Implants - Course Contents

Rational, Evolution & Scope of Oral Implantology

• Aims & objectives of oral rehabilitation using dental implants
• Wolff’s law & its clinical implications in Implantology
• Historical review & evolution of dental implants

Philosophy of contemporary Implant surgery

• Definition of Oral Implantology
• ASA classification & its significance
• Alveolar bone & basal bone
• Occlusal plateau & its significance
• Preprosthetic surgeries
• Absolute contraindications for Implant surgery
• Relative contraindications for Implant surgery
• French volumetric classification of bone (Quantitative)
• Classification of bone based on density by Carl E Misch (Qualitative)
• Osteointegration
• Primary & secondary interferences
• Confidential medical questionnaire
• Tests of primary intention & tests of secondary intention
• Clinical examination
• Medical imaging
• Medicines of interests to implant dentistry
• Life style related factors
• Osteoporosis : primary & secondary
• PRF, PRP, GTR

Treatment planning

• Treatment planning & its objectives
• Oral rehabilitation using Endosseous root form implants with or without bone grafting’s
• Advantages & disadvantages of a single tooth implant
• Factors that influence treatment planning
• Two stage implants , one stage implants , immediate loading implants

Asepsis, Sterilisation & Disinfection

• Define asepsis
• Difference between asepsis & sterilisation
• Cross contamination , nosocomial infections
• Bactericidal & bacteriostatic
• Modalities of sterilisation
• Autoclaving
• Standard international protocol of sterilisation
• Standard international operation theatre protocol

Hands-0n …Asepsis

• Cleaning , packing & sterilisat6ion of instruments
• Arrangement & management of surgical disposables
• Scrub suits for doctors & patients
• International protocol for scrubbing
• How to wear surgical gloves
• How to drape a patient
• Management of trolleys
• How to connect suction & handpiece for implant motor
• How to administer L.A. without hampering asepsis
• Role of operating surgeon, assistant , mentor & circulating nurse
• Brief idea about implant placement under G.A. & Conscious sedation

Dental Implants (TECHINACL SPECIFICATIONS)

• Types of dental implants (Endosseous & Sub-periosteal)
• Implant body & prosthetic abutment
• Design of Endosseous root form implants – Length, diameter ,shape ,surface characteristics
• Crest module considerations & design of apex
• Surgical placement of Implants
• Sub - gingival healing & Trans - gingival healing
• 2nd stage surgery
• Healing abutment/healing screw/gingival former
• Impression coping (Transfer coping & Pick up coping)
• Permanent abutment (Straight , angled , screw retained , cement retained & abutment for attachment)

Diagnostic Cast & Surgical Template

• Surgical stent/surgical guide
• Radiographic stent
• Computer guided implant placement
• Computer assisted design and manufacturing of surgical stent
• Surgical navigation / electronic surgery

Hands-on …Implant Placement in Dummy Mandible

• Introduction to armamentarium of surgical & prosthetic kit
• Introduction to implant motor / physiodispenser
• Introduction to surgical guide
• Osteotomy on dummy mandible with sequential drilling
• Introduction to external or internal irrigation
• Implant placement on dummy mandible
• Placement of cover screw
• Introduction to prosthetic components
• Basic idea of impression procedure in implant dentistry
• Sinus graft procedure
• Suturing

Prosthetic options in Dentistry

• Prosthetic classification (Carl E Misch)
• Kennedy’s classification & Applegate’s modification
• Crown height space
• Effect of bone density on treatment planning
• Key implant position & number
• Short V/S long implants
• Narrow V/S wide implants
• Implant length & diameter selection
• Preimplant prosthodontics

Implant Prosthodontics

• Prosthodontics review of the patient
• FPD Impression V/S Implant Impression
• Hex design of Implant …External Hex & Internal Hex
• Cement retained V/S screw retained restorations
• Implant level screw retained & abutment level screw retained restorations
• An introduction to all prosthetic components
• Sub-gingival & trans-gingival healing
• 2nd stage surgery
• Healing abutment / Healing Screw / Gingival former
• Implant level impression & Abutment level impression
• Closed tray impression & open tray impression
• Transfer coping / Impression coping / Impression post
• Transfer coping & Pick Up Coping
• Impression materials in Implant Prosthodontics
• Impression trays / tray adhesives
• Protective caps
• Incorporation of soft tissue contours around implants
• Convertible abutments
• Single piece abutments & two piece abutments
• CAD - CAM prosthesis
• Precision attachment in Implants
• O – ring / Ball attachment
• Locator attachment
• Hadder bar & Dolder bar
• Single tooth replacement & multiple teeth replacement
• Complete implant supported prosthesis
• Implant supported over dentures …Mandible & Maxilla
• Implant supported fixed prosthesis …Mandible & Maxilla
• Partial edentulous conditions
• Mandibular dynamics
• Maxillary arch implant considerations …Fixed V/S IOD
• Special considerations for posterior edentulous maxilla

2nd Stage Surgery

• Uncovery & management of complications
• Surgical failure
• Osseous healing failure
• Early loading failure
• Intermediate failure
• Late failure
• Criterion for evaluation of success
• Bone loss at 2nd stage surgery
• Rigid fixation determination

Hands-on …Implant Prosthodontics

• Prosthetic review of case
• Mounted articulated study casts
• LIVE demonstration of 2nd stage surgery
• Management of complications at 2nd stage surgery
• Abutment selection
• Temporisation
• Platform switching
• Loading protocol
• Impression techniques
• Implant occlusion
• Lab communication
• Prosthesis insertion
• Establishing occlusion
• Instructions to the patients
• Follow ups

Bone Physiology, Metabolism & Biomechanics (Didactics & One Hands-on & One Live Surgery)

• Functions of bone
• Modelling & Remodelling of bone
• B.M.U. / Cutting filling Cones
• Osteoblasts & Osteoclasts
• Activation
• Sigma??
• Composition of Bone
• Osteoinduction & Osteoconduction
• BONE DENSITY : Effect on surgical approach & Healing

Periosteum

• • What is Periosteum?
• Function , histology & physiology of Periosteum
• Blood supply of Periosteum
• Protective mechanism of Periosteum
• Causes & consequences of periosteal destruction
• Importance of periosteal handling in uneventful healing

Healing

• What is healing?
• Factors that affect healing
• Purpose of healing
• Effect of osseous healing on the behaviour of soft tissue
• Primary healing & definitive healing
• What is One Sigma
• Woven bone
• Lamellar bone
• Ideal conditions for healing
• Principle phases of surgical healing
• Management of post extraction socket
• Healing after fracture
• Necessary conditions required for successful healing after implant surgery
• Necessary conditions required for success of graft

Bone Compaction & Expansion

• What is compaction & expansion of bone?
• Ultimate aim of bone expansion
• Effect of bone expansion on bone density
• What is the meaning of compaction & expansion?
• Scientific basis of compaction & expansion

Hands-on … Soft tissue management & suturing (Animal Cadaver)

• Review of asepsis & gowning
• Basic surgical techniques
  1. Flap design
  2. Incision pattern
  3. Flap retraction
  4. Meticulous handling of Periosteum
  5. Osteotomy preparation
  6. Compaction & expansion of bone
  7. Demonstration of autogenously bone grafting techniques

Hands-on Live Surgery

• Case presentation & treatment planning by participant
• Briefing of surgery
• Review & live demonstration of OT protocol
• Preparation & arrangement of armamentarium
• Patient preparation
• Administration of L.A. without hampering asepsis
• Flap design
• Incision
• Flap retraction
• Sequential osteotomy
• Implant placement
• Placement of cover screw & suturing
• Post-operative instructions
• Debriefing
• Healing without antibiotics

Graft

• Vital bone
• Viable bone
• PRF & PRP
• Grafts
  1. Autograft
  2. Allograft
  3. Xenograft
  4. Isograft
• Standard protocol of tissue bank
• Treated human bone
  1. Lyophilised bone
  2. Demineralised bone
  3. Free dried demineralised bone
  4. Grafton
  5. Irradiated bone
  6. Rocky mountain tissue bank

Clinical biomechanics in implant dentistry

• Force
• Stress
• Movements
  1. Occlusal movement
  2. Apical movement
  3. Facial movement
  4. Lingual movement
  5. Movement against vertical axis
  6. Movement against faciopalatal plane

Immediate Implantation

• What’s immediate implantation
• Possible causes of tooth loss
• Oral conditions required for surgical success
• True immediate implantation – dilemma with infected tooth?
• Alveolar bone destruction
• Primary stability of implant
• Treatment planning
• GTR
• Soft tissue management
• Advantages & disadvantages
• Complications & management
• Key to success

Hands-on Live Advanced surgical procedure

1. Placement of Implant in Cat B bone with bone expansion
2. Immediate implantation
3. Harvesting of Autograft & graft stabilisation using osteosynthetic device
4. Manufacturing and use of PRF
5. Review of implant placement under GA or conscious sedation
6. Implant placement in posterior edentulous maxilla ( SINUS GRAFT)
7. Implant placement in posterior atrophic mandible

Ø Implant supported over dentures

Ø Implant supported full mouth rehabilitation

Salient features

1. 6 months, 6 modules, 12 days.
2. Multiple hands-on & live surgeries.
3. Each participant will be provided comprehensive notes written by mentor covering all surgical & prosthetic aspects of implant dentistry.
4. One year’s complimentary monitoring by mentor.

Unique offer – 1st time in India

If any of the participants submits five complete cases to the mentor with in a time period of one year from the date of initiation of course, he/she will be provided a cash refund of 40,000 INR.

Additional 4,000 INR may be cash refunded to the participant based on performance throughout course and in the written examination at the end of course.

If a participant fails to complete all 5 cases within one year, we still have options for cash refund

1. One case – 7000 INR
2. Two cases – 14000 INR
3. Three cases – 22000 INR
4. Four cases – 30000 INR

Dr Sanjay Chauhan

P.G. Diploma in Implant Dentistry (France)
P.G. Certificate in Endodontics (Pacific Dental College, Udaipur, Rajasthan)
B.D.S. (Govt. Dental College, Goa)
Cell - 9812180000
E-mail - dr09812180000@gmail.com
Website - www.drsanjaychauhan.com