AAID covers it all in New Orleans

The meeting offered three days of education on new techniques on a wide variety of subjects. Here is a sampling of the meeting’s topics:

NEW IMPLANT DESIGN

Dr Henry Salama, Dr Maurice Salama and Dr David Garber presented from the perspective that implant-supported restoration must cosmetically equal or surpass that of conventional restorative dentistry.

They outlined the biological, clinical and biomechanical factors that allow clinicians to reduce or eliminate the waiting period to implant loading without sacrificing predictably successful osseointegration.

EMERGENCY MEDICINE

Dr Stanley Malamed presented a dynamic program with high-quality videos and helpful acronyms such as PABCD and MONA. Malamed’s presentation began with a startling video example of what might happen if a patient or family member had a heart attack in the waiting room of an unprepared dentist’s office. The dentist and staff did not have a plan for this type of event, and the victim in this video died.

“It didn’t have to be like this,” Dr Malamed said. “Are you prepared? Is your entire office staff trained for an emergency situation?”

To the musical strains of “Stayin’ Alive,” the University of Southern California professor offered tips and advice. His main point was “your legal obligation is to keep the patient alive,” which means following steps to ensure the patient either gets better or simply remains alive until emergency professionals arrive on the scene.

Acronyms such as PABCD (Positioning; Airway; Breathing; Circulation; Definitive care) and MONA (Morphine; Oxygen; Nitroglycerin ; Aspirin) will help practitioners remember what to focus on during an emergency.

“Remember: Doing nothing means the person is going to die,” he said.

He also recommended that everyone purchase to automated external defibrillators (AEDs) to use in the case of an emergency.

“They’re simple to use, they’re available over-the-counter, you cannot do it wrong,l and you might save a life.”

LASER TREATMENTS

Dr Edward Kusek of Sioux Falls told his AAID colleagues he has employed lasers in most of the surgeries he has performed in the last five years, which include implants and endodontic procedures. He said the lasers use low levels of non-ionizing radiation and actually generate less heat and discomfort than other devices commonly used in dental surgery.

“Erbium and/or diode lasers can accelerate healing in dental surgery and are very effective for detoxifying an area to clear up infection,” Dr Kusek said. “In our practice and in several studies we have conducted, lasers have proven to stimulate better tissue growth and height and also foster stronger bone growth and better contact with the implant. As a result, we have cut the cycle time for most implant procedures from six to three months.”

Dr Kusek added that for most patients, laser detoxification allows immediate placement of the implant and securing a temporary crown in one visit. “Being able to send the patient home in one day with an immediate load implant in the smile zone helps socially because the missing teeth aren’t noticeable,” he said. “Three months later, the permanent crown can be affixed.”

In his presentation, Dr Kusek covered a case of young women whose root canal failed because the root cracked and the area was badly infected. The tooth was extracted and the laser was used to clear up the infection. “Once the socket and surrounding area were detoxified by the laser treatment, the implant was inserted and a temporary crown attached. The patient went home with her smile looking great and the final outcome in three months was excellent,” said Dr Kusek. “Given the degree of infection, she would not have received an immediate-load implant in the same visit without the laser treatment.”

Dr Kusek said about 7 per cent of dentists have some type of lasers in their offices and many are evaluating the cost benefits. “In my experience, nothing matches laser applications for overall implant procedure outcomes in infection management, bone regeneration, osseointegration, tissue-growth enhancement and overall aesthetic success,” he said.

ESTHETIC ZONE

Dr Eric Van Dooren, who maintains a private practice in Belgium, provided a lecture focusing on less invasive procedures that allow for preserving soft-tissue quality.

“It’s all about soft-tissue stability,” Dr Van Dooren said.

He offered surgical and prosthetic concepts for five different cases and explained what sort of intuition he used to determine what techniques to use in each case.

Some techniques Dr Van Dooren discussed included modified socket seal surgery; flapless surgery; both delayed and immediate implant placement; connective tissue grafting with Bio-Oss; and hybrid techniques.

ACCESSIBLE TREATMENT

In a candid address, noted dental researcher, author and lecturer Gordon Christensen, DDS, PhD, urged more dentists to add implants to their practices, but said the procedure must become simpler and less costly to achieve optimal public and professional acceptance.

“I strongly encourage more dentists to add implants to their practices and make this treatment accessible and affordable for their patients,” said Dr Christensen. “The statistics on missing teeth in the U.S are staggering and frankly embarrassing for the dental profession. We can make a major contribution to improving the nation’s oral health by further utilization of dental implants, but we must get serious about reducing the cost of the procedure. Ultimately, costly implant placements don’t serve the public or the profession, even though dental implants are the best treatment available for replacing missing teeth, ” he said.

Impressive advances in technology have made implant procedures safer and more predictable with 95 per cent-plus success rates, Dr Christensen noted.

“However, we need more innovative and simpler implant designs — short, wide, narrow, hollow, non-round — and simpler and more reliable methods for evaluating bone quality, quantity and osseointegration.”