Lecture Notes on Dental Implantology

Introduction

• Goal of the Lecture:
  • Cover extractions, grafting, proper implant placement.
  • Discuss pre-operative planning, implant choice, platform choice, and provisionalization.
• Speaker's Background:
  • Graduated in 2002 from Case.
  • Studied at Midwest Implant Institute, assisted Dr. Duke Keller.
  • Completed externship and maxi course.
  • Passed board exams for American Board of Oral Implantology and American Academy of Implant Dentistry.
  • Founded Cleveland Implant Institute.

Implant Courses and Strategies

• Course Offerings:
  • Comprehensive implant courses.
  • Topics include full arch courses, photogrammetry, All-on-X cases, and complications.
  • Coding courses for insurance reimbursement.
• Practice Tips:
  • Implant practices can be PPO-proof if codes are understood and used correctly.

Importance of Planning and Patient Management

• Case Examples:
  • Importance of planning in implant placement.
  • Financial and treatment planning should be clear to avoid patient dissatisfaction.
• Surgical and Restorative Focus:
  • Emphasize good surgical and restorative skills for successful implant practices.

Implant Placement and Complications

• Case Study Highlights:
  • Issues with improper implant placement and planning.
  • Importance of planning for prosthetic considerations.
• Surgical Techniques and Teaching:
  • Developing papilla and maintaining bone during placement.
  • Using provisionals and photogrammetry for full arch restorations.

Extractions and Grafting

• Extraction Techniques:
  • Importance of atraumatic extractions to preserve bone.
  • Use of periotomes and surgical burrs for effective extractions.
• Socket Grafting:
  • Categorizing defects (five-wall, four-wall, etc.) and using appropriate grafting techniques.
  • Use of prf to aid in healing and prevent dry socket.
• Bone Grafts and Materials:
  • Types of bone grafts (autograft, allograft, xenograft, alloplast).
  • Properties of grafts: osteogenic, osteoinductive, osteoconductive.
• Membranes:
  • Use of collagen and PTFE membranes for grafting.
  • Importance of proper membrane placement and maintenance.

Implant Design and Types

• Implant Features:
  • Thread designs for primary stability.
  • Importance of platform switching to reduce marginal bone loss.
• Placement Techniques:
  • Correct positioning for incisal and occlusal alignment.
  • Importance of maintaining space between implant and adjacent structures.

Restorative Considerations

• Custom Healing Abutments:
  • Importance of developing proper emergence profiles.
  • Techniques for using peak abutments and flowable composite.
• Provisionalization and Healing:
  • Use of provisional restorations for aesthetic and functional healing.

Suturing Techniques

• Suturing Importance:
  • Proper suturing techniques to maintain tissue integrity and promote healing.
• Knot Tying:
  • Difference between square and granny knots.
  • Importance of tying proper knots to prevent suture failure.
• Suture Types and Materials:
  • Options include chromic gut, PTFE, and vicryl.
  • Use of continuous locking sutures for stability in large extractions.

Conclusion

• Takeaways:
  • Emphasize planning and precision in all phases of implantology.
  • Continuous learning and adaptation to new techniques and materials.