Saturday, April 9, 2016
The concept of replacing a full arch of teeth with an implant supported fixed detachable restoration has become a popular patient request. Since the introduction of the "All-on-Four” surgical and restorative protocol, there have been many modifications presented in the literature to accomplish replacement of a full arch of teeth with a fixed detachable implant-retained prosthesis utilizing anywhere from 4 to 6 or 8 dental implants per arch. My restorative colleagues and I have gained experience in restoring a full arch with the implant- retained fixed detachable prosthesis over the past 10 years due to loss of the dentition related to blast injuries from the wars in Iraq and Afghanistan, as well as from tooth loss from other sources of trauma, caries and periodontal disease.Many patients are just not tolerant of a removable prosthesis due to negative effects related to their speech, taste or instability and poor retention of the prosthesis, and desire a fixed option. The fixed detachable prosthesis in many instances provides the treatment option patients request, and resolves their complaints of an ill-fitting and unstable prosthesis. This treatment option may be the solution for the hopeless or mutilated dentition, with an opportunity for improved speech, esthetics, function and taste in patients who desire a fixed option. This presentation will discuss the treatment planning, work-up, surgical procedures and the prosthodontic considerations and steps involved in delivering the "teeth in a day” concept through the direct approach. This presentation will focus on evidence-based outcomes reported in the literature as well as survival and success rates reported by the presenter.
Immediate Molar Implant Replacement
Molar extraction due to fractures, caries or periodontal disease is unfortunately not an uncommon presentation for the restorative dentist or the endodontist. Traditionally these non-restorable teeth have been extracted and allowed to heal or the sockets augmented with a ridge preservation bone graft for future implant placement. Another option was to attempt to place a traditional size implant into the inter-septal bone with an attempt to achieve primary stability. This is frequently an unpredictable procedure with implants placed in less than ideal positions for the restoration or with implants being placed too deep or too shallow.
There are now molar sized implants (7-9mm in diameter) that are designed to be placed at the time of molar extraction that will occupy most of the socket and achieve a very high degree of primary stability and will allow for ideal emergence profile for the restoration. This presentation will discuss the advantages and disadvantages of immediate molar implant replacement and a technique that can provide a predictable outcome with a high degree of patient satisfaction. The surgical protocol regarding the molar extraction and immediate implant placement will be discussed in detail and examples of various molar relationships to the nerve and sinus will be reviewed utilizing clinical cases. The results of our evidence-based clinical study on immediate molar replacement implants will be disclosed and will serve as the basis for the success of this technique.
Law School 101 – Legal Lessons for Protecting Your Practice
Mr. John Murphy, Esq is a founding member of Walker, Murphy & Nelson, LLP, a civil litigation law firm representing dentists, among other health care providers, throughout Maryland and the District of Columbia. Mr. Murphy’s practice areas include, but are not limited to, defending health care providers in professional malpractice claims, contract disputes, and disciplinary Board actions. His presentation will focus on legal considerations dentists need to be aware of when practicing in the State of Maryland and range from legal obligations that are involved in creating / joining a dental practice, to their rights and responsibilities to patients when faced with a lawsuit or disciplinary action.