Just like everywhere else in the mouth, the replacement of missing teeth in the esthetic zone using dental implants is usually the treatment of choice. Nevertheless, assessment and treatment planning for dental implants in the esthetic zones involves a level of complexity that is very different compared to that applied elsewhere in the mouth. Multiple systemic and local factors play in important role in choosing the most appropriate treatment option in every case. This webinar will present an overview of these variables and provide a structured approach to the assessment of these cases and and how they affect treatment decision-making. Clinical cases to demonstrate those variables and how treatment options and sequencing is modified accordingly.

In modern implant-prosthetic therapy, the reconstruction of soft tissues is increasingly a key aspect of treatment for both functional and aesthetic purposes. The most recent literature has, in fact, confirmed that the presence of keratinized tissue of adequate size around the implants is a key element for maintaining the health and stability over time of peri-implant tissues in a broad sense, while the increase in thickness at the level of soft tissues it is of great importance from an aesthetic point of view. At the level of therapeutic options, then, the choice of the "timing" of the soft tissue augmentation surgery becomes important to be associated with the different techniques, borrowed from periodontal plastic surgery, with or without the use of autologous tissue grafts. More recently, research has focused on collagen matrices as substitutes for autologous soft tissue grafts, in order to reduce morbidity and post-operative discomfort for patients. During the presentation, the most effective methods for the correction of soft tissue deficits in correspondence of the implant sites will be illustrated, especially through clinical cases.

Como resolver desde casos simples a complejos usando el kit Naviguide

Frequently in daily clinical practice we meet patients that require an implant- supported rehabilitation in the upper posterior jaw.
This anatomical region shows often an insufficient quantity of bone that allows a traditional implants insertion only by drilling the bone following standard protocols due to the presence of the maxillary sinus. The residual bone crest under the cortical plate of the sinus floor can be augmented by the execution of sinus lifting tecniques.
In the literature have been published different tecniques with different surgical approach: lateral and crestal.
The crestal approach allows to obtain the lifting of the sinus floor in the place where the insertion of an implant is required with a reduced surgical trauma and with less morbility for the patients.
Different crestal tecniques are described focusing in particular on the SCA tecnique that follows a well defined protocol and requires especially made tools.

Augmentation de sinus maxillaire : a-t-on besoin d’un matériau de comblement
La perte des dents postérieures et la pneumatisation consécutive du sinus maxillaire entraînent une atrophie de l'os alvéolaire et peuvent affecter la réhabilitation des patients candidats pour des implants ostéointégrés. Dans ce contexte, la chirurgie de greffe des sinus maxillaires a été considérée comme une modalité de traitement sûre avec un faible taux de complications. Traditionnellement, le succès de la procédure est déterminé par la quantité de formation d’os vivant après la maturation de la greffe et le taux de survie à long terme des implants. Divers matériaux de greffe ont été utilisés pour la chirurgie de sinus lift. Ces greffons peuvent avoir un potentiel d'ostéogenèse, d'ostéoconduction ou d'ostéoinduction.
Selon Chen et al. La formation osseuse dans le sinus maxillaire ne nécessite pas la présence de biomatériau. Le maintien de l'espace pour la formation de caillots sanguins accompagné de la résorption et du dépôt de cellules osseuses dérivées du périoste sinusal ou de l'os spongieux du maxillaire serait responsable de la formation osseuse dans cette région.
Dans cette conférence, nous essaierons de discuter l’intérêt de l’utilisation du matériel de greffe dans la chirurgie de sinus et exposerons notre expérience dans le sinus lift par voie crestale avec le dispositif Neo Biotech SCA sans utiliser de matériel de greffe.