Osseous Syndrome, that falls way outside what could be consider “a normative baseline” for implant-based rehabilitation. With a natural dentition congenitally “failing” through malformation, disrupted eruption patterns and amelogenesis imperfecta, difficult decisions about tooth extraction and a plan for alveolar as well as dental rehabilitation push the boundaries of treatment to the limits.

Upon completion of this presentation, participants should be able to: 1) describe what constitutes a complex reconstruction; 2) explain the thought processes required to visualize and externalize a clear and precise treatment plan; and 3) discuss the type of procedures and processes necessary to take a complex case through to a successful outcome.

Noon - 12:15 pm
Q&A with Drs. Anadioti, Morton, Norton and Mr. Culp

12:15 - 12:45 pm
Break

12:45 - 1:45 pm
Novel Techniques to Maximize Anterior Esthetics
Harold Baumgarten, DMD; Stephen Chu, DMD, MSD, CDT
Immediate tooth replacement therapy and treatment of extraction sockets with implants have become a mainstream treatment modality for single and multiple tooth sites in the esthetic zone. However, achieving primary stability relative to implant diameter and gap distance within the limits of a finite socket dimension is a delicate yet essential balance for survival and esthetics. In addition, esthetic risks and complications exist such as apical socket perforation, loss of labial plate thickness over time, and loss of the interdental papilla due to proximity issues with tooth-to-implant distance following placement. Solutions in treatment, as well as innovations in implant design, will be presented that reinforces the biologic principles in wound healing that ultimately enhances esthetic outcomes in modern day implantology.

Upon completion of this presentation, participants should be able to: 1) discuss the implant risks and complications in the esthetic zone; 2) explain the biology behind circumferential bone volume for long-term maintenance to prevent ridge collapse, recession, and papillae loss; and 3) describe the inverted body-shift concept in macro implant design.

1:45 - 2:45 pm
Implant Prosthetic Predictability
Todd Schoenbaum, DDS; Chandur Wadhwani, MSD
This program is intended to aid the clinician in identifying and preventing the most common complications of implant restorations. In order to maximize predictability, one must recognize the potential challenges and limitation of various implant restoration modalities. Pre-treatment recognition of the various complications will ensure that clinician and patient alike will be satisfied with treatment outcomes. This lecture will address common complications such as screw loosening, porcelain failure, debonding, peri-implantitis, open interproximal contacts, and occlusal changes. We will explain the science behind the complications and provide solutions and protocols to enhance success.

Upon completion of this presentation, participants should be able to: 1) recognize the five most common challenges of implant restorations; 2) discuss the protocols and techniques to eliminate or minimize these issues; and 3) explain the treatment of the partially edentulous patient.

2:45 - 3:00 pm
Q&A with Drs. Baumgarten, Chu, Schoenbaum and Wadhwani

Surgical Track: Thinking Outside of the Box – See more details

These sessions have been pre-recorded. Join LIVE Q&A immediately following each presentation.

Moderator - Peter Moy, DMD

10:00 - 11:00 am
Point/Counterpoint: Flap Management in the Esthetic Zone
Marius Steigmann, DDS, PhD; Giovanni Zucchelli, DDS, PhD
Flap management in the aesthetic zone differs from flap management in the non-aesthetic zone, hence it requires specific, well-determined approaches according to their indication. Flap management for access and GBR, soft tissue maintenance or soft tissue correction has to be performed after precise diagnosis. To avoid soft tissue failures in the aesthetic zone, a good understanding of the biology, reaction to trauma and healing patterns is absolutely necessary. As there are multiple options, the lecture will describe different modern opinions on flap design in the aesthetic in a point-counterpoint discussion for an ideal soft tissue outcome.

Upon completion of this presentation, participants should be able to: 1) discuss the importance of pre-surgical soft tissue assessment in the aesthetic zone; 2) recognize the factors which make surgery in the aesthetic zone predictable; and 3) explain different techniques used to correct soft tissue failures.

11:00 am - noon
Interdisciplinary Treatment Strategies for Alveolar Ridge Deficiencies in the Esthetic Zone
Jim Janakievski, DDS, MSD; Greggory Kinzer, DDS, MSD
Planning treatment for patients with missing or compromised anterior teeth and implants can often be complex. A detailed examination will uncover many clinical and patient factors that will guide the collaborative strategies and techniques that are selected for each patient. These include augmentation protocols for ridge enhancement, prosthetic design unique to each patient and orthodontic space/site management. This presentation will focus on collaborative treatment options for patients with anterior alveolar ridge deficiencies and compromised aesthetics.

Upon completion of this presentation, participants should be able : 1) explain how a compromised implant may affect the outcome; 2) describe how the alveolar and gingival architecture can be preserved or enhanced; and 3) recognize how a collaborative approach can assist in treating the implant patient.

Noon - 12:15 pm
Q&A with Drs. Steigmann, Zucchelli, Janakievski and Kinzer

12:15 - 12:45 pm
Break

12:45 - 1:45 pm
Conometric Concept
Michael Block, DMD; Marco Degidi, MD, DDS
Short and long-term problems with implants commonly result from problems with cement excess in the adjacent tissues or screw loosening which can result in screw fracture and inflammation from mobility. This friction fit solution eliminated these problems and creates a safe environment. This presentation will briefly illustrate the developmental history and then show multiple case examples of the technique. Data on retention of consecutive series of friction fit crowns will be shown.

Upon completion of this presentation, participants should be able to: 1) compare the difference between friction fit and cementation of crowns to abutments; 2) recognize the importance of proper technique to have long-standing retentive crowns on abutments; and 3) discuss the evidence base that establishes friction fit connections as a very healthy environment for implant restorations.

1:45 - 2:45 pm
Ortho-perio Implant Site Development
Daniel Berant, DMD; Frank Celenza, DDS
The advent and success of implantology continues to transform dentistry, and the inclusion of implants as integral components in orthodontic mechanotherapy is a particularly interesting application. Historically, orthodontics has played a preparatory role to implant placement, by virtue of aligning teeth to permit proper spatial relations for implant placement, which occurs subsequently. More recently, orthodontic modalities designed to alter tissue morphology, both hard and soft, have begun to be realized. In these two ways, orthodontic site preparation for implant placement has become an important modality to consider.

Perhaps even more interestingly, orthodontic techniques that actually employ implants for the purpose of anchorage can have a dramatic effect on previously unattainable possibilities and outcomes. Implant-enhanced orthodontics can be achieved by a variety of means but can be broken down to direct or indirect anchorage. Various devices and applications of these modalities exist and are expanding continually.

Upon completion of this presentation, participants should be able to: 1) explain the physiology of tooth movement; 2) describe the implementation of adjunctive orthodontic modalities for prosthetic benefit; and 3) discuss how orthodontics can interact with implants.

2:45 - 3:00 pm
Q&A with Drs. lock, Degidi, Berant and Celenza

Esthetics – See more details

These sessions were pre-recorded. Join LIVE Q&A immediately following each presentation.

Moderator - Jacinthe Paquette, DDS

10:00 - 10:30 am
Taking Control Over Challenging Esthetic Cases Using the Power Trio: Ceramics, Implants and Veneers
Victor Clavijo, DDS, MS, PhD
With the popularization of dental implants for single to complex restorations, the importance of treatment planning has been emphasized. We are frequently challenged by malpositioned implants, loss of interdental papillae, soft tissue discoloration, and other problems. The connective zone between the restoration and the soft tissue is one of the most important aspects that will lead to an imperceptible esthetic oral rehabilitation. This lecture will highlight the treatment planning options for highly challenging and demanding esthetic cases by using pink ceramics, implants, and/or veneers analogic and digital workflow.

Upon completion of this presentation, participants should be able to: 1) discuss treatment planning options for highly challenging and demanding esthetic cases; 2) list the benefits of using pink ceramics, implants, and/or veneers; and 3) explain how digital workflow can improve esthetic outcomes.

10:30 - 11:00 am
Fully-guided Full-arch Immediate Implant Reconstruction: 2021
Michael Pikos, DDS
This clinically based presentation will focus on the integration of restorative, surgical and laboratory disciplines, combined with CBCT technology, to provide a seamless approach for fully guided full arch and full mouth immediate implant reconstruction for the terminal dentition and edentulous patient. This protocol includes placement of a prefabricated computer guided monolithic acrylic bar supported prosthesis for both edentulous and dentate arches. Clinical cases will be presented that will feature indications and protocol for this approach, as well as advantages over the conventional conversion denture protocol.

Upon completion of this presentation, participants should be able to: 1) discuss the indications and protocol for fully guided full arch and full mouth immediate placement with a prefabricated monolithic acrylic bar supported provisional. 2) compare the advantages of this protocol over the conventional conversion denture protocol for full arch and full mouth implant reconstruction. 3) recognize the limitations of this fully guided surgical and prosthetic protocol for full arch immediate implant reconstruction.

11:00 am - noon
The Total Face Approach (TFA) in Modern Implantology: A Novel Diagnostic/Therapeutic Algorithm
Giovanna Perrotti, DDS; Tiziano Testori, MD, DDS, FICD
Choosing the most appropriate prosthesis type like fixed prosthesis with custom abutments and crowns, hybrid prosthesis and overdenture, for complex implant cases is a clinical dilemma for most clinicians. Even though dedicated software facilitates implant planning in the available bone and the accuracy of the surgical phase, the choice of the appropriate treatment plan and future prosthesis type remains the less investigated side of the treatment. The Total Face Approach allows the clinician to rationally choose between different prosthetic designs based on anatomical, esthetic, functional and surgical parameters.

Upon completion of this presentation, participants should be able to: 1) select the best type of prosthetic design according to the clinical patient situation; 2) plan the most appropriate surgical approach; and 3) avoid miscommunication with the patient.

Noon - 12:15 pm
Q&A with Drs. Clavijo, Pikos, Perrotti and Testori

12:15 - 12:45 pm
Break

Complications – See more details

These presentations were pre-recorded. Join LIVE Q&A immediate following each presentation.

Moderator - Jay Malmquist, DMD

12:45 - 1:15 pm
Long-term Complications With Implant Dentistry
Fereidoun Daftary, DDS
This lecture discusses the long-term complications of implant supported restoration due to craniofacial changes and the alternative treatment options in the aesthetic zone.

Upon completion of this presentation, participants should be able to: 1) describe the elements contributing to craniofacial changes; 2) recognizing the patients with a higher risk; and 3) explain the treatment alternative.

1:15 - 1:45 pm
Inter-implant Papilla Management With Root Shield: What We Know, What We Do Not Know, and What We Think We Know
Joseph Kan, DDS, MS
Leaving a piece of root fragment (root shield) to maintain buccal and proximity tissue for esthetics has gathered a lot of interest since it was first advocated in 2010. To many, this is a standard of care, while many others consider it a risky treatment option. This presentation will discuss the author's experience with this procedure over the past decade.

Upon completion of this presentation, participants should be able to: 1) discuss guidelines for root shield; 2) explain complications involved with root shield and how to manage them; and 3) determine whether or not root shield is a viable option.

1:45 - 2:15 pm
Platform Switching: Promise or Panacea?
Tomas Linkevičius, DDS, Dip Pros, PhD
This lecture will focus on this special design feature of implant and lead through its influence on crestal bone stability. We will see if it is a panacea, or maybe just a simple promise, difficult to keep.

Upon completion of this presentation, participants should be able to: 1) review how the gingiva, teeth, and bone interface to harmoniously create idealized implant esthetics; 2) discuss the role that the position of the implant fixture and the characteristics of the abutment play in maintaining and idealizing soft tissue contours; and 3) utilize digital surgical modalities to optimize implant placement and digital restorative modalities to register provisional contours and seamlessly transfer them to final restorations.

2:15 - 2:30 pm
Q&A with Drs. Daftary, Kan and Linkevičius

Risk Management – See more details

These courses were previously recorded. Join LIVE Q&A immediately following each presentation.

Moderator - Tara Aghaloo, DDS, MD, PhD

10:00 - 10:25 am
Risk Profiling of Patients
Don Curtis, DMD
This program will review how a risk assessment questionnaire (RAQ) can be used to estimate cumulative risk for late-term biologic complications related to implants. In private practice settings where this risk assessment tool has been used, patent acceptance and clinician feedback have been positive. Several ongoing clinical validation studies of the risk assessment algorithm will be reviewed in the context of how treatment planning and patient compliance can be improved. The goal is fewer unanticipated surprises for the clinician and fewer unexplained surprises for the patient. Calculating aggregate risk for a health outcome allows risk to be stratified so that the unique risk profile of a patient is identified and managed. In medicine, there are hundreds of risk assessment questionnaires that are used to provide an estimate or aggregate risk for a health outcome. This is the basis of personalized medicine. The RAQ discussed includes a summary of 20 individual factors that can increase the risk for biologic complications in patients being treated with dental implants. It can serve as a checklist for the clinician, informed consent for the patient, and as a means by which to establish a patient-specific maintenance program.

Upon completion of this presentation, participants should be able to: 1) identify how risk assessment can be helpful in treatment planning, providing informed consent, and providing a patient-specific maintenance plan; 2) identify some of the clinician-based risks that can limit success with dental implants; and 3) explain why a maintenance plan should be patient specific, risk-based, age-appropriate and account for the type of prosthesis being fabricated.

10:25 - 10:50 am
Minimizing Risk with Digital Planning and Dynamic Placement
Michael Block, DMD
Lack of appropriate treatment planning and malposition of implants at time of placement increase liability as well as implant success. Risk assessment of failed implants often reveals lack o optimal placement. This session will highlight a time-efficient means to utilize digital technology easily, with the use of one software program, to determine the final restoration and implant placement in a time efficient manner. Implant placement using dynamic systems allows for accurate and precise placement which decreases risk.

Upon completion of this presentation, participants should be able to: 1) identify which pieces of equipment are needed to utilize digital planning and dynamic placement; 2) recognize how the digital methods are time efficient for both the clinician and patient; and 3) explain how digital planning and dynamic placement increase accuracy and precision for implant placement, resulting in less risk.

10:50 - 11:15 am
Risks and Pitfalls of Guided Implant Surgery
Waldemar Polido, DDS, MS, PhD
Surgical procedures with the goal of implant placement require a high degree of accuracy. Digital planning is part of everyday practice, and guided implant surgery was developed in order to increase surgical accuracy. However, as its use becomes more widespread, understanding technological tools, and the clinic workflow are important steps to take the most advantage of guided surgery. This presentation will review different indications for guided surgery, as well as potential pitfalls, and what are the important details that clinicians need to understand to reduce and avoid complications.

Upon completion of this presentation, participants should be able to: 1) list the components of a digital workflow for guided implant surgery; 2) choose the correct digital pathway for a specific clinical situation; and 3) recognize potential pitfalls for guided implant surgery.

11:15 - 11:30
Q&A with Drs. Curtis, Bloc and Polido

11:30 am - noon
Break

Noon - 12:30 pm
Understanding Risks Associated With Patients Terminal Dentition
Ricardo Mitrani, DDS, PhD
For over a decade, the term "terminal dentition", has unquestionably gained a lot of traction in the dental community, and it implies that there is a need to remove a patient's remaining dentition. Implant-supported solutions for these patients have been around for quite some time and even now, there seems to be confusion among dental practitioners as to what is the ideal prosthetic solution for these patients, and what are the risks associated with these prosthetic solutions.

Upon completion of this presentation, participants should be able to: 1) review a treatment planning algorithm that allows the treating team to follow a linear thought process in assessing the remaining dentition; 2) discuss common complications associated with full arch implant supported solutions; and 3) improve communication amongst the treating team.

12:30 - 12:55 pm
Optimal Digital Design for Restorative Contours
Mark Ludlow, DMD, MS
Nothing is more satisfying (and sometimes more elusive) than an absolutely perfect implant restoration that is indistinguishable from the surrounding natural teeth. In this presentation, we will look at what needs to come together to achieve ideal results from a surgical and restorative perspective and how digital tools can help us make these results predictable.

Upon completion of this presentation, participants should be able to: 1) review how the gingiva, teeth, and bone interface to harmoniously create idealized implant esthetics; 2) discuss the role that the position of the implant fixture and the characteristics of he abutment play in maintaining and idealizing soft tissue contours; and 3) utilize digital surgical modalities to optimize implant placement and digital restorative modalities to register provisional contours and seamlessly transfer them to final restorations.

12:55 - 1:20 pm
Influence of A.I. in the Digital Planning of Advanced Interdisciplinary Care
German Gallucci, DMD, PhD
During this lecture, clinical considerations and indications for dental implants will be analyzed in the context of their direct application to esthetic implant-prosthetic rehabilitations. Risk assessment, treatment planning, surgical protocols and esthetic/prosthodontic rehabilitations will be discussed in detail according to different clinical situations. Recommended planning steps and treatment procedures will be presented through scientific evidence. Modern Implant-prosthetic restorations using different implant designs and digital technology call for a harmonious esthetic integration with the pre-existing environment. A scalloped gingival line with distinct papillae and free of any abrupt vertical differences in clinical crown length between anterior implants, is paramount. In this context, biologic considerations affecting normal peri-implant soft tissue integration will be discussed as a major esthetic parameter.

Upon completion of this presentation, participants should be able to: 1) discuss current trends in esthetic implant dentistry; 2) assess associated risk factor for suitable treatment planning; and 3) widen treatment planning options using a selective approach.

1:20 - 1:35 pm
Q&A with Drs. Mitrani, Ludlow and Gallucci

1:35 - 2:00 pm
Break

Surgical Complications – See more details

These courses were pre-recorded. Join LIVE Q&A immediately following each presentation.

Moderator - Michael Norton, BDS, FDS, RCS(Ed)

10:00 - 10:25 am
Is Peri-implant Mucositis and Peri-implantitis an Inevitable Outcome?
Mario Roccuzzo, DDS
As utilization of dental implants continues to rise, so does the incidence of complications. Regardless of common thinking, long-term maintenance of healthy peri-implant tissues constitutes a major challenge for every clinician. It should be clear by now, that patients should be informed about their risk profile before treatment is initiated. On the other hand, biological complications, detected at an early stage, can be successfully treated by means of decontamination and/or regenerative surgery in a high percentage of cases.

Upon completion of this presentation, participants should be able to: 1) establish effective measures to reduce the risk of complications; 2) recognize situations where peri-implant soft tissue augmentations is recommended; and 3) select the ideal peri-implant regenerative surgical treatment.

10:25 - 10:50 am
Factors Contributing to Surgical Complications and Failures
Bach Le, DDS, MD
The predictability and long-term success rate of dental implants is well documented in the literature. Nevertheless, complications and failures occur and can have a significant impact on overall treatment. Failing implants and the consequences of implant removal usually results in significant loss of hard and soft tissues and jeopardize efforts to achieve satisfactory function and esthetics. This lecture will discuss risk factors for treatment failures and treatment modalities to deal with dental implant failure. When an implant fails, a customized treatment plan should be provided for each patient depending on the relevant needs. Patients should be informed regarding all possible treatment options and that achieving an ideal result in the compromised site is sometimes elusive, and in some cases impossible.

Upon completion of this presentation, participants should be able to: 1) identify risk factors associated with surgical complications; 2) explain the difference between patient-related versus site-related etiology for surgical complications and failures; and 3) describe treatment options to mitigate risks of surgical complications and failures.

10:50 - 11:15 am
Autogenous Teeth for Alveolar Ridge Augmentation
Frank Schwarz, DMD
Preclinical and clinical data provide clear evidence that tooth roots reveal a structural and biological potential to serve as alternative autografts for localized ridge augmentation. In fact, dentin has a similar anorganic and organic composition as bone and features osteoconductive as well as osteoinductive properties, while getting involved in the bone remodeling process. This presentation will elucidate this new biological concept and focus on associated surgical procedures for current clinical applications.

Upon completion of this presentation, participants should be able to: 1) discuss the biological background for using tooth roots for alveolar ridge augmentation; 2) select appropriate clinical indications and surgical protocols; and 3) evaluate the overall efficacy and safety of the procedure.

11:15 - 11:30 am
Q&A with Drs. Roccuzzo, Le and Schwarz

11:30 am - noon
Break

Noon - 12:30 pm
Cell Therapies Applied to Bone Regeneration
Mariano Sanz, MD, DDS, PhD
Bone regenerative interventions remain an important part of implant practice and the advent of bioengineering opportunities enhances the possibility to obtain more predictable outcomes. In this presentation, I shall present the background of using autologous mesenchymal cells for bone regeneration and I shall convey my experience on the clinical use and results of applying adjunctive cell therapy to GBR approaches using synthetic biomaterials.

Upon completion of this presentation, participants should be able to: 1) discuss the potential of cell therapies in bone regeneration interventions; 2) describe the process of harvesting and applying autologous mesenchymal cells: and 3) assess the results obtained after the application of a cell therapy as adjunctive to GBR in bone regeneration prior to implant placement.

12:30 - 12:55 pm
Predicting and Averting Hard and Soft Tissue Complications
Rodrigo Neiva, DDS
New treatment options for hard and soft tissue development have been introduced to implant dentistry in recent years. This presentation is to discuss possible advantages, disadvantages, and realistic short- and long-term expectations of these new treatment modalities.

Upon completion of this presentation, participants should be able to: 1) explain the rationale for new materials and techniques; 2) discuss the advantages and disadvantages of the new treatments; and 3) select materials based on material properties and features.

12:55 - 1:20 pm
New Biologic Challenges in Implant Dentistry
J.E. Davies, BDS, PhD, DSc
This presentation will focus on new emerging evidence of the important biologic processes that precede bone formation in the earliest phase of osseointegration. We are all familiar with the sinusoidal curve of secondary healing first conceptualized by Raghavendra et al in 2005, which includes an initial lag phase. We now know that two important events occur during this phase of healing: peri-implant angiogenesis and the ingress of the mesenchymal progenitors that will become, among other cells, osteoblasts. Both of these phenomena are profoundly influenced by implant surface design and provide the important foundation for the bone formation that follows. Understanding these biologic events can provide new targets to accelerate the early healing that is so important in clinical practice.

Upon completion of this presentation, participants should be able to: 1) explain the important biologic processes that precede peri-implant bone formation; 2) discuss how these biologic phenomena are influenced by implant surface design; and 3) describe how these early events can accelerate secondary implant stability

1:20 - 1:35 pm
Q&A with Drs. Sanz, Neiva and Davies

Business Meeting

Open to all AO members

30 minutes

Closing Symposium – The Future of Implant Practice Models – See more details

These are LIVE PRESENTATIONS with a PANEL DISCUSSION immediately following.

Moderator - Clark Stanford, DDS, PhD, MHA

2:00 - 2:30 pm
The Generational Shift: Five Things Dentists Need to Know About the Changing Implant Patient
Lyndon Cooper, DDS, PhD
Our patients literally change beneath our dental implants and patient factors are emerging as key mediators of implant success. First, our patients are becoming more diverse. Secondly, our patients are becoming older. Third, the retention of teeth and their failing restorations increases local complexity of need and therapy. Forth, they present with greater and changing systemic health complexity. Finally, our patients have changing expectations. We need to acknowledge the impact of these factors that affect the success of our treatment and the expectations of our patients regarding our care. It is not enough to focus on the dental implant as the central factor in our continued professional success.

Upon completion of this presentation, participants should be able to: 1) understand the impact of changing demographics on dental implant therapy; 2) appreciate the key systemic and pharmacologic factors that negatively influence dental implant success; and 3) know how changing patient expectations may color our treatment planning decisions that influence dental implant outcomes.

3:00 - 3:30 pm
Multi-specialty Practice: 40 Years in Retrospect
Dennis Tarnow, DDS; Paul Fletcher, DDS
The multi-specialty private office has become an increasingly desirable practice model in recent years. Benefits such as eliminating miscommunication between offices, single office consults as opposed to the patient traveling between multiple offices, and the efficiencies of combined, sequential multidisciplinary procedures are readily achievable. In addition, collaboration between compatible individuals attuned to the same goals can be synergistic, and can produce an intellectually, emotionally, and financially fulfilling practice environment that can lead to long term professional satisfaction. Two members of a multidisciplinary group specialty practice that has been in existence for more than 40 years will discuss the obvious benefits, the not so obvious benefits, and the pitfalls to avoid in developing this practice model.

Upon completion of this presentation, participants should be able to: 1) discuss the patient and doctor benefits of an interdisciplinary multi-practitioner; 2) explain the treatment efficiencies of an interactive multi-specialty office; and 3) describe the professional, intellectual, and lifestyle benefits of practicing in a multi-specialty environment.

3:30 - 4:00 pm
DSO Group Practice Models Offering Implant-only Solutions
Theresa Wang, DDS, MS
Over the last decade, Dental Support Organizations (DSO's) have become more prevalent and are projected for continued growth within the market of Dentistry. DSO's provide business management and support dental practices in their non-clinical operations. This lecture will cover the clinicians’ perspective in working with a DSO offering Implant-only solutions and discuss the advantages of partnering with a DSO.

Upon completion of this presentation, participants should be able to: 1) recognize DSO trends in dentistry and identify the contributing factors to these trends; 2) identify how a dental implant practice can positively impact treatment outcomes and patient experience through working with a DSO; 3) recognize how a dental implant practice benefits from the support of a DSO in business management and leadership development; and 4) discuss unique opportunities to analyze data within a DSO Implant practice due to size and scale.

4:00 - 4:30 pm
Solo Specialist Practitioner: Thriving in the COVID World
Paul Fugazzotto, DDS
Between the multi-specialty in house practices, restorative dentists doing everything themselves, corporate dentistry and adversarial relationships with insurance companies, it was already difficult enough to survive as a solo specialist practitioner. Now add the COVID pandemic, which has placed greater financial demands on all dentists, increased patient fear of visiting the dentist, and made patients less willing to be referred to "another" office for specialty care, and I don't know how I will survive! I hear various permutations of the above from colleagues on almost a daily basis. Fortunately, none of the above is true in today's world. While a horrible world crisis which no one of sane mind welcomes, the pandemic has presented practitioners and patients alike a unique opportunity for self-reflection and reassessment our value systems. The opportunity to remake our practices through rediscovery of our missions, and strengthening of communications with referring doctors and patients by combining well established and "cutting edge" approaches and technologies, is unmatched in my almost 40 years of private practice experience. We have a choice: become flotsam in a sea of change, or lead our referring partners, our patients and ourselves to greater heights of therapeutic and practice success, and overall health.

Upon completion of this presentation, participants should be able to: 1) discuss the unique practice challenges of the COVID world; 2) recognize the opportunities to improve patient treatment outcomes in the COVID world; and 3) identify effective approaches for establishing a dialectic referral network in the COVID world.

4:30 - 4:45 pm
Q&A with Drs. Cooper, Tarnow, Fletcher, Wang and Fuggazzotto

Coffee and Controversies – See more details

These presentations are recorded and available ON DEMAND at any time during and after the meeting.

New Guidelines for Successful Ridge Preservation Combined with Immediate Implant Placement
Mauricio Araujo, DDS, MSc, PhD
The management of the ridge alterations that take place following tooth extraction is of great interest for implant dentistry. This presentation will describe a series of studies that used ridge preservation combined with immediate implant placement for achieving good esthetic outcomes. It will be demonstrated that the anatomy of the alveolar process markedly influences the amount of post-extraction bone loss and clinical success. The surgical technique for ridge preservation, a clinical procedure that aims at preserving the ridge volume within the envelope existing at the time of extraction, and immediate implant placement will be described.

Upon completion of this presentation, participants should be able to: 1) discuss the rational and scientific evidence for ridge preservation procedures; 2) describe the scientific evidence concerning the benefit of ridge preservation and immediate implant placement; and 3) explain the guidelines for a successful ridge preservation combined with immediate implant placement.

Extending the Resorption Properties of PRF From Two Weeks to Four Months in 10 Minutes of Prep Time
Richard Miron, DDS, MSc, PhD, DMD
Platelet rich fibrin (PRF) has been widely utilized in implant dentistry, primarily owing to its ability to favor soft tissue wound healing. While many have attempted to use PRF as a GBR barrier membrane, many remain disappointed by its rather quick resorption properties (two-three weeks). From the lead editor of Quintessence's 2021 textbook titled "Understanding Platelet Rich Fibrin", Dr. Miron discusses a variety of methods to improve PRF in routine daily practice. One main discovery has been the ability to extend the resorption properties of PRF from two weeks to four months utilizing the Bio-Heat Technology. Within 10 minutes, membranes can be transformed towards a slow degrading fibrin mesh and utilized similarly to collagen membranes. Recent trends to minimize early implant failure will also be discussed with respect to biomaterial integration.

Upon completion of this presentation, participants should be able to: 1) explain how to transform PRF membranes from 2 weeks resorption properties to 4 months; 2) discuss new advancements in bone grafting utilizing custom 3D bone grafts utilizing PRF; and 3) describe the number one cause of unexplained early implant failure and how to rapidly lower your number of lost implant cases.

Zirconia Implants: An Alternate for Tooth Replacement
Joan Pi-Anfruns, DMD
Your patient is asking for a metal-free alternative for tooth replacement. How well equipped are you for treating patients who request this type of treatment? In dentistry today, ceramic materials are widely accepted in prosthetic reconstruction. Contrary to this, dental implants made from Zirconium-dioxide are not yet part of the standard treatment but can be an attractive alternative to titanium. This lecture will cover the scientific evidence and clinical applications of zirconia implants and will review the indications and contraindications for their use

Upon completion of this presentation, participants should be able to: 1) explain the science behind ceramic implants; 2) recognize the advantages and limitations of ceramic implants compared to titanium; and 3) describe how to incorporate ceramic implants in your practice and attract new patients.

Metallosis: Myth or Reality?
Tom Wilson, Jr., DDS, PA
The number of implants suffering from peri-implant disease is increasing. There are continued questions concerning the etiology and treatment of these problems. This presentation will cover new data on these topics. The role of titanium found in soft tissues surrounding implants affected by these problems will be discussed. The effect of early and late colonizing bacteria on the implant surfaces and their role in the production of these foreign bodies will also be detailed. New therapeutic modalities will be discussed including appropriate methods for removing biofilm from infected implant surfaces and how these approaches may or may not result in new attachments to implant surfaces previously covered with biofilm.

Upon completion of this presentation, participants should be able to: 1) discuss metallosis and peri-implant problems; 2) describe the possible role of titanium particles in the etiology of these problems; and 3) describe current approaches for treating these diseases.

Opportunities, Evidence, and Controversies of Lasers in Peri-implantitis Treatment
Georgios Romanos, DDS, PhD, DMD
Peri-implantitis is a relatively common complication in implant dentistry. The presentation is focused on the use of lasers for implant surface decontamination. The lecture will provide the scientific basis and evidenced-based information about the long-term success of dental implants using the appropriate laser wavelength.

Upon completion of this presentation, participants should be able to: 1) demonstrate the appropriate laser-implant interactions; 2) evaluate the best evidence for treatment of periimplantitis; and 3) present long-term success after laser-assisted therapy.

Is a Soft Diet Healthy for Your Patients? Understanding the Risks and the Benefits
Reva Barewal, DDS, MS
Many people gradually migrate to a softer diet with loss of teeth, dental pain, or ill-fitting prosthetics. Dental implants are often the best solution we have to regain a regular diet. However, we all place our patients on a soft diet during the early healing period. But what is the psychosocial and physiological cost of a soft diet? How long should we place a person on a soft diet? How can we time our soft diet recommendations with patterns of osseointegration to reduce the burden for our patients? What are the categories within the soft diet that we need to know to effectively transition our patients back to a regular texture diet?

Join Dr. Barewal as she explores how masticatory function impacts the swallow reflex, brain health, and food enjoyment for individuals and can become an integral part of the initial conversation with patients about dental implants. Novel transitional foods will be discussed that help reduce the burden of a soft diet, may improve soft texture compliance post-surgically and overall health outcomes. A downloadable soft diet regimen will be provided that can more effectively guide your patients on appropriate choices to maintain compliance and overall satisfaction.

Upon completion of this presentation, participants should be able to: 1) define soft diets and the associated risks; 2) explain the consequence of a soft diet -- short- and long-term -- on nutrition, cognition, and psychosocial well-being; and 3) summarize the role of transitional foods in management of the soft diet during the post-implant healing period.

Biological Assessment of Used Dental Implant Healing Abutments: Is Surface Detoxification a Realistic Expectation?
Aniruddh Narvekar, BDS, MS
Once exposed to the oral environment, healing abutments become contaminated from several sources which may play a fundamental role in shaping the immune response in proximity to dental implants, Manufacturers recommend healing abutments are for single use. However, it is well known that clinicians re-use healing abutments following decontamination and sterilization methods available in clinical settings. This lecture will present the findings of a study evaluating four decontamination strategies, available in most clinical settings, to determine the extent to which biomaterial can be removed on used healing abutments and secondly to determine the degree to which decontaminated healing abutments trigger an inflammatory response in-vitro compared to unused sterile healing abutments.

Upon completion of this presentation, participants should be able to: 1) discuss the current literature on the decontamination of used dental implant healing abutments; 2) recognize and evaluate the efficacy of four common decontamination strategies on removal of biomaterial from used dental implant healing abutments; and 3) explain the potential for re-used healing abutments to trigger an inflammatory response in-vitro compared to unused sterile healing abutments.

Young Clinicians Program – See more details

These courses were pre-recorded and available ON DEMAND at any time during and after the meeting.

Paired Approach to Soft and Hard Tissue Complex for Anterior Immediate Implant Placement
Michi Katafuchi, DDS, MSD, PhD
Immediate implant placement after tooth extraction is an established method. Flapless implant placement has successfully been documented, especially in the esthetic zone. The question arises if the buccal plate lasts when it is thin, and a buccal bone concavity is present. This presentation is to propose a technique, Paired Approach, that increases peri-implant tissue thickness for the crestal area of the immediate implant without opening a full thickness flap and accesses the bone concavity to augment the bone. This approach may contribute to maintaining esthetics, promoting peri-implant health and reducing the risks for peri-implantitis.

Upon completion of this presentation, participants should be able to: 1) identify the clinical scenario to perform the Paired Approach technique for anterior immediate implant placement; 2) explain the step-by-step surgical procedure for the proposed Paired Approach; and 3) discuss complications related to Paired Approach.

Multidisciplinary Treatment of Full-arch Rehabilitation for Class III Malocclusion Patients
Ye Shi, DDS
Patient’s dental classification and skeletal classifications may not always coincide and treatments will vary depending on the appropriate diagnosis. To treat severe Class III malocclusion, orthognathic surgery in conjunction with orthodontic therapy will be needed. Orthodontic therapy only can be utilized to camouflage mild to moderate Class III malocclusions. However, as teeth are extracted and the dentoalveolar resorption process begins, it becomes more challenging to restore the function and esthetics for the patient to that of their initial dental classification. Comprehensive and multidisciplinary treatment is imperative to have a favorable outcome for these mutilated Class III malocclusion patients. Patients that present with edentulous spaces can greatly benefit from dental implants and prostheses as tooth replacement is required. This lecture will discuss treatment modalities to deal with the mutilated Class III malocclusion patients for full-arch rehabilitation. It will address clinical guidelines to help clinicians to correctly diagnose these patients so that an appropriate treatment for Class III patients can be selected. Understanding the differences between skeletal, dental and mutilated dentition is imperative to successfully treat malocclusion patients and to reduce the risks of adverse treatments.

Upon completion of this presentation, participants should be able to: 1)provide a brief overview on the etiology and diagnoses of skeletal and dental classifications, and mutilated dentitions of varying severities; 2) identify possible solutions to treating the mutilated Class III patients; and 3) list the indications and contraindications for such treatments.

Social Media: The New Standard in Dental Education?
Wesley Mullins, DDS; Jonathan Rogers, DMD
Social media has taken the world by storm and has changed the way people acquire and consume information. We have seen a tremendous impact on dental education through the ready availability of photos, videos and opinions on how to best treat patients. Now, a clinician can easily be inundated with information from these outlets or individuals, some of whom claim that they are experts in various aspects of clinical treatment. We will discuss the effects of this phenomenon on dental education and explore the pros and cons of this new way to "learn." Is social media pushing our profession away from evidence-based decision making or is there a potential for this to help our profession and improve outcomes for our patients?

Upon completion of this presentation, participants should be able to: 1) identify the current state of social media in implant dentistry and its impact on education; 2) describe the risk and benefits of social media as an educational platform; 3) explain ways we can leverage social media to improve standards in implant dentistry; and 4) discuss how social media could impact the future of implant dentistry.

TEAM Program – See more details

These courses were pre-recorded and available ON DEMAND at any time during and after the meeting.

Trust Transformed: Strategies for Leading Teams and Placing People Where They Shine
Tracey Butler, CRDH, MFT
Today's dental practice requires more than clinical acumen. Influence is the currency of leadership and there are levels of leadership throughout the dental team. People are the lifeblood of your practice and people want to be lead and not managed. Even the most ironclad strategy can be exposed by an antagonizing culture. Learn how to identify the strengths of each individual on your team and put them where they shine.

Upon completion of this presentation, participants should be able to: 1) describe the elements of the Inclusivity Model; 2) differentiate between hierarchy and idea meritocracy; 3) review Gallup 34 strengths evaluation and implementation; and 4) define your people, products and processes.

Current Concepts in Hygiene
Janis Spiliadis, CRDH
Many things have changed for dental professional in 2020 including the way our patients view health. Now is the perfect time to implement new technology and concepts that will help patients improve oral health and impacts overall health. This course will discuss current technology and techniques for efficient and effective biofilm removal and concepts to increase patient compliance.

Upon completion of this presentation, participants should be able to: 1) integrate biofilm removal techniques into clinical protocols; 2) review the science behind the new technology in biofilm removal; and 3) implement protocols to increase patient compliance.

Digital Dentistry to Increase Precision and Productivity. Dinosaur to Digital Diva
Sophie Garcia
The most significant change in dentistry in the past 20 years is the introduction of digital technology. The question is how do we best use this technology to benefit our patients and our practice as well which technology is right for you? This presentation presents a real-world private practice road map to decide which technology is best for your situation, as well as step-by-step instructions on use and benefits of available systems with an emphasis on intra-oral scanners. You cannot afford to ignore or miss out on the overwhelming benefits of this technology to improve patient care and practice productivity.

Upon completion of this presentation, participants should be able to: 1) discuss the benefits of available intra-oral scanners; 2) explain how digital technology can improve patient care and practice productivity; and 3) determine which technology is right for you.

Solutions to Generational Friction
Lisa Copeland, RDH, CSP, CVP
The key to cultivating a passionate team is a generational perception. The Generational Friction Factor is real and influencing the dynamics of your team's success. Each generation, team and patents, measures everything against their own language, perceptions, and work value. According to the US Census Bureau, the Gen Z cohort (age 4 – early 20's) are currently entering the work environment and becoming patients in your practice. Gen Z will change dentistry – so be the practice that is ready for it. They are the first cohort that are digital natives, never knowing life without technology, and will move on if they don't immediately see what they are looking for on your website and social media platforms. To help them bridge the divide and flourish, Lisa educates leaders and team members about the value of recognizing and addressing generational differences. Her 4-G Concept instructs audiences how to spot generational markers or signs, and then offers simple yet powerful ways to reduce or even eliminate friction points that are particularly damaging to the team, patients, and bottom line. Attendees will be given the tools that positively improve issues around patient scheduling, optimized care, and stagnant or declining production. How we communicate cross-generationally impacts our bottom line. Build a dental practice that speaks each generational language and meets their expectations now to guarantee future practice growth!

Upon completion of this presentation, participants should be able to: 1) cultivate a generationally perceptive team; 2) enhance and build relationships of trust using customized language tactics; 3) recognize how disregarding generational stereotypes can create a better patient experience; and 4) explore how to attract new Gen Z patients and employees.

Mastering Inter-Office Communication to Improve Referrals - No Donuts Required
Emilee Secondino
The description and objectives for this course are currently unavailable.

Become the Go-to Office for Implant Referrals
Robert Vogel, DDS
This fast-moving presentation will cover state of the art topics, tips and techniques in implant dentistry for the surgical practice to become indispensable to restorative dentists. This program stresses ideal interaction for simplification of even the most advanced Implant cases to ensure long-term stability, predictability and productivity. Also discussed in depth is streamlining inter-office communication to make the referral process stress free for patients and staff. This presentation will also review the newest equipment, components and technologies that need to be incorporated into everyday use to stay viable in our new landscape.

Upon completion of this presentation, participants should be able to: 1) explain how to become the go-to office for implant referrals; 2) implement team coordination for productivity and ideal care; and 3) discuss the importance and use of latest technologies.

Laboratory Technician Program – See more details

These courses were pre-recorded and available ON DEMAND at any time during and after the meeting.

3D Printing and Complex Cases
Alejandro Lanis, DDS, MS
CAD/CAM procedures and specially 3D Printing are changing the way humans consume products and services. In our field, 3D Printing is changing the way we diagnose, plan and execute our treatments, allowing to optimize our clinical procedures. In the following presentation I will describe the alternatives in the use of 3D Printing for the treatment of complex oral rehabilitation cases.

Upon completion of this presentation, participants should be able to: 1) describe the 3D Printing workflow applied to implant dentistry; 2) analyze diverse alternatives of 3D Printers and their specific use for oral devices fabrication; and 3)evaluate the use of different 3D printed surgical templates depending on the clinical situation.

Milled Zirconium Restorations
Alex Wuensche, CDT, ZT
Zirconia is without any doubt, one of the most important restorative materials of modern times in dentistry. Zirconia is also one of the most sensitive materials we are utilizing for dental restorations. If using a single unit crown or a full arch reconstruction, it is very important to know how to handle this material. This presentation will review the different available zirconia types and how to properly handle them in their fabrication.

Upon completion of this presentation, participants should be able to: 1) describe how to plan zirconia restorations; 2) explain working the pre-sinter stage without scarifying the stability; and 3) discuss how to properly finish the sintered zirconia to an aesthetic and functional dental restoration.

Optimizing Solid Monolithic Zirconia Solutions with Restorative and Implant Esthetics
Pincus Adar, MDT, CDT
This presentation will address more effective methods of utilizing the latest CAD/CAM technology workflow and how to communicate esthetic smile design solutions through several tools such as digital workflow designs, Trial Pop In Smiles™, PMMA’s and temporary restorations. These new CAD/CAM technologies have made proper communication between the laboratory technician and the dentist not only very different but extremely crucial to achieve optimal outcomes and save precious chair time. In CAD/CAM technology, just as with ceramic powders, the skill level of the technician is critical, this presentation will cover the key points that make the difference between laboratories using digital solutions for Full Monolithic (no ceramic layering) Zirconium. The 20% that is still the “human” touch is what makes the difference. Effective communication tools for a consistent and predictable outcome with the zirconia implant supported hybrid will also be covered.

Upon completion of this presentation, participants should be able to: 1) utilize the digital workflow as a planning tool for predictable outcomes; 2) implement new processes to lessen appointments, save time and ensure the final seat times are around 10 minutes for screw retained zirconia hybrids

Is Smile Design Under Control?
Christian Coachman, DDS, CDT
The importance of mastering how to consistently create adequate smile designs in harmony with faces is underrated in dentistry, and the notion that this topic is under control is overrated. The aim of this lecture is to highlight the challenges, the evolution, and the important concepts to become a great smile designer, and also how to use technology to streamline the process and deliver natural beautiful healthy smiles consistently.

Upon completion of this presentation, participants should be able to: 1) recognize the differences between artificial-looking and natural-looking smiles; 2) plan with the ideal smile in mind and better evaluate the 3D soft and hard tissue defect; 3) outline the most important facial references to create a smile in harmony with faces; and 4) describe the white and pink components of a natural smile.

Ceramics

Techniques and Protocols from a Laboratory Perspective for Long-term Prognosis in Implant Dentistry
Olivier Tric, MDT
This presentation will discuss temporization techniques, implant supported single central and material selection.

Upon completion of this presentation, participants should be able to: 1) discuss temporization techniques; 2) describe implant supported single central; and 3) explain material selection.

Full Arch Treatment Planning: Getting Back to Basics - Using Digital Technology to Facilitate Consistent Successful Treatment
Brandon Dickerman, CDT
Over the past few years, Fixed Hybrid Implant Therapy has become increasingly popular and widely accepted. With CBCT scans, photography, IOS data acquisition, and guided surgery implant planning software, we have the ability to plan and execute successful full arch rehabilitation with ease. A cornerstone of successfully executing this treatment is proper case documentation and pre surgical interdisciplinary planning.

Upon completion of this presentation, participants should be able to: 1) explore fundamental treatment planning concepts that are keys to successful hybrid restorations; 2) determine restorative material choices for fixed hybrid restorations; and 3) discuss what makes a patient a good candidate for a hybrid, and more importantly who is not a good candidate.

AO Research Award Recipients

2020 Osseointegration Foundation Applied Science Research Grant Presentation
Characterization of Markers from Saliva and Peri-implant Crevicular Fluid in Osteoporotic Patients Receiving a Dental Implant. An Exploratory Study
Elena Calciolari, DDS, MS(Perio), PhD
Currently, the diagnosis of peri-implant diseases and the monitoring of peri-implant health are mainly based on clinical parameters, such as visual inspection of signs of inflammation, bleeding on probing and/or suppuration, probing depth and radiographic marginal bone level. Such clinical criteria present, however, significant limitations and can often have limited sensitivity. In recent years, markers identified in the saliva and peri-implant crevicular fluid (PICF) have attracted growing interest for the possibility to predict implant-related outcomes. This lecture will present the data from an exploratory study that investigated the use of proteins expressed in saliva and PICF (including exosomes) to predict different clinically relevant implant-related outcomes in a population of osteoporotic patients receiving a dental implant.

2019 Osseointegration Foundation Applied Science Research Grant Presentation
Using Digital Implant Planning in Assessing Outcomes of Maxillary Sinus Augmentation Procedures: A Retrospective Study
Irina Dragan, DDS, MS, Tufts University
The aim of this retrospective study was to use digital implant planning and assess radiographic outcomes of maxillary sinus augmentation procedures (ideal bone graft, excess bone graft, and insufficient bone graft) in reference to three-dimensional prosthetic-driven implant placement. The majority of the outcomes highlight an excess in bone grafting during the maxillary sinus elevation. The implant digital planning prior to maxillary sinus elevation can facilitate a better understanding of the expected clinical result. With the use of technology, we can leverage not only reviewing the anatomy of the sinus but quantifying the precise amount of bone graft needed for an adequate site development for future implant placement. This can be achieved only by the collaboration of the interdisciplinary team (surgical-restorative), than have a direct impact on the patient care: time of healing and the cost of the procedure.

2021 Basic Science Research Grant
A Novel Growth Factor-free Adhesive Hydrogel Delivery System for Enhanced Bone Tissue Engineering Applications
Sahar Ansari, MSc, PhD
In the US over a million bone reconstructive procedures are performed due to injury, surgical removal of diseased tissue or congenital defects, representing substantial morbidity, pain and disability toll on the society. Furthermore, this induces major social and economic hurdles, as bone regeneration therapies represent a cost of more than $2.5 billion in the U.S. each year alone. To treat patients, clinicians are often faced with a challenging task of harvesting and grafting in order to recreate the necessary tissue architecture and function. These complex procedures commonly fail to deliver consistent benefits and often result in complications. Thus, a new paradigm for the treatment of damaged bone tissue is needed that can provide effective, and long-term therapy for most patients. Delivery of mesenchymal stromal cells (MSCs) such as gingival mesenchymal stem cells (GMSCs) presents an advantageous therapeutic option for bone tissue engineering, due to the accelerated tissue repairing rates. However, the major drawbacks of the current cell-laden biomaterials for cell delivery applications are low adhesion to the surrounding tissues, lack of suitable mechanical strength, uncontrolled degradation rate, and absence of tissue regenerative properties.

In this research project, we developed an adhesive osteoconductive hydrogel delivery system with the ability to direct human gingival mesenchymal stem cells (GMSCs) toward osteogenesis. The hydrogel biomaterial contains bioceramic microparticles with bone regeneration capacity. We have shown that our engineered adhesive biocomposite are highly osteoconductive, osteoinductive, and able to promote osteogenesis and downregulate osteoclastogenesis in vivo. This accomplishment has been a paradigm shift in engineering bone tissues towards their use in treating maxillofacial and skeletal bone defects and disorders to provide an effective and innovative treatment modality for bone regenerative therapies.

2020 Basic Science Research Grant
Effect of Drilling Preparation on the Cortical Bone Around Implants Subjected to Immediate Mechanical Load
Michele Stocchero, DDS, PhD
When implants are subjected to immediate load, the bone-implant interface is challenged. The implant anchorage is expected to withstand such load and implant primary stability is considered as a pre-requisite for a successful immediate loading protocol. A commonly used strategy to increase the initial implant stability is undersized preparation. This procedure, however, may generate excessive pressure and a major extent of remodelling, which could decrease the implant stability during the healing phase. Contrarily, implants placed with a non-undersized preparation observe an eventual increase of stability with time, but on the other hand they may not exhibit sufficient primary stability.
With this in vivo experiment we simulated immediate occlusal load to implants placed after two different drilling protocols. Thanks to this methodology we evaluated the implant osseointegration and implant stability after 5 weeks of loading.

2021 William R. Laney Award
The Effect of Crown-to-Implant Ratio on the Clinical Outcomes of Dental Implants: A Systematic Review
Andrea Ravida, DDS, MS
The purpose of this study was to investigate the effect of C/I ratio (clinical and anatomical) on implant survival, marginal bone loss, and prosthetic complications. Systematic electronic and manual search was conducted to include clinical trials with a minimum follow-up of 1 year. In total, 15 articles were included in the final analysis. Linear regression analysis did not reveal a significant correlation between anatomical C/I ratios and survival rate, marginal bone loss, or prosthetic complications. Similarly, no significant correlation was observed in the articles providing the clinical C/I ratios. In conclusion, Increased C/I ratio does not seem to be directly related with increased marginal bone loss and does not represent a biomechanical risk factor for the stability of the prosthesis and for the survival of dental implants.

2020 William R. Laney Award
The Effect of Moderately Controlled Type 2 Diabetes on Dental Implant Survival and Peri-implant
Bone Loss: A Long-Term Retrospective Study
Zeev Ormianer, DMD
Diabetes mellitus (DM) is a metabolic disorder, a part of a group of metabolic diseases which influences the patient's healthstatus. A common complication that is associated with DM, especially DM type 2 (DMT2), is advanced periodontal disease. The prevalence of the periodontal disease is much higher in patients with DMT2 than people without the disease. In addition, the loss of periodontal attachment and alveolar bone starts in early stages of life in such patients compared to general population. One of the main diagnosis of DM is according to HbA1C values. HbA1C < 5.7% is defined as normal and patients with 5.7%
The American Diabetic Association (ADA) recommends for most patients to be counterbalanced as close as possible as normal range, hence, HbA1C below 6.5% to 7%, avoiding glycemic risk. For patients with lack of awareness for such a risk the equivalent goal of HbA1C will be at the range of 7.5%-8%. For patients with a very low life expectancy, long-term diabetic sickness, additional risk factors and other day-to-day vulnerability the recommended equivalent is 8%-8.5%. On 2019 new clinical guidance of the American College of Physicians (ACP) was published. It defines that HbA1C values in patients with Type 2 DM should be kept at a range of 7%-8%. Some studies in the dental literature defined this HbA1C value (7%-8%) as moderately controlled diabetes and found high survival rates and marginal bone loss comparable to non-diabetic patients. However, these studies were mainly with short time follow-up. The aim of this study is to assess implant survival rates and long-term bone loss around implants in a population of patients with moderately-controlled T2DM, followed for a minimum period of 4.9 years.

Materials and Methods: This retrospective observational study utilized patient medical records from a general practitioner’s office. The records of patients who had moderately-controlled T2DM with hemoglobin A1C (HbA1C) up to 8% and glucose level below 150mg/dl were reviewed. Follow-up data was recorded and analyzed. Results: After review of over 3,256 medical records, we identified 169 patients (with 1,112 implants) who met the inclusion criteria. Average follow-up time was 8.7 years, with a minimum of 4.9 years. Sixty-seven implants failed, yielding a 94% overall implant survival rate. Overall average bone loss around the implants was 1.98 (±1.81) mm. The delayed insertion protocol presented the least bone loss, compared to immediate insertion, and compared to early insertion.

Conclusions: The results show that implant survival and bone loss levels were comparable to reported outcomes in the non-diabetic population. The delayed insertion protocol presented less bone loss compared to other insertion methods. Likewise, less bone loss was found in implants placed in the posterior region.

Supported by a grant from Quintessence Publishing Co., Inc.