Prof. Dr. Urs Belser

Update on Reconstructive Dentistry - with special emphasis on the rehabilitation of the Compromised Anterior Dentition

Saturday - May 24th, 10:30 - 12:00

Questions

• Can we explain the phenomen of porcelain chippings and are there differences between teeth and implant restorations?
• What are the objective rules to decide when to restore with bridges on implants, when on teeth?
• Do we have to differentiate between implant and tooth restoration by raising the vertical dimension of occlusion (VDO)?
• Based on which criteria should we select the right restorative material? Is Zirkonia the stone of wisdom?
• Treatment planning case: which are the problems in determining the adequate prognosis for a long term esthetic result?
• How can we stabilize the soft tissue around dental prostheses (teeth and implants)

Abstract:

In recent years the range of indications for conventional toothborne crown and bridge prosthodontics has been constantly reduced. This trend is due on the one hand to the increased performance of dentin adhesion technology, permitting - even in case of severely broken down teeth - to avoid cemented full coverage single crowns and, by this, some of their inherent shortcomings. Such novel approaches are based on principles defined as biomimetics. On the other end of the restorative spectrum, fixed partial dentures (FPD's) appear to be used less frequently as well, either due to their invasive character or due to the reported increased risk for failures and difficulty of eventual reinterventions when compared to implant restorations.

Various clinical approaches for the replacement of extracted teeth with implant supported restorations have emerged in recent years. This program will focus on treatment protocols currently used to predictably restore esthetics and function in the partially edentulous anterior maxilla. In this context, long term data of anterior implants, specifically addressing esthetic parameters, will be presented. Based on these results, the rationale for an early placement/early loading concept will be discussed in detail, comprising the related preoperative analysis, decision making process and clinical/laboratory step-by-step procedures. In particular, the fundamental difference between single tooth sites, two adjacent missing anterior maxillary teeth, and more extended edentulous segments, often accompanied by significant horizontal and vertical tissue deficiencies, will be addressed. Finally, a critical appraisal of the recent evolution in implant design and novel restorative components, such as CAD/CAM derived high-strength ceramic elements and a newly developed bone level implant, implementing the principle of "platform-switching", will be made.

This program will focus on objective ("evidence-based") parameters and well defined clinical decision making criteria when it comes to the treatment of broken down teeth or edentulous jaw segments. In this context, special emphasis will be given to diagnostics, esthetic aspects and most recent developments as they relate to anterior restorations on natural teeth and on implants. Treatment planning discussions, clinical and laboratory step-by-step procedures, as well as restorative tips and tricks will complete the presentation.