Welcome to the 2020 AA-OS Global Summit!

Management of Complex, Unexpected, Rare and Life-Threatening Complications in Implant Surgery

Although a high predictability and long-term success rate of dental implants is well documented in the literature, complications and failures do occur on a regular basis and have been rising as more clinicians who do not have advanced training and skills are involved in implant placement and implant-related surgeries. Some complications may be relatively minor and easy to control, while others will be major and result not only in the loss of the implant but also cause permanent damage of adjacent anatomical structures or can be complex in nature and even life-threatening.

This lecture is based on numerous clinical examples as a well as on a literature review demonstrating that even simple implant procedures are invasive in nature and can trigger unexpected and rare but serious complications. Specialists and dentists, no matter how skilled and experienced in implant surgery, must be at all times aware of this kind of complications, in order to promptly plan an emergency intervention.

Demystifying bone Augmentation in Implants

An overview of the biology and science behind Bone regeneration, classification and techniques, and treatment modalities with case presentation.

Immediate Loading of Dental Implants in Conjunction with Bone Grafting. Long-Term Results

Will explain the biological impact of immediate loading. Presentation of the protocols required for immediate function

especially when bone has low bone Quantity and Quality. Demonstrate long term results.

A Science/Common Sense Approach to Managing Implant Disease

While inflammation associated with implant is at an all-time high, we can prevent loss of implants with innovative chairside techniques to reverse implant mucositis. We will also show success via laser minimally invasive techniques with bone loss implantiits. Long-term implant survival can depend on quality prevention, treatment and maintenance.

HPV-Related Lesions Affecting the Oral Cavity and Oropharynx

This presentation will provide the clinician with an update on HPV-related lesions affecting the oral cavity and oropharynx. Current information on HPV-related oropharyngeal squamous cell carcinoma (OPSCC) including the etiology, epidemiology, prognosis and prevention will be discussed. Emphasis will be placed on clinically relevant information. At the conclusion of the lecture, the practitioner will have the knowledge to answer HPV-related questions asked in the clinical setting.

Surgical Complications You Need to Know Before You Pick Up a Scalpel

Surgical procedures are much different than anything else we do in dentistry. They involve making an incision through tissue and exposing and modifying bone on a living, breathing patient. Before you can successfully complete a surgical procedure, you need to be aware of the anatomy, biology, pharmacology, medical issues, and steps of the procedure. You need to be able to know what complications can occur during and after surgery and be able to prevent and manage them without hesitation. Until you can do this, you don't do surgery. This course will discuss the most common intraoperative and postoperative complications so that you will be prepared for managing your patients presenting for surgical treatment.

GPS Surgery: Believing in Better--Dental Implants and Alveolar Site Development via 3D Dynamic Computer Navigation = Improved Outcomes and Longevity

Currently, patients desire dental treatments with better esthetic results, less treatment time, and improved long-term outcomes. Ideally, implant placement should be prosthetically driven. This can be achieved by correct three-dimensional positioning in the alveolus, allowing optimal support and stability of surrounding hard- and soft-tissues2 and thus improved esthetics and durability. Dental implant technology has made grand advances in recent years with CBCT scans. Previous CBCT implant procedures required splints to be created for their respective implants. However, this potentially increases cost and time for the patient and clinical human error for the surgeon. These static guides allow accurate positioning of dental implants for functional and aesthetic results, but lack last-minute or intraoperative corrections and possibly changing the desired outcome.

Latest advances in technology allow for dynamic navigated implant placement. Leading this transfer of information is computer navigated dynamic implant surgery, known as dynamic navigation. The ideal implant position is planned digitally, in advance by the clinician on a CBCT scan. Software is used to map the final prosthetic restoration, evaluate bone morphology, and highlight anatomical landmarks. Dynamic navigation aids in the accuracy and precision of dental implant placement by using a camera to correlate information from a custom-fitted bite jig containing tracking sensors worn by the patient during surgery. Additional tracking sensors on the drill and other implant tools are calibrated to the camera, the patient’s CBCT scan, and the planned procedure using the computer software. This is similar to the process of laparoscopic surgery in that it allows the surgeon to make smaller incisions, use smaller and more precise movements with increased accuracy than traditional direct vision.

The author has transitioned from linear implant placement, and used these technological advances for 3D planar cutting and surgical implant site development.

Management of Medical Emergencies

This course will review the prevention, diagnosis and management of common medical emergencies in the dental office. The course content is applicable for the entire dental team. Emergencies can range from relatively benign conditions to life-threatening situations. Emergencies discussed in this course will include syncope, asthma attack, anaphylactic reaction, epileptic seizures, serotonin syndrome, neuroleptic malignant syndrome, angina/MI, hypoglycemia, severe hyperglycemia, thyroid storm, stroke, LA toxicity, and bleeding. Special attention will be placed on recognizing medical emergencies and their management. Additionally, this course will also shed light on what emergency equipment and medications are appropriate to stock for your dental office for the management of medical emergencies.

IPG-DET Technique for Implant Placement Into the Sinus Without S.F.E.

In many occasions, during treatment planning, various procedures such as bone augmentation,

bone transplantation, or both are considered necessary in order to acquire the desired alveolar

ridge dimensions so as to achieve implant stability and long term aesthetic results.

In cases of vertical alveolar ridge deficiencies of the posterior areas of the upper jaw, either

extensive bone transplantation techniques are utilized, or in most cases sinus floor elevation

procedures are undertaken in order to create the necessary bone height for implant stability to

occur.

The IPG-DET technique involves the use of the biomaterial Matrix CGF-CD34+, an autologous

complex of: Fibrin, Concentrated Growth Factors ( CGF ) and stem cells CD34+, combined with

bone grafting materials and implant placement into the intentionally perforated sinus

membranes, in such a manner that the sinus can adapt to the new conditions and form new

bone around the implants without the need to perform an SFE procedure.

Advanced Bone Grafting- What Are The Basics, Where Are The Limits?

In many cases bone augmentation is necessary before implants can be inserted. Additionally, the soft tissue management can be a decisive factor for the implant success. In all cases the “Gold Standard” of using autologous bone is in competition with the use of Bone Graft Material products. This lecture gives deep insights in the Concept of Biological Bone Augmentation (BBA) with pure autogenous bone and tissue and is addressed to all clinicians, who have already own experience in augmentation techniques. Clear guidelines for the use of autogenous bone harvesting and augmentation techniques in order to achieve predictable results will be provided as well as reliable techniques in complication treatment.

Concepts of Treatment in Patients with Atrophic Maxilla

The combination of several augmentation and surgical procedures, enables better correction of the alveolar ridge in 3D (ridge height, width and trajectory), which results in a better prosthetic and face esthetics outcomes. Techniques that are described in this presentation should be considered reliable, safe and very effective to obtain high bone graft survival rate. Moreover, we believe that PRP and BMA as an autologous source of growth factors and stem cells, mixed with osteoconductive bone substitute and covered with PPP as a biological membrane may offer a novel therapy with greater efficacy than any other combination or single therapies that were used in bone regeneration up to now.

The anatomic configuration in the atrophic site, creates acquired Angle Class III malocclusion influencing the surgical choices. Clinical cases of severe maxillary atrophy are described: A combination of sub-nasal, sinus elevation procedure and intra-oral autogenous onlay bone graft were used for ridge augmentation combined with bovine bone substitutes mixed with platelets rich plasma (PRP) or bone-marrow aspirate concentrate (BMAC) and covered with platelets-poor-plasma (PPP) as a biological membrane. Le Fort I Osteotomy was performed in a few cases, simultaneously with dental implantation and immediate loading or as a separate procedure.

Cone Beam CT: Incidental Findings and How to Manage Them

In the process of examining cone beam CT volumes, the dentist may come across radiographic findings that were not expected. These are known as incidental findings. In other words, they represent conditions in the patient that were not anticipated or not the reason for ordering the scan. This course will focus on how to recognize the various types of incidental findings typical of CBCT scans and what to do about them.

New Trends In Oral Surgery

Thanks to the latest developments of medical technologies and simultaneous advancement of medical sciences, Medicine became more efficient, faster, and most importantly safer. Implantology has not stayed aside from the technological revolution of the 21st century.

Nowadays, we can make Predictable Implant Procedures with much more confidence, in shorter periods, and with better functional and aesthetic results.

The aim of this conference is to present and discuss the latest innovation trends in modern Oral Surgery, showing that the foundation of aesthetic implant dentistry starts with surgery (Red), has a component of periodontology (Pink) and finishes with prosthetic rehabilitation (White).

We aim to cover several state-of-the-art topics in the field, including: Implant Stability Quotient (ISQ) Measure, predictable advanced surgical techniques, Plasma Rich Fibrin (PRF), LLLT, T-scan, … and how can these techniques help us to obtain better clinical results.

These current procedures can make a great difference and impact in our daily practice.

New Trends in Facial Aesthetics with Smart Blood Derivatives.

Cleopatra Technique TM

"Mesotherapy" is a non-surgical, minimally invasive method of blood derivatives that consists of multiple intradermal or subcutaneous injections, stimulating the body's natural healing cascade, yielding visible results within a short period of time.

Using blood derivatives in liquid matrices are able to enhance healing after facial procedures, as well as to rejuvenate the face without tissue manipulation. i-PRF+ utilizes activated platelets, inflammatory cells and stem cells found in our blood for regeneration of skin and ultimately alleviate wrinkles. The release of cytokines associated with the niche of mesenchymal stem activates the regenerative process and angiogenesis for better oxygenation of the skin, in order to convert the stem cells in mature cells. This procedure begins the production of collagen and elastin fibers which is helped by the fibrin biological matrix produced naturally from the soluble fibrinogen. Moreover, the plasma contains proteins, minerals, vitamins and other nutritional substances, which lead to skin rejuvenation.

Cleopatra Technique TM using smart blood concentrates (combination of i-PRF+ and A-PRF liquid) induces a dramatic improvement in facial texture, firmness, and fine lines with long term results, up to two years.

Immediate Implants In the Aesthetic Zone

The loss of a tooth in the aesthetic zone is a very challenging treatment modality. The use of immediate post extraction implant technique in this zone is intended to provide a faster treatment modality with a less morbidity and a better provisionalization and tissue maintenance. The goal of this presentation is to discuss the immediate post extraction therapy indications, its clinical parameters and the need of an aesthetic and functional long term result.

Vestibular Dehiscences of Implants - Compromise vs Radical Solutions

The longer we deal with implantology, the more complications we can expect. One of these complications is the gingival recession at the implant, called dehiscence. It is not always an indication for implant removal. It is possible to save the situation effectively, but one should distinguish between compromise methods and radical methods. The author will talk about the criteria for making a decision about removing an implant or saving it based on his own clinical experience.

Multidisciplinary Cases Involving Implants, How To Act To Unify Function and Aesthetics

Patients are increasingly looking for implant solutions to their edentulous problems. This is the best choice to date after natural teeth. As such they require the unification of implant elements with existing dentition, a task not always easy. They would also like to solve these problems with a single intervention if possible. The alveolar tooth, with rare exceptions, changes significantly after a tooth is removed. This then leads to the need for different graft materials to be applied to the post-extractive alveoli before a dental implant or denture is placed, to maintain the volume of hard and soft tissue. Good implant positioning with the prosthetic in mind is also essential. This is the only way to preserve the aesthetics and allow normal restoration.

Appraisal of the Treatment Protocols for Peri-Implantitis

As one in six patients receiving implant therapy are likely to show signs of peri-implant diseases with varying degrees of severity throughout the lifespan of the implants, clinicians will be confronted with peri-implant complications requiring appropriate management. The ideal management of peri-implant infections should focus both on infection control of the lesion, detoxification of the implant surface, and regeneration of lost support. Treatment options can be surgical or nonsurgical. Host's medical status, defect configuration, aesthetic outcome, ability to access for plaque control post-treatment, and the patient's wishes are key factors to consider. The purpose of this presentation is to provide a contemporary synopsis on the management of peri-implantitis with emphasis on explanation.

TO SAVE or EXTRACT- CLINICIAN'S DILEMMA

Decision making in terms of saving a affected natural tooth or extracting it and replacing it with dental implant has never been an easy decision for the clinician. This is especially true in the aesthetic zone, when the situation appears to present a compromised condition with calcification, perforation , bone destruction, tooth mobility and in some cases presence of gingival recession. The posterior dentition most of the time would require advanced restorative procedures, endodontic therapy in saving the naturals. . Irrespective of whether the tooth is anterior or posterior, numerous factors need to be considered when deciding whether to save or extract a tooth: restorability, disease susceptibility, papillary and gingival considerations, tooth esthetics, etc. In conclusion, the decision to extract or maintain teeth must include deliberation with regard to benefits vs risks of retaining compromised teeth. The judgment to remove a tooth may be based on one critical issue or it may rely on collective risks related to a few factors. The presentation will elaborate on all such aspects and clinical situations.