Aesthetic Implant Therapy: Patient Desire - Clinical Demands - Scientific Short Falls (Pt. 2) - Dental Online College
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Aesthetic Implant Therapy: Patient Desire - Clinical Demands - Scientific Short Falls (Pt. 2)

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Duration:

01:01:28

Instructors:

Dr. Zuhr, Prof. Dr. Wachtel, Prof. Dr. Hürzeler

Implantology in the aestethic zone is a continuous burner for every dental practitioner who tries to place implants to the patients fullest satisfaction. Professor Markus Hürzeler and Professor Hannes Wachtel, both well known implantologists from Munich/Germany, share their clinical experiences and scientific insights. In this part 2 of their lecture Dr. Otto Zuhr, also Munich/Germany, joins them to present clinical cases with different levels of difficulty. They give examples for clinical situations that will end up predictable or with esthetic failure. Due to their experience they enroll a clinical classification system staging the diagnostic outcome in four types.

In the beginning Prof. Hürzeler, Prof. Wachtel and Dr. Zuhr present cases with an intact hard and soft tissue. In this clinical situation a flapless single step implantology procedure can be carried out with immediate provisionalization. Patients with a thin biotype should be treated previously with a staged approach to thicken the soft tissue complex. The morphological biotype has to be switched with a connective tissue graft to avoid recessions and a visible, shiny implant surface. After a healing period the extraction and implant insertion can take place in one visit. Orthodontic extrusions with a magnet enable the vertical decrease of the buccal bone and the gingival margin. The elastic fibres are stretched with the orthodontic advice. Due to that a long retention phase is necessary. Otherwise the elastic fibres are banding back when the soft tissue is detached during the extraction procedure.

In complex cases with loss of hard and soft tissue and thin biotype a CT-scan enables an optimized implant placement. Guided surgery with a radiographic template offers minimally invasive flapless procedures. The three-dimensional computerized navigation system can be combined with individual Guided bone regeneration (GBR) and Guided tissue regeneration (GTR) to thicken the hard and soft tissue volume for a long-lasting and esthetic implant loading. A customized impression copy of the emergence profile creates an integrated and stable gingival complex. The distraction osteogenesis technique enables vertical bone augmentation in front teeth regions with progressive bone loss.

In some cases the best decision might be a bridge. In the future the implantology technique has to develop a way to deal with borderline situations in difficult operation sites in the esthetic zone succesfully. It is necessary to give the patient realistic expectations. The classification systems of the three experts - based on actual studies and scientific implantology outcome - helps to find the best decision.

Content of the expert video

Dr. Otto Zuhr presents cases with different levels of difficulty.
Dr. Otto Zuhr presents cases with different levels of difficulty.
The radiographic diagnostic presents a missing lateral left incisor.
The radiographic diagnostic presents a missing lateral left incisor.
The easy case: An implant is placed in a flapless single step procedure.
The easy case: An implant is placed in a flapless single step procedure.
The emergence profile is sculptured out five month later due to the immediate provisionalization.
The emergence profile is sculptured out five month later due to the immediate provisionalization.
The final prosthetic result with an optimized esthetic outcome.
The final prosthetic result with an optimized esthetic outcome.

The experts

Dr. Otto Zuhr

Specialist for Periodontology in Private Practice Hürzeler/Zuhr, Munich

  • 1986-92 Studied dentistry at the RWTH University in Aachen 
  • 1992 State examinations and graduation in the field of dental, maxillary and plastic facial surgery at the RWTH University in Aachen 
  • 1993-1994 Post-graduate programme in periodontics and implant dentistry in the Oral Implant Centre at the Loma Linda University / California / USA 
  • 1994 Assistant in the group practice of Bolz, Wachtel, Richter and active participation in the private Institute for Periodontology and Implantology IPI in Munich 
  • 1994-95 Various study visits in Sw ...more »
Dr. Otto Zuhr

Prof. Dr. Hannes Wachtel

Dental office in Munich

Hannes Wachtel received his dental degree in 1982 at the University of Tübingen, Germany. In 1982/83 he followed the Postgraduate Program in prosthodontics at the University of Southern California, Los Angeles, USA. Beginning of 1984, he served as Associate Professor in the Department of Periodontology at the Free University of Berlin for ten years and obtained his Ph.D. in 1992. Since 1994 he maintains a private clinic in Munich, together with Dr. Bolz, devoted to periodontology, implantology and restorative dentistry and established with his partner Dr. Bolz the Institute for Periodontolog ...more »
Prof. Dr. Hannes Wachtel

Prof. Dr. Markus Hürzeler

Private practice Hürzeler/Zuhr in Munich

  • Practising dentist in the joint practice Hürzeler/Zuhr in Munich
  • 2003 Conferment of degree; adjunct professor by the Albert-Ludwigs University in Freiburg
  • Specialist for periodontology (medical specialist equivalent) according to the Swiss (SSP) and German Association of Periodontology (DGP)
  • Specialist for prosthetics (medical specialist equivalent) according to the German Association for Dental Prosthetics and Materials Science (DGZPW)
  • Professorship at the Albert-Ludwigs University in Freiburg and at the University of Texas in Houston / Texas / USA
  • more »
  • Align Technology Inc.
  • Zimmer Dental
  • Komet/Gebr. Brasseler GmbH &Co KG
  • IDI-PARO
  • DZR
  • CLINICAL HOUSE EUROPE
  • Kuraray
  • Health AG
  • DSI DentaScience Institute®
  • Sirona
  • W&H Deutschland GmbH
  • Dentsply Sirona Implants
  • Mectron
  • BEGO Implant Systems GmbH & Co. KG
  • Henry Schein
  • IPI München
  • CAMLOG
  • botiss dental Gmbh

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