Research Foundation Symposium
The Research Foundation of the AAID provides for over $100,000 in research grants every year. This year, to commemorate the Foundation's achievements in being the forerunner of implant research, this symposium has been created to foster basic science and transnational research that enhances clinical practice.
Thursday, October 4, 2012
8:00 am - 8:30 am
Development and Validation of a New Maxillary Sinus Classification System for Minimally Invasive Surgical Approach
AGD Subject Code: 694
Samuel Lee, DDS
- Associate Fellow, American Academy of Implant Dentistry
- Diplomate, American Board of Oral Implantology/Implant Dentistry
- Private practice, implant and orthodontic dentistry
The traditional guideline for sinus lift depends on initial bone height. >5mm transalveolar and < 5mm lateral window. However, with the aid of CT technology and newer techniques we need new guidelines for sinus bone grafting. In this presentation, Dr. Lee will present various sinus bone grafting techniques and give clinical recommentations of which techniques to use depending on 3D morphology of alveolar bone.
Learning Objectives:
1. Know advantages and disadvantages of each sinus bone grafting technique
2. Know the indications and contraindications for each technique
3. Learn various sinus morphology, abnormality, and pathologies. And, how to deal with them.
8:30 am - 9:00 am
Management of implants for Success Using Stability Measurements at Insertion
AGD Subject Code: 694
Rita K. Han, DDS, MMSc
- Board-eligible prosthodontist
- Specialty certificate in periodontology from the Harvard School of Dental Medicine
- Private practice in implant dentistry, Wellesley Hills, Massachusetts
Paul A. Schnitman, DDS, MSD
- Past President and Honored Fellow, American Academy of Implant Dentistry
- Diplomate and Past President, American Board of Oral Implantology/Implant Dentistry
- Former Chair, Department of Implant Dentistry, Harvard University
Ability to accurately measure implant stability will improve capacity to assess implant prognosis at the time of insertion. Past studies have discussed how to measure implant stability, however, there has been a great controversy over which technique is accurate and reproducible. Three widely accepted methods were used in this research to assess implant stability at the time of insertion: 1) Insertion torque (Ncm), 2) resonance frequency analysis (ISQ) by Osstell®, and 3) Periotest® value (PTV). On the basis of these measures determination was made as to whether to submerge, expose or immediate load. This research will report on 62 implants in 23 patients placed by a guided approach and grouped by treatment for analysis. These implants will be compared with 58 implants in 18 patients treated by the free hand approach. The aim of this research is to asses the correlation among three methods at implant insertion to determine whether they are sufficiently sensitive to predict implant survival at time of placement.
Learning Objectives:
1. Understand the importance of initial implant stability to success
2. Describe techniques that can objectively measure initial implant stability
3. Identify differences between guided and free hand implant placement in terms of initial implant stability
9:00 am - 9:30 am
Comparative Insertion Protocols for Mini Dental Implants (MDIs) and Small-Diameter Implants (SDIs) as Critical Implant Survival Elements
AGD Subject Code: 694
Victor I. Sendax, DDS
- Past President and Honored Fellow, American Academy of Implant Dentistry
- Past President and Diplomate, American Board of Oral Implantology/Implant Dentistry
- Recipient of AAID Gershkoff Memorial Award and AAID Isaih Lew Memorial Award
While there is an ongoing tendency for clinician-lecturers to lump all narrow - width implants (under 3mm), there are in fact, substantive reasons why this can be a fundamental misconception - not only in terms of the width, length and anatomical shape, but even more pertinent, the underlying rationales behind the MDI & SDI insertion protocols that determine if, under controlled scrutiny, they can be realistically considered as immediately functional and predictable long-term support devices, and not merely transitional entities:
- Minimally invasive surgery: typically no-flap, no osteotomy, no suturing: for carefully selected cases
- Trans-epithelial penetration through attached, keratinized gingiva for ongoing periodontal health
- Bicortical Stabilization: cortical crest to apical cortical bone (essentially dense type 1 bone)
- Immediate MDI Osseo-Apposition = Immediate Stabilization = Immediate Loading & Function (no variable waiting period for osseointegration to provide healed/regenerated bone stability)
- Cost-Effective Affordability: Enhanced patient access to essential Implant support for both removable and fixed prosthodontics
Learning Objectives:
1. Formally distinguish between the variables for MDIs and SDIs, so as to enhance their successful outcomes
1:30 pm - 2:00 pm
Atypical Implant Failures and Long-Term Oral Bisphosphonates - More than Osteonecrosis?
AGD Subject Code: 016
Gayathri Subramanian, BDS, PhD, DMD
- Resident Representative, Master Educator’s Guild, New Jersey Dental School
- Completed General Practice Residency, New Jersey Dental School
Concern that long-term bisphosphonate therapy may significantly undermine bone quality in osteoporotic patients has been heightened by rare instances of low-impact atypical femoral fractures that are often bilateral. Reduced fracture toughness is believed to result from reduced bone remodeling leading to increased homogeneity in bone microarchitecture, narrowed bone mineral density distribution and increased bone tissue micro-damage burden. This presentation postulates that these long-term alterations in bone quality may undermine the ongoing remodeling surrounding osteointegrated endosseous dental implants as well. To illustrate the hypothesis, the presentation reports the catastrophic failure of multiple, successfully osteointegrated dental implants in two osteoporotic patients following long-term bisphosphonate treatment. This clinical presentation may reflect underlying adverse changes in bone quality, in a manner analogous to atypical fractures in a small percentage of patients on bisphosphonates. This presentation highlights the need for multi-disciplinary care of patients who have dental implants, and begin or are receiving long-term bisphosphonate therapy.
Learning Objectives:
1. Understand the principles of bone remodeling
2. Review the pharmacological aspects of Oral Bisphonates in the treatment of osteoporosis
3. Illustrate with clinical examples the catastrophic failures or implants associated with oral bisphosphonates
4. Develop a hypothesis that provides an explanation for mandibular implant failures in patients on term oral bisphosphonates
2:00 pm - 2:30 pm
Is Periodontal Disease the Common Denominator in the Spectrum of Chronic Inflammatory Diseases?
AGD Subject Code: 495
William Nordquist, DMD, MS
- Honored Fellow, American Academy of Implant Dentistry
- Diplomate, American Board of Oral Implantology/Implant Dentistry
- Co-Author, The Stealth Killer and The Silent Saboteurs
A completely different understanding of oral infection and its relationship to Chronic Inflammatory Diseases (CID) and immune suppression, including Alzheimer’s disease and atherosclerotic heart disease, will be presented. Convincing evidence theorizes the mechanism involved with CID and a common denominator instigator - oral spirochetes. Oral spirochetal infections when treated with antibiotics force these microbes to hideaway into a protective “spore-like” form within the gingival sulcus, inside the epithelial cells that line the gingival sulcus and in adjacent granulation tissue. Morphologically identical spores were found in the atherosclerotic plaque in blood vessels and in several other tissues in the body. This lecture will change the way you understand and treat periodontal disease. It will aid in the understanding of the relationship between periodontal disease and chronic disease, plus help you prevent tooth loss and implant failure in your patients.
Learning Objectives:
1. Gain a new understanding of periodontal disease and its relationship to chronic inflammatory diseases and immune suppression
2. Learn the similarities of symptoms between periodontal disease and other spirochetal diseases, such as syphilis and Lyme disease
3. Learn the way spirochetes transform to a more protected form in the face of adverse conditions, such as, antibiotic treatment
4. Learn the value of a microscope in diagnosing and treatment planning to eliminate and/or minimize the effects of periodontal disease systemically
2:30 pm - 3:00 pm
Interproximal Papillae Adjacent to Single Implant Crowns in the Esthetic Zone: Clinical and Radiographic Findings from a Multi-Private Practice Based Research Network (PBRN) and Post-Graduate Prosthodontic Residency Programs
AGD Subject Code: 691
Mark H.E. Lin, DDS
- Fellow, American Academy of Implant Dentistry
- Diplomate, American Board of Oral Implantology/Implant Dentistry
- Assistant Professor, faculty of dentistry, discipline of prosthodontics, University of Toronto
- Fellow and examiner, Royal College of Dentists
This study was designed to determine if the following two variables influence the predictability of the presence of the interproximal papilla between a single implant supported crown adjacent to a natural tooth: (a) the vertical measurement from the crest of bone on the natural tooth to the contact point, and (b) the horizontal measurement from the platform of the implant to the adjacent tooth root. Retrospective data from a multi-private based research network (PBRN) and from a graduate teaching institution were analyzed specific to the maxillary anterior aesthetic zones. 116 patients who had 139 dental implants restored for at least 6 months, with mesial and/or distal sites (N=253) were included in the analysis. Assessments of the implant position based on osseous crestal topography were conducted using standardized radiographs which were digitized and interpreted with "Access" software. The gingival papilla morphology was assessed using the Jemt Papillary Index from calibrated digital clinical photographs. Contrary to previously published data, our results indicate that the presence of interproximal papillae is independent of the vertical and horizontal measurements investigated.
Learning Objective:
1. Critical appraisal of existing scientific literature on the topic of interproximal papillae between the anterior natural teeth adjacent to implant restoration
2. Review of current study metholodology as compared to previous studies to improved scientific validation of results
3. Review of current study findings as contrast to previously published studies
4. Clinical relevance and suggested protocol based on results of current study to improve predictability for presence of interproximal papillae between the anterior natural teeth adjacent to the implant restoration