John A. Sorensen, DMD, PhD, FACP

Course Director

2011 PDI Implant Continuum  

At the

2011 Implant Continuum Course Schedule                                                                     9:00am-5:00pm

This continuum is aimed at making the participant comfortable and confident in most aspects of implant prosthodontics.

• Master site assessment, treatment planning & treatment sequencing skills

• Achieve predictable clinical results

• Optimize surgeon- restorative dentist communication

• Create natural esthetics

• Get the entire office staff on board with implant dentistry

Course Objectives

• Establish a protocol & treatment planning sequence to consistently achieve predictable implant placement, prosthodontic restoration & life-like esthetic results.

• Be comfortable with the full gamut of implant dentistry from single tooth to partially edentulous situations to completely edentulous patients.

• Successfully communicate with the implant surgeon to achieve optimal implant placement.

• Have research documented, evidence-based systematic practical approach to all phases of implant dentistry.

• Be comfortable with appropriate component selection, abutment & prosthesis design, materials selection & laboratory communication.

• Techniques & technology for case photo documentation, before & after photos, patient presentation of          treatment plans and internal marketing.

 This program is sponsored in part by unrestricted educational grants from our corporate sponsors.

                                             

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Implant Treatment Planning For Single Tooth & Fixed Partially Edentulous Treatment

Session 1, May 20, 2011

8:00am-5:00pm

Instructor: John A. Sorensen, DMD, PhD

A. Lecture- Prosthetically Driven Implant Placement –
- Understand the osseous & soft-tissues healing process post extraction
- Radiographic evaluation- Intraoral, Panoramic, Cone Beam CT
- Site assessment
- Understand the indications, contraindications, risks and benefits of both soft- and hard- tissue grafting procedures
- Dimensions and anatomic landmarks for fixture placement
- Predictable Peri-Implant Esthetics -> Diagnostic aids for esthetic soft tissue results
- Assess biologic, biomechanical, prosthodontic and esthetic risk factors
- Contraindications to implant placement and high risk of failure situations
- Clinical selection criteria for choice of implant design, shape, length, surface treatment and number of stages needed f or a given clinical situation
- Medical history & medical cautions/contraindications to implant placement
- Treatment planning & sequencing implant treatment
- Diagnostic workup: Clinical, study casts, diagnostic wax-up
- Dentist – Surgeon communication
- Getting the surgeon to place the implants where you need them
- Surgical guide fabrication
- Understanding biologic considerations in timing of implant placement and loading
- Implement selection of single stage vs two-stage vs immediate loading of fixtures

B. Group Treatment Planning Session on Participants’ Patients
- Bring patients’ diagnostic casts, radiographs, charting & photographs

C. Hands-On Exercise - Make radiographic stents for improved treatment planning &
make surgical stents to achieve predictable implant placement

a. Model Mapping for Planning Implant Placement
b. Surgical Guide Fabrication Workshop
c. Digital Photography & Image Management (Bring your camera & computer)
- Clinical Photography
- Digital Image and File Management
- Powerpoint Presentations

Treatment Planning

Session Learning Objectives:

• Understand the biologic dimensions of bone and tooth position that impact the predictably of soft-tissue levels around implants.
• Understand how to properly use periapical, panoramic and Cone Beam CT radiography to predictably diagnose available bone and know the limitations of each of these modalities.
• Understand potential implant site assessment criteria.
• Understand how implant placement should be a prosthetically driven process.
• Know how to perform a diagnostic workup and fabricate a surgical guide for exacting implant placement by the surgical referral.
• Understand how to communicate with an implant surgeon as to the desired treatment plan and implant position
• Be familiar with research documentation on various implant systems’ clinical success rates; immediate, delayed and conventional two-stage placement; and maintenance of bone and soft tissue levels.
• Be familiar with techniques & technology for case photo documentation, before & after photos, patient presentation of treatment plans and internal marketing.

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Implant Provisional Restorations: Lecture & Hands-on Course

Session 2, June 3, 2001

9:00AM-5:00pm

A. Lecture- Implant Provisional Restorations
- Biologic dimensions for optimized osseous & soft-tissue levels
- Ovate pontic concepts
- Fabrication of implant supported bridge provisional restorations
- Provisional restoration design concepts
- From top of implant
- Socket form
- Emergence profile
- Soft-tissue site development with provisional restorations
- Materials selection criteria
- Screw-retained vs. cemented
- Overcoming the challenges of seating prefabricated plastic cap temporary crowns during
cementation
- Systematic methodologies for direct & indirect provisional fabrication
- Using the provisional restoration as a prototype for the definitive restoration
- Cast of provisionals provides 3D model for communicating final restoration design to technician
- Review of research on timing of implant placement and loading with implant provisionals
- Immediate provisionalization concepts and techniques
- Non-functional single tooth provisional
- Functional full arch fixed provisional prosthesis
- Techniques for fabrication of custom impression coping to record soft-tissue contours
- Following healing of soft tissues after implant placement evaluation of need for secondary
grafting considerations & procedures

B. Hands-On Implant Provisional Workshop
a. Fabricate single central screw-retained implant crown
b. Fabricate custom abutment & cemented crown
c. Fabricate abutment supported 6-unit fixed partial denture

C. Group Treatment Planning Session on Participants’ Patients


Includes: Implant analogue model, temporary abutment components, materials, instruments,
Brasseler USA Temporary Adjustment & Polishing Kit.

Implant Provisional Restorations

Session Learning Objectives:

• Understand the biologic dimensions critical to favorable hard and soft tissues.
• Understand soft tissue management in the esthetic zone – maintenance and enhancement of the interdental papilla, ovate pontic design and techniques for natural looking bridges & implant restorations.
• Understand the principles of provisional restoration design to maximize peri-implant soft-tissue levels.
• Know techniques for fabrication of implant provisional restorations.
• Understand the advantages and disadvantages of cemented versus screw-retained implant provisional prostheses.
• Implement techniques for fabrication of direct and indirect implant provisional prostheses.

Implant Uncovering Surgery, Soft Tissue Management, Abutments, Temporization, Impressions

Session 3, September 16, 2011

9:00am-5:00pm

A. Lecture- Uncovering surgery principles & techniques
- Simple biopsy punch technique
- Flap design
- Additional hard tissue grafting
- Second chance to build up soft tissue
- Small flap design
- Large flap design
- Connective tissue grafting
- Use of Diode Lasers for conservative uncovering procedures & tissue contouring
- Decision tree for “abutment & crown” or “screw-retained crown”?
- Selection criteria for prefabricated abutment or custom abutment for provisionals
- Abutment design for provisionals
- Fabrication of temporary restorations
- Materials & system selection criteria
- Design criteria
- Direct fabrication techniques
- Indirect fabrication techniques
- Principles of occlusion for dentate patients
- Principles of stable occlusion
- What reference position to use? – Repeatability & Accuracy
- Character of the intercuspal position & design
- Anterior guidance
- Jaw relations & interocclusal record materials’ considerations
- Occlusion for implant restorations
- Design of occlusal surfaces, width of occlusal table
- Shade selection & communication
- Anterior vs. posterior
- Shade mapping of adjacent teeth
- Opacity-translucency
- Metal-ceramic vs. all-ceramic
- Veneering porcelain: Powdered porcelain buildup, Press-on ceramics
- Clinical procedures for abutment placement
- Impression procedures
- Closed tray impressions
- Fixture level open-tray impression techniques
- Techniques for capturing the shape of the peri-implant socket area
- Increased accuracy impression techniques for implant bridges
- Jaw relation recording techniques

B. Group Treatment Planning Session on Participants’ Patients

Uncovering Procedures, Tissue Management and Impressions


Session Learning Objectives:

• Understand the rationale and techniques for second stage uncovering of the implant.
• Understand the clinical decision process for determining if the implant provisional restorations can be screw-retained or must be cemented.
• Understand the concepts of occlusion for implants and teeth as well as recording jaw relations.
• Understand ceramic shade determination and communication techniques with the dental laboratory.
• Understand the rationale for impression techniques and materials for single tooth implants, bridges, overdentures and full arch bridges.

The Prosthesis Design Process:

Laboratory & Clinical Considerations For Abutments, Crowns, & Bridges

Session 4, October 21,2011

9:00am-5:00pm 

Choosing the right materials for a predictable and successful prosthetic outcome.

A. Lecture
- Cemented vs. screw-retained implant prostheses
- Stock vs. custom abutments – Titanium, cast gold, PFM, zirconia
- Abutment & prosthesis design
- Single crown, fixed partial denture, hybrid FPD, tissue bar overdenture
- Abutment & prosthesis materials selection
- CAD/CAM abutments & frameworks
- Occlusal & parafunctional forces considerations
- Ceramic crown material selection criteria
- Shade selection & communication
- Anterior vs. posterior
- Opacity-translucency
- Metal-ceramic vs. all-ceramic
- Veneering porcelain: Powdered porcelain buildup or Press-on ceramics
- Management of multi-prosthodontic media treatment
- Often have full crown &/or veneer on teeth adjacent to implant
- Design, materials & systems selection
- Design of occlusal surfaces, width of occlusal table
- How to make money doing sophisticated implant prosthodontics
- Dentist – technician communication
- Fixture level impressions allowing maximum flexibility & simplification of design
- Rapid & efficient implant model work
- The Prosthodontic Design Process -> Contours of provisionals, cemented or screw-retained
prosthesis?, abutment selection, abutment design
- Anatomic landmarks for prosthesis design considerations
- Tissue emergence design considerations – esthetics, tissue support & biologically
compatible & sustainable, control of restoration contour
- Control at various levels: Abutment-restoration interface, substructure-ceramic interface,
Crown-abutment interface, transgingival


B. Hands-on Exercise Working With Implant & Abutment Components

C. Dentist – Technician Dialogue

C. Group Treatment Planning Session on Participants’ Patients

D. Patient Procedure Videos

The Prosthesis Design Process: Laboratory & Clinical Considerations


Session Learning Objectives:

• Understand the advantages and disadvantages of cemented versus screw-retained implant prostheses and potential peri-implant tissue complications with cemented prostheses.
• Know the abutment design considerations and selection criteria for implant abutment materials.
• Be familiar with various available CAD/CAM systems for making abutments, crowns and bridges.
• Understand selection criteria for fixed prosthesis substructure and veneering ceramics for clinical predictability in practice.
• Understand some of the pitfalls of porcelain veneering systems for zirconia and metal substructures.
• Selection criteria for the most appropriate ceramic material and cement to match existing teeth.
• Be familiar with the new optical impressioning systems.

Impressions & Delivery of Definitive Prostheses;
Trouble Shooting; Internal Marketing Techniques

Session 5, November 11, 2011

9:00am-5:00pm