Knowledge on the Spotlight

Thursday, 30 September 2021, 14:30-15:30, Room: MC2
KNOWLEDGE ON THE SPOTLIGHT 1: Rehabilitation with Complete Dentures
Argirios PISSIOTIS, Eleni KOTSIOMITI, Vassiliki ANASTASIADOU, Konstantinos MICHALAKIS

Pissiotis Argirios: Complete Denture Function
The successful treatment with complete dentures is associated with a quick and uneventfuladaptation periodthat enables the neuromuscular mechanism to take control of the function with the dentures. Factors that enhance the quick adaptation of the complete dentures and allow for patient satisfaction are: the accurate impression of the denture bearing tissues, and thus the support, retention and stability that is therefore achieved and the stability that the occlusion provides to the removable dentures. The more attention given by the clinician to these items of denture construction the easier the adaptation will be and the faster the neuromuscular control is going to control the function of the complete dentures.

Kotsiomiti Eleni: Exploring the lower limits of the age spectrum: Complete Dentures in children.
Failure of teeth formation  in young children, termed anodontia, is the clinical manifestation of  extensive tooth agenesis, caused by genetic anomalies of the genes involved in tooth mprphogenesis. Complete endentulism in the early years of life constitutes a severe impairment and generates strong needs, not only for immediate alleviation, but also for  long-term control and restoration. It also poses a significant prosthodontic challenge, since it combines the special morphology and small size, the inherent craniosceletal deviations, the sensitive child psychology and  the impaired growth processes. The treatment must be early planned and patient-centered,  designed towards the two main therapy targets, to cover the needs of each growth period and to establish optimum background for the final rehabilitation  A well-structured protocol helps to maintain clear objectives and holistic control through the consecutive stages of the long-term therapy.

Anastassiadou Vassiliki: Essential protocol modifications in constructingcomplete dentures for older adults.
The scientific data highlight the need for complete denture restoration in an increasing number of older patients, whether it is constructing the first pair or its replacement in cases of long-term edentulousness. The clinical protocol should reflect the older patient’s needs, expectations, and the aged substrate response. Therefore, modifications within the entire spectrum of management are essential. A detailed assessment leads from the accurate diagnosis and appropriate treatment plan to (a) the meticulous clinical and laboratory process using either dynamic traditional or modern techniques, (b) the foolproof delivery of dentures and relevant instructions to patient and (c) the individualised maintenance programme for successful long-term prognosis ensuring functionality, comfort and aesthetics.

Michalakis Konstantinos: The complete denture as a blueprint for digitally constructed fixed implant supported restorations
Complete dentures are very often used as provisional restorations during the transition from edentulism to a definitive implant complete fixed prosthesis. Although these complete dentures will be used for a limited period of time, they should be made following the guidelines for properly constructed complete dentures and ensure optimum stability, support, retention, esthetics and function. In this way the provisional complete dentures can serve adequately the patient and be used as a blueprint for the definitive fixed prosthesis that follows.

 

Thursday, 30 September 2021, 15:30-16:30, Room: MC2
KNOWLEDGE ON THE SPOTLIGHT 2: Therapeutic protocols, methodology and techniques for the treatment of peri-implant diseases
Ioannis KAROUSSIS, Spyridon SILVESTROS

 A few years after incorporation of dental implants in clinical practice it was realized that peri-Implant tissues may be subjected to inflammation, which is initially limited to the soft tissues, and often extends to the underlying supporting bone, causing its destruction. Nowadays it is unanimously accepted that the incidence and progression of peri-implant diseases are of great concern to the dental community, due to the high frequency with which they occur and the particularly difficult therapeutic approach, at least for the more advanced cases.

The purpose of this presentation is two-fold. Firstly, to report the methodology followed for the earliest possible therapeutic intervention and to present all the treatment regimens applied today internationally, from the Guided Biofilm Therapy® to the promising EmunDo® treatment which achieves photothermal elimination of pathogenic microbes in peri-implant pockets.

Secondly, in cases of extended peri-implant bone loss treatment protocols include surgical resective or regenerative techniques in order to eliminate peri-implant tissues’ inflammation, to that extent that stops the progress of their damage and to regenerate lost tissues where is feasible.

 

Thursday, 30 September 2021, 16:30-17:30, Room: MC2
KNOWLEDGE ON THE SPOTLIGHT 3: Aesthetic zone implant placement and craniofacial growth: Risks, solutions and decisions
Ioannis FOURMOUSIS, Vasilios CHRONOPOULOS, Angeliki LAMPRINOUDI

The absence of permanent anterior teeth can be a result of dental trauma or congenital aplasia. Treatment plans on replacing missing teeth are based on patients’ development phase, number of missing teeth and general health condition. Dental implants are a common option of prosthetic rehabilitation. However, changes of implant position in relation to adjacent teeth during the life – long craniofacial growth can deteriorate periimplant condition and lead to biological, aesthetic and functional failures.

A series of complicated implant cases with compromised implant restorations will be presented. Discrepancies between teeth and implants in both vertical and horizontal direction created biological and functional problems. Custom made prosthetic reconstructions can be a valuable solution after implant placement. However, conservative prosthodontic resin-bonded fixed dental prostheses can be an alternative treatment option for growing patients. Therefore, the implant placement should be postponed until the patients’ skeletal growth is ceased. But it is ceased?

The aim of this presentation is to describe the craniofacial growth pattern of the aesthetic area and the impact on the existing implant position. Alternative treatment options ensure the right time of placing implants at the anterior maxilla. The patient should be aware of all the risks and possible complications of implant treatment, in order to make a decision.

 

Friday, 1 October 2021, 09:00-10:00, Room: MC2
KNOWLEDGE ON THE SPOTLIGHT 4:  Treatment Options and Solutions on Challenging Oral and Maxillofacial Cases through a Team Approach with the Use of Contemporary Digital Techniques and Materials
Dimitrios STAVROPOULOS, Charalampos APOSTOLIDIS, Christos ASIMOMITIS

Tumors of the maxillofacial region usually require extensive ablative surgical procedures for tumor-free specimen margins. Such resections often create defects with devastating effects on the patient’s function (mastication and deglutition), phonetic ability as well as aesthetic form. The reconstruction of such defects to a satisfactory level for the patient is challenging.

Fortunately, advances in reconstructive surgery and prosthodontics, as well as computer-aided planning, are helping clinicians to both a more aggressive/oncological safer tumor extirpation and a more effective reconstruction.

The absence of vital neuromuscular as well as osseous and dental anatomical structures, the high variability of the healing progress of the resected areas, and the sensitivity and vulnerability of the marginal tissues of the defects are some of the parameters that need to be evaluated in order to choose the optimal treatment options.

The team approach of these patients and the close cooperation between all the involved disciplines, from the pre-surgical planning to the post-surgical rehabilitation, is imperative. In addition, the contemporary development of techniques and materials offers us a variety of new and improved tools that widen the spectrum of our treatment options in these cases that often require from us to stretch the limits of our capabilities to the maximum. The continued progress of osseointegrated implant applications for the retention of prostheses, the use of free vascularized grafts during surgical procedures, and the application of digital technology during the planning, the surgical procedure and the prosthetic restoration phases are allowing us to not only establish an advanced level of communication between disciplines and towards the patient, but also significantly improve the therapeutic options we can develop for the best possible rehabilitation of our patients.

During this session we will present several cases of mainly malignant tumors of the oral cavity and the jaws that were treated by a team-approach: an oral/maxillofacial surgeon, a plastic surgeon and an oral/maxillofacial prosthodontist. All three specialists will discuss and analyze the beneficial effects but also the considerations of all the above mentioned procedures through the presentation of the clinical cases.

 

Saturday, 2 October 2021, 09:00-10:00, Room: MC2
KNOWLEDGE ON THE SPOTLIGHT 5: Is zirconia the material of choice for implant-supported restorations?
Aspasia SARAFIANOU, Meni CHATZINIKOLAOU, Paris RAVANIS

Material selection may influence the clinical outcome of implant-supported prostheses in terms of success, survival rate, and technical and biological complications. The use of implant-supported metal ceramic restorations has been considered the gold standard for many years, exhibiting high prosthesis survival rate. Metal ceramic frameworks may be fabricated using CAD/CAM technology, providing excellent fit to the implant interface, while being more time-  and cost-efficient than traditional cast fabrication. However, the manual veneering process remains time-consuming, while the fracture of the veneering ceramic (“chipping”) is the main technical complication.

With the development of high-strength ceramic materials, zirconia emerged as a viable alternative for implant-supported restorations. This is mainly due to its high biocompatibility, low bacterial surface adhesion, high flexural strength, toughness, faster processing time with CAD-CAM and favorable esthetic properties. Zirconia may be used as a monolithic restoration or as a porcelain-veneered framework. The most usual complication of veneered zirconia frameworks is chipping, due to the dissimilar zirconia- porcelain interface. In order to minimize these complications, monolithic zirconia has been introduced. However, the long-term outcome of these restorations remains unknown, due to the lack of sufficient clinical studies.

There is little evidence on the impact of the restoration material on the success of the implant treatment. Clinician and patient preferences play an important role in the choice of the restoration material. In any case, care should be taken considering the handling properties of the chosen material, the design of the supporting framework and  the veneering material build-up.

 

Saturday, 2 October 2021, 10:00-11:00, Room: MC2
KNOWLEDGE ON THE SPOTLIGHT 6: Digital tips & tricks for enhanced treatment predictability in fixed prosthodontics.
Alexandros MANOLAKIS
Sponsored by Miltiadis Vitsaropoulos – DMG

Precise treatment planning is prerequisite for successful dental rehabilitation. During prosthodontic treatment dentists and dental technicians often face the challenge of implement the diagnostic wax-up into provisional restorations accurately. Even in the phase of manufacturing the final restorations, information regarding teeth position, midline, implant emergence profile, pontic shape or even the occlusal level cannot always be transferred precisely from the provisional restorations. This loss of detail leads to frustration and the need to perform multiple corrections or remake restorations.

Digital implant planning & digital wax-up facilitate a faster and more accurate evaluation of diagnostic parameters and treatment planning procedure. Utilising intraoral scanning and 3D printing enables the exact capture and transfer of information from one treatment step to the next by scanning established emergence profile and pontic shapes as well as performing virtual cross-mounting of different scans. This presentation will demonstrate how CAD/CAM technology can assist in providing quicker and more precise dental treatment in a predictable way.

 

Saturday, 2 October 2021, 11:00-12:00, Room: MC2
KNOWLEDGE ON THE SPOTLIGHT 7: PRF Facial Aesthetics – Cleopatra Technique TM
Cleopatra NACOPOULOS
Sponsored by John Tsaprazis S.A.

In aesthetic medicine, different derma-filler materials are used for superficial and deep soft-tissue augmentation. Natural filling materials include collagen and hyaluronic acid. However, regenerative medicine is towards developing natural concepts without the use of external biomaterials. Micro-needling was introduced as a minimal invasive procedure that is based on natural wound healing concept, which leads to minimum trauma to the skin and induces its regeneration by the production of autologous collagen and elastin. Furthermore, autologous concepts have gained a lot of attention in regenerative medicine recently. Among others Platelet-rich-Fibrin (PRF) is an autologous blood concentrate system that is produced by the centrifugation of the patient’s own peripheral blood without any additional substances, such as anticoagulants. Liquid PRF consists of platelets, leukocytes, growth factors and stem cells. The development of the so-called low speed centrifugation concept (LSCC) allowed the preparation of highly regenerative PRF liquid matrices. The release of cytokines associated to the niche of mesenchymal stem cells activates the regenerative process and angiogenesis for better oxygenation of the skin, in order to convert the undifferentiated cells in to mature cells. This procedure stimulates the fibroblasts to produce collagen and elastin fibers which are imbedded in the fibrin matrix. Moreover, the plasma contains proteins, minerals, vitamins and other nutritional substances, which lead to skin rejuvenation. Cleopatra Technique TM is an innovative treatment, using PRF liquid which is then injected intradermally or applied superficially resulting to skin rejuvenation and augmentation. The procedure is totally autologous and safe and very well accepted by the patients as it is a life-style treatment giving them an improvement in skin texture, firmness,  fine lines and wrinkles with long term results, up to two years.

 

Saturday, 2 October 2021, 12:30-13:30, Room: MC2
KNOWLEDGE ON THE SPOTLIGHT 8: The Digital Implantology era. A paradigm shift or too much too soon?
George  MICHELINAKIS, Dimitrios NIKOLIDAKIS, Dimitrios APOSTOLAKIS

In recent years, the rise of digital technologies such as Cone Beam CT, Surface Scanning, Rapid Prototyping and their implementation into everyday Dentistry, has led Prosthodontics into a new era. Particularly in the field of Implant Prosthodontics, the completion of a restoration following a full digital workflow needless of a physical stone or plastic cast is now feasible. The accessibility of CBCT and its reduced x-ray dose compared to MDCT, the availability of suitable software, the increase in IOS accuracy, the advent of new aesthetic monolithic materials and their improved production methods have enabled dentists to realize an implant fixture placement and restoration workflow that promises shorter and fewer clinical and laboratory steps, increased aesthetics, greater patient acceptance and thus greater overall treatment efficiency. Certain shortcomings and limitations do exist however, which will also be outlined in the course of this lecture, thus assisting the dentist in reaching an informed decision regarding the indications of digital dental technologies in implant therapy.