programfüzet - Fogorvostudományi Kar - Szegedi Tudományegyetem

34 Lectures
Scott D. Ganz:
Achieving True Prosthetically-Driven Implant Reconstruction and Maximizing
Esthetics Utilizing the Triangle of Bone ® Concept
Replacing missing teeth with an implant supported restoration represents both
a surgical and restorative challenge. Often there can be lack of space between
the roots for standard diameter implants or issues with root convergence, bony
defects / concavities, soft tissue concerns, emergence profile, and sufficient
bone volume and /or density to stabilize an implant. The use of two dimensional
periapical or panoramic imaging fails to provide clinicians with an adequate
appraisal of the existing bone anatomy. Cone Beam CT (CBCT) allows for an
unprecedented visualization of the bone, adjacent roots, and nearby vital
structures which empowers the clinician with new state-of-the-art tools to diagnose
and treatment plan. The goal is to provide true restoratively driven implant dentistry.
The “Triangle of Bone®” (TOB) concept provides clinicians with a decision tree protocol to evaluate implant
receptor sites. Based upon actual patient anatomy the following can be accurately determined using
the TOB: the available volume of bone; the thickness of the facial and lingual cortical plates; the density
of the bone; the presence or absence of concavities; need for bone or soft tissue grafting; the length
and width of an implant; straight or tapered design implant; screw-retained or cementable restoration;
abutment choice; and the appropriate bone grafting modality when required.
The purpose of this presentation will be to aid clinicians in understanding how to achieve successful diagnosis
and management of deficient sites, matching implant types with receptor sites within the framework
of restoratively driven protocols to maximize esthetics and long term success. Once implant locations
have been determined, the options for placement can include freehand, template-assisted, or CT-derived
template-guided with implant specific hardware for precision deliver to the osteotomy.
Objectives:
• Demonstrate methods to assess the available bone volume for implant placement
• Demonstrate a protocol to maximize communication for the desired surgical and restorative result, and
how these decisions are made.
• Abutment Planning Concepts – Prior to Surgery
• Illustrate the impact of the bone receptor and implant simulation on screw-retained vs cementretained
restorations.
• Demonstrate different CT-derived templates to increase accuracy based upon the virtual plan.