The International Quintessence Symposium of periodontics and implantology 2021

Welcome speech of Alexander Ostrovskiy (Head of the PH «Quintessence» in Moscow, Honorary professor of Moscow Medical Academy)

Welcome speech of the Chairman of the Symposium

Maxillary sinus elevation surgery has evolved during the last 25 years to a point where it is considered the most successful augmentation procedure performed today and the survival rate of implants placed in these grafts is as high or higher than that of implants placed in the non-grafted posterior maxilla. The sinus elevation procedure is still evolving due to the development of new surgical techniques and new biomimetic technologies, however, there is still no unanimous consensus on when to adopt the lateral/crestal approach or alternative treatments like short, transinus and tilted implants. This lecture will address both evidence-based and the latest state-of-the-art techniques.

Innovation and new techniques emerge almost weekly and clinicians are often tempted to experience new trends losing sight of the most important factors in treating patients. Diagnosis, treatment plan, prognosis and minimally-invasive therapeutic alternatives are the fundamentals in treating patients in an ethically and professionally oriented manner. The lecture examines, in the fully edentulous and transitional patients, the treatment process from multiple points of view in an effort to balance the very complex process of making a diagnosis, on the one hand, with the need for simplicity and coherence, on the other.

Aim of the lecture is to analyze the critical factors influencing the bone augmentation procedure outcomes in the posterior mandible and maxilla as well as in the esthetic area. A new method for bone harvesting will be also presented which is based on a computer guided approach improving the predictability of the technique in terms of safety, bone quantity and user friendly. Also the topic of soft tissue management will pointed underlining the critical factors influencing the primary wound healing from flap design, flap passivation and suture protocol points of view.

In the new digital world very, little has been changed for the manipulation of the soft tissues. The planning of implant positioning, the amount of bone grafting and the delivery of the prosthetic work can be done digitally. However, the manipulation of the soft tissue for a for bone or tissue Augmentation have not being influenced. Still planning for guided bone regeneration and the amount of necessary soft tissue manipulation can be visualized Digitally. Still the lecture will focus on the analog execution of incision flap, design and suture in the aesthetic zone and the non-aesthetic zone, from concept to execution of new developments surgical technique for achieving predictable result. In these cases, soft tissue assessment before surgery is key for success.

Why soft tissues are the key point when dealing with esthetics in implant dentistry? What is their biological role? Why pink esthetics, intended as the proper relationship between the implant fixture and the supported crown, is so important for the final outcome of the therapy? The concept of soft-tissue integration is the new challenge in implant dentistry. The knowledge about the dynamics of healing in post-extraction sites recommends to avoid a staged approach with spontaneous healing after tooth extraction. To achieve an optimal result clinicians should consider to preserve the anatomy of the ridge and the soft tissue contour. During this lecture different surgical and prosthetic approaches will be discussed for single tooth and multiple teeth rehabilitations. From immediate implant placement to ridge preservation,the use of connective tissue graft as well as the use of tridimensional collagen matrix, together with the description of a novel volume-stable cross-linked matrix will be assessed. Different sites, different protocols, one goal: predicability.

Contemporary clinicians have focused on the osseointegration of their implants together with their survival rates. But when we evaluate implant placement in the anterior area, esthetics becomes crucial to the success of the final restoration. The pursuing of an optimal soft tissue integration, with perfect pink esthetics may represent an obligation, and this is related to the patients' increasing demand of restorations that are as esthetic as they are functional. Implant-supported restorations to replace teeth in the esthetic area represent a challenge for clinicians, especially in sites with multiple missing teeth and soft tissues defects. The preservation or the creation of an optimal soft tissue contour in order to reproduce the natural architecture of the gingival tissues is always a priority. augmentation procedures are needed when the pre-existing bone height doesn't allow for a correct space-related implant insertion, when a proper primary stability cannot be reached or when the prosthetic rehabilitation will provide an unfavorable crown/root ratio. Once hard tissue has been successfully augmented, an adequate soft tissue thickness becomes mandatory in order to create healthy and stable peri-implant tissues and to improve the final esthetic outcome
Contemporary clinicians have focused on the osseointegration of their implants together with their survival rates. But when we evaluate implant placement in the anterior area, esthetics becomes crucial to the success of the final restoration. The pursuing of an optimal soft tissue integration, with perfect pink esthetics may represent an obligation, and this is related to the patients' increasing demand of restorations that are as esthetic as they are functional. Implant-supported restorations to replace teeth in the esthetic area represent a challenge for clinicians, especially in sites with multiple missing teeth and soft tissues defects. The preservation or the creation of an optimal soft tissue contour in order to reproduce the natural architecture of the gingival tissues is always a priority. augmentation procedures are needed when the pre-existing bone height doesn't allow for a correct space-related implant insertion, when a proper primary stability cannot be reached or when the prosthetic rehabilitation will provide an unfavorable crown/root ratio. Once hard tissue has been successfully augmented, an adequate soft tissue thickness becomes mandatory in order to create healthy and stable peri-implant tissues and to improve the final esthetic outcome

Nowadays rehabilitation of total edentulous patients is a growing demand that dentistry is facing. Transition from failing dentition to total implant-supported prosthesis, patients demanding immediate solutions and managing compromised patients are common problems that general practitioners have to solve in everyday clinical activity. Furthermore fast and simple handling of immediate function, esthetic and natural final result are mandatory requirements in dentistry when facing patients in need of a total rehabilitation. During the lecture will be shown how is possible to immediately rehabilitate patients with functional and esthetic result thanks to the use of tilted implants.

Nowadays rehabilitation of total edentulous patients is a growing demand that dentistry is facing. Transition from failing dentition to total implant-supported prosthesis, patients demanding immediate solutions and managing compromised patients are common problems that general practitioners have to solve in everyday clinical activity. Furthermore fast and simple handling of immediate function, esthetic and natural final result are mandatory requirements in dentistry when facing patients in need of a total rehabilitation. During the lecture will be shown how is possible to immediately rehabilitate patients with functional and esthetic result thanks to the use of tilted implants.