logo 50 | the Camlog Partner Magazine logo 50 | the Camlog Partner Magazine 40 | Events Events | 41 Dr. llaria Franchini gave a lecture on the subject of delayed implant dentistry Dr. Jan Hermann Koch Dentist Finally, the time had come again: on October 14 and 15, 2022, some 1,000 colleagues working in implant dentistry met near Munich to attend a major international congress. Hosted by the Oral Reconstruction Foundation, current evidence-based research on important clinical issues was presented on the one hand. On the other, the congress offered numerous practical details on proven and new clinical methods much to the liking of the participants. The common thread was biological principles and options for treating patients in a minimally invasive and thus tissue-sparing manner. Abutment connection and crown material Studies as well as daily experience have proven: the peri-implant bone level can be stabilized in an epi- or subcrestal implant position with conical connections and Platform Switching [1]. CONELOG® Promote® plus implants with their optimized implant shoulder and clearly defined insertion depth in relation to the bone offer extensively documented advantages here [2]. Add to this the high manufacturing precision of the abutment connection, with a significantly better rotational and very good vertical positioning reliability compared to other leading implant systems, even after repeated assembly [3]. In a recent study involving a total of 310 implants, Dr. Arndt Happe, who is based in Münster, Germany, also demonstrated minimal bone remodeling for CAMLOG® Promote® plus with a Tube-in-Tube® connection. This was significantly lower than for a comparator product [4]. Single crowns and bridges on titanium bases CAD/CAM, in combination with zirconia abutments or abutment crowns were included. According to an in vitro study sponsored by the OR Foundation, hybrid abutment crowns made of lithium disilicate proved to be mechanically more resilient than those made of zirconia (Dr. Joao Pitta, University of Geneva, Switzerland) [5]. Further clinical studies are still required here. Platform Switching and abutment change At the same time, Dr. Happe stressed that deep bone positioning is only suitable for implants with a conical connection and horizontal offset of the abutment (Platform Switching). Here, the implant diameter also influences the emergence profile, which should be designed slender in the apical section in keeping with biological requirements [6-8]. Based on the literature and clinical experience, there was predominant agreement in Munich that the concept is proven and can be recommended when CONELOG® implants are used [9,10]. The question of how often the gingiva former, abutment or temporary abutment crown are changed after implantation is also of biological significance [11-13]. A randomized controlled study presented by Dr. Ana Molina (Complutense University of Madrid, Spain) in the Young Clinicians' Research Forum showed that immediate definitive fixation of the abutment on CONELOG® SCREW-LINE implants results in approximately 50 percent less bone loss than when simply changing the abutment (0.7 vs. 1.4 mm after 12 months, publication in preparation). Thickening and widening soft tissue If the soft tissue is initially to be shaped with temporary components, then CAD/CAM gingiva formers and impression posts made of PEEK from DEDICAM® have proven effective. In combination with intraoperative position determination using an intraoral scanner, a natural emergence profile can thus be achieved in a minimally invasive manner and with little effort (Dr. Claudio Cacaci and Uwe Gehringer, dental technicians, both Munich). This can also be used later on for the final CAD/CAM restoration. Dr. Anette Strunz (Berlin), Prof. Vygandas Rutkunas (Vilnius, Lithuania) and Prof. Benedikt Spies (University of Freiburg) presented the current status of digital workflows including recommendations for 3D planning. To avoid peri-implant bone loss, Dr. Michael Stimmelmayr (Cham) recommends Platform Switching and a soft tissue thickness of 3-4 mm above the implant platform [14]. The thickest possible tissue should be aimed for, particularly if an abutment change cannot be avoided. Furthermore, the attached buccal soft tissue should be 4 mm high. While vestibuloplasties require autogenous mucosal grafts, an acellular dermal matrix can be used successfully for thickening the soft tissue (for example NovoMatrix®) [15, 16]. This eliminates the need for an additional surgical procedure with corresponding stress for the patient [17]. However, according to Prof. Katja Nelson (University of Freiburg), the crucial factor for success is that the matrix is covered as completely as possible. More biological, faster, less invasive » Practical concepts with a broad scientific foundation were presented in Munich at the International Symposium of the Oral Reconstruction Foundation (ORIS). EVENTS PD Dr. Markus Schlee speaks in front of an almost full auditorium at the ORIS in Munich Dr. Peter Randelzhofer addressed the new aspects of soft tissue management PD Dr. Arndt Happe discussed Implant therapy in the esthetic zone – implant position and emergence profile as success factors Prof. Katja Nelson and Prof. Frank Schwarz moderated the eight sessions in a masterly and lively manner
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