I. 2 days (16 hours)
INTRODUCTION, REVIEW OF DENTAL IMPLANTS, PHYSIOLOGY AND PHARMACOLOGY
Day 1 – 8 hours
*All course material review, introduction of lecturers. Description of course advantages and importance.
*Review of contemporary dental implant systems and use them in clinical practice.
*Transitional or temporary dental implants and indications for their application.
*The advantages of dental implants and basic principles of their function.
*Screw shaped dental implants review: most popular systems, implant surfaces, connections and shapes.
*Definition of osseointegration: anatomical, histological and functional peculiarities. Physiologic processes around dental implant and biologic width concept.
*Indications and contraindications for dental implants.
*Surgical, functional and aesthetic risk evaluation.
*Terminology used in implant dentistry (implant parts, manipulations, processes).
*Short presentation of dental implant procedure and discussion.
*Review of history of dental implantolgy.
*Plate form dental implants − indications and contraindications, principles of functioning; timing of prosthetic treatment and longevity.
*Subperiosteal dental implants − indications and contraindications, principles of functioning; timing of prosthetic treatment and longevity. Materials used in production of those implants, stages of production.
*Retrospective evaluation of mentioned implants function success.
Day 2 – 8 hours
*Applied pharmacology: pain and others conditions control, pharmacokinetics and topical drugs application, premedication, sedation.
*Urgent help (ABC algorithm and medicaments): various conditions (edema Quincke’s, urticaria, asthma, anaphylactic shock) diagnosis, evaluation, and treatment. Treatment and management of critical conditions: diabetes, epilepsy, cardiovascular system (syncope, collapse, myocardial infarction, insult), clinical death.
*Infection control: personnel, operating room and operation zone preoperative preparation; personnel functions during surgical operation; utilization of biologic contaminated materials.
*Economic benefits from implant dentistry in your clinical practice, marketing and possible psychological communication problems with patients. Suggestions concerning possible guarantees and obligations.
II. 2 days (16 hours)
PATIENT EXAMINATION, IMPLANTATION PLANNING
Day 1– 8 hours
* Patient examination: general and local.
* Radiological examination and its interpretation.
* Bone quality and quantity assessment according to Lekholm&Zarb and bone condition influence on the surgical protocol.
* Indications and contraindications for implantation operation (prosthetic, surgical, functional). Specific conditions influence limiting implantation.
* Assessment of the adjacent teeth condition. Pre-implant treatment: oral cavity preparation for implantation operation.
* Influence of periodontal pathology for implantation planning and success.
* Periodontal biotypes.
*Which tooth should be extracted and which should be left and treated? Tactics after tooth extraction.
* Presentation of clinical cases and discussions.
Day 2 – 8 hours
* Implantation techniques: immediate, early, delayed implantation and implantation after GBR and GTR.
* Delayed implantation – save technique is recommended for beginners; its advantages and disadvantages.
* One-stage implantation vs. two-stage implantation. Comparison.
* Flapless technique: advantages and disadvantages.
* Selection of implant diameter and length for immediate implantation (acc. G. Juodžbalys, acc. Salama&Salama).
* Understanding of soft and hard tissue architecture in the implant site; its assessment, effect on late results and overview of possible corrections. The course and terms of implant integration.
* Tooth extraction peculiarities and instruments for immediate implantation.
* Presentation of simple clinical cases and discussions.
* Selection of implant type, shape, position, and number depending on the size of edentulous segment, localization, jawbone density and timing of implant installation and loading.
* Computer planning of implant number, location, and position. Virtual planning of a future prosthesis and prosthesis parts – demo.
* Diagnostic models and case planning presentation (theoretical and practical session).
* Selection of the type of the surgical stent and its practical use.
* Peculiarities of one-piece implants positioning planning.
* Presentation of clinical cases, video materials, and discussions.
III. 2 days (16 hours)
BASICS OF DENTAL IMPLANTOLOGY (PART I)
Day 1 – 8 hours
* Prosthetic treatment on implant techniques and particular indications.
* Prosthesis fixation techniques on screw shaped implants (implant-retained and implant-supported, screwed and cemented).
* Intra-alveolar height influence on the prosthesis structure planning.
* Bone density influence on implantation and prosthesis structure planning.
* Diagnostic interpretation of radiograms.
* Prosthesis construction planning depending on implant number, diameter, and length.
* Materials and biomechanics.
* Prosthetic preparation of oral cavity before implantation operation.
* Materials used for prosthesis preparation.
* Hybrid prostheses.
* Selection of prosthesis abutment.
* Selection principles of prosthetic implant parts (theoretical and practical session).
* Impression taking techniques and impression materials (continuation of the practical session).
* Prosthesis production: direct and indirect techniques.
* Timing of implant loading.
* Temporal prosthesis.
* Mechanical and biological complications; prosthetic’s tactics.
Day 2 – 8 hours
* Introduction to surgical insertion of dental implant.
* Dental implant stability evaluation criteria.
* Presentation of dental implant surgical insertion operation – surgical steps from incision to suturing.
* The surgical instrumentation for a conventional implant procedure.
* Surgical Protocol for insertion of dental implants with or without surgical guide. Demonstration and training on plastic models.
* Demonstration and planning of clinical cases with audience. Work with diagnostic stone casts.
* Presentation and discussions of particular clinical case before operation.
* Surgical dental implant insertion operation – video demonstration.
IV. 2 days (16 hours)
BASICS OF DENTAL IMPLANTOLOGY (PART II)
Day 1 – 8 hours
* Presentation of particular clinical cases before operation.
* Live surgery - demonstration of surgical dental implant insertion in the operating room.
* Discussion.
* Techniques of anesthesia. Post-op medicaments prescription.
* Review of operation materials and instruments (suture materials, needles, surgical instruments, bone traps and others).
* Incisions design and some techniques of local tissue plastic. Work with surgical instruments - manipulations peculiarities.
* Suturing technique. Suturing technique improvement - practical training.
Day 2 – 8 hours
* Simulation of masticatory function, terminology, definitions. Hinge axis and related upper jaw position simulation. Face bow.
* Articulators. Arcon and nonarcon articulators, comparison of construction and possibilities. Usage of face bow, upper jaw model mounting in articulator’s space. Demonstration, practical workshop.
* Central relation. Recording problems.
*Acquiring central relation with Sliding guide, recording. Mounting of lower jaw in articulator’s space according central relation record. Demonstration, practical workshop.
* Lower jaw movements. Regi bite wax plates and eccentric lower jaw positions records. Articulator’s set up according wax bites. Correction of individual values transferring models from arconto nonarcon type of articulator. Demonstration, practical workshop.
* Analysis of occlusion and models. Analysis of maximal intercuspal position and occlusion from central relation. Demonstration, practical workshop.
Attendants have to have their own jaws models representing status praesens situation and will be provided with Artex (CR ir CP) articulators and face bows.
V. 2 days (16 hours)
BASICS OF DENTAL IMPLANTOLOGY (PART III)
Day 1 - 8 hours
* Presentation and discussions of particular clinical cases before operation.
* Live demonstration of dental implant surgical insertion operation in operating room.
*The causes of teeth los in aesthetic zone.
*Alveolar process alteration after tooth extraction.
*Extraction socket soft and hard tissue preservation possibilities after tooth extraction.
*Bone augmentation in aesthetic zone before treatment and simultaneously with implant surgical installation.
*Peculiarities of implantation in aesthetic zone: psychological, aesthetic, surgical and prosthetic.
*Complex case preparation.
*Radiological examination.
*Clinical and laboratory examination.
*Extraction socket classification and treatment algorithms.
*Implantation methods depending on time: immediate, delayed, late implantation.
*Surgical protocol and planning remind.
*Incisions design and manipulations with soft tissues.
*Bone and gingival condition influence on final result.
*Periodontal biotypes and their response to surgical intervention or trauma. Presentation of clinical cases.
*Suture materials and technique.
*Introduction to surgical instruments.
*Dental implant installation into pig jaws, hands on training.
Day 2 – 8 hours
*Optimal implant selection in aesthetic zone.
*Optimal implant position.
*Implant positioning in sites with multiple missing teeth.
*Discussion about clinical cases.
*Selection of proper abutments.
*Temporal crown production and fixation.
*Second surgical stage – soft tissue formation before prosthetic treatment.
*Timing and methods: healing cap fixation, soft tissue formation on temporary crown.
*Incisions design and manipulations.
*Introduction to soft tissue plastic methods designed for periimplant soft tissue correction.
*Crown lengthening operation.
*Gingival recession treatment methods.
*Flapless dental implantation: indications and technique.
*Possible complications and their management in aesthetic zone.
*Aesthetic result evaluation methods.
VI. 2 days (16 hours)
ESSENTIALS BASICS IN PROSTHODONTICS ON IMPLANTS
Day 1 - 8 hours
* Implant design and osseointegration basics.
* Primary stability, shift into osseoinegration. Immediate loading
* Periimplant tissues.
* Impression taking methods according to clinical situation.
* Fixed prosthodontics on implants.
* Restoring molars on implants.
* Restoring cuspids and bicuspids on implants.
* Restoring front teeth on implants.
* Specific issues restoring upper or lower jaw, jaw bone elasticity.
* Specific issues restoring single front tooth.
* Esthetics basics.
* Biological width ant it‘s importance.
* Cantilevers, connection with natural teeth.
* Discussion on patient‘s clinical situation, x-ray, models analysis, possible treatment plans.
* Attendants have to have their patients x-rays (panoramic), models with possibility to evaluate habitual intercupation.
Day 2 - 8 hours
* Owerdentures on implants, indications.
* Upper owerdenture.
* Lower owerdenture.
* Passive fit of supraconstruction.
* Dental implants and bruxism.
* Solutions to diminish effects of bruxism.
* Splints, night guards.
* Impressions and models for splints fabrication management.
* Visiting to dental technician laboratory. Laboratory stages of prosthesis and implant production
* Preparation for work on implants (impression assessment, production of artificial gums, model casting)
* Abutment selection and technician’s attitude towards different abutments. Abutment milling and casting, step localization.
* Production stages of fixed cemented prostheses. Waxing, casting, and adjustment to the abutment. The technical accuracy concept. Frame looseness.
* CAD/CAM technologies in frame production. Milling of zirconium oxide, titanium, chrome-cobalt. Advantages and disadvantages compared to the casting technique.
* Burning ceramics, corrections, glazing.
* Production stages of threaded prostheses. Differences from cemented prostheses.
* Production stages of hybrid prostheses. Differences from metal ceramic prostheses. The role of the dental technician in reduction of mechanical complication incidences.
* Occlusion and form modeling for prostheses over implants.
* Participation of the dental technician in treatment planning and structure selection.
* Removable prostheses over implants. Beams, ball attachments, Locator attachment system.
* Inaccuracies of dentist’s work that hinder to achieve the best results in the lab. A bad position of an implant, non-formed gums, deranged occlusal curves, no teeth placement. Communication with a patient.
* Inaccuracies of dental technician’s work; how to recognize them.
VII. 2 days (16 hours)
GUIDED BONE AND SOFT TISSUES REGENERATION WITH LIVE PRESENTATION
Day 1 - 8 hours
* Bone physiology.
* Topographic anatomy of the jaws.
* Donor sites of autogenous bones. Risk factors.
* Planning of operation: clinical, radiologic and virtual.
* Review of bone plastic materials, growth factors, PRP and PRGF.
* Review of membranes.
* Principles of guided bone regeneration (GBR): matrix formation, stability of transplant, timing of healing, implantation and loading.
* GBR Methods: chips, block, distractors, osteotomes and combinations.
* Preservation of width and height of alveolar ridre after tooth extraction.
* Clinical protocols of horizontal GBR: chips, block, split technique and osteotomes.
* Clinical protocols of vertical GBR: chips, block, osteotomes and distractors.
* Presentation of clinical cases and demonstration of decision tree.
* Discussion.
Day 2 - 8 hours
*Peculiarities of distraction osteogenesis, technique and terms.
* Indications and clinical application of orthodontic extrusion.
* Evaluation and augmentation of post-extraction socket.
* Methods, indications, terms, topographic anatomy of sinuslift operations: Summers’ technique through implant bed with or without bone plastic materials; classic – windows approach. Clinical protocols and instrumentation.
* Practical application of piezosurgery and demonstration of the device’s possibilities.
* Implantation and prosthetic treatment in the augmented bone.
* Principles of guided tissue regeneration (GTR): purpose, donor site, indications, methods, operation technique and instrumentation.
* Creation of fixed mucous membrane around implant.
* Patient introduction and case discussion before operation.
* Live surgery – demonstration of GBR in the operating room.
VIII. 2 days (16 hours)
RISK AND COMPLICATION MANAGEMENT, MANAGEMENT, ASSISTANCE DURING SURGICAL PROCEDURES
Day 1 – 8 hours
* Risk control during surgical treatment planning.
* Risk control during surgical operation and management of critical situations.
* Risk control during prosthetic treatment.
* Patients follow up and dental implant function control.
* Complications (immediate, early and late) identification and management.
* Medicament treatment protocol for prevention and treatment of complications.
* Empirical antimicrobial treatment. Antibioticoprophylaxis. Post op inflammation diagnostics, prevention and management.
* Lecture of psychologist. Principles of communication with patient.
* Lecture of marketing specialist. Selling of implantation service.
Day 2 – 8 hours
* Course participants’ assistance during surgical procedures.
* Discussion about patients informed consent.
* Preparation for the membership examination (examples of all tickets – familiarization with prospective questions).
* A rehearsal examination in writing.
* Questions and answers. Discussion.
IX. June – EXAMINATION (2 hours)
Evening banquette.
