Complete Post-Extraction Implant Workflow

Complete Post-Extraction Implant Workflow

Category: Periodontology

Instructor(s): Gianluca Paniz, Luca Gobbato, Fabio Mazzocco

Course structure: Lessons: 11 lessons | Duration: 6 hours

Course overview

How could we improve the aesthetic outcome of our post-extraction implant-supported rehabilitations, encompassing extraction, soft and hard tissue management and final crown delivery?

Immediate implant installation in post-extraction sockets presents many clinical advantages, and requires comprehensive view and knowledge of all the treatment steps to be put into action.

For this reason, we created a monothematic video course that focuses specifically on the entire post-extraction implant management workflow, brought to you thanks to 3 experts sharing their knowledge and expertise, gathered through extensive training and teaching experience at the Tufts University in Boston (MA), at the prestigious Harvard University (Boston, MA), at the historic University of Padua and at the University of Barcelona.

At the end of the course you will gain a deeper understanding of:
-the healing mechanism of the alveolar anatomy
-the atraumatic, minimally invasive post-extraction techniques
-implant insertion timing and best practices
-immediate or delayed loading choice rationale
-surgical and instrumental options
-bone-implant gap filling, when and how
-prosthetic-driven soft tissue conditioning
-provisional prosthesis management and delivery
-soft tissue management tips and tricks.

Curriculum

Lesson 1: Post-extraction socket healing: how a deeper understanding of the biological healing process facilitates clinical decision-making

• Biology of the alveolar healing process: what happens after the extraction of the tooth
• Patient and site-specific diagnosis: socket anatomy, what to focus on in CBCT scan and how to detect bone sounding
• Risk factors: periodontitis, peri-apical lesions, systemic factors, site-specific anatomical features
• The protocol for maintaining the alveolar volume during and after extraction

Lesson 2: Diagnosis and identification of key factors: how to identify the correct surgical and prosthetic protocol

• How to perform the clinical and radiographic diagnosis procedures
• The most appropriate clinical conditions to plan and perform post-extraction implant placement
• How to reduce invasiveness and trauma in tooth extraction

Lesson 3: How to surgically manage hard tissue and implant placement if the vestibular bone is preserved after extraction

• The correct guidelines for post-extraction implant placement: axis, position and depth of the implant head
• How to contain the physiological bone contraction with biomaterials and obtain a predictable result over time
• Risks considering if the correct guidelines are not respected and in case of incorrect implant positioning.

Lesson 4: How to surgically manage post-extraction implants with no vestibular bone wall; techniques and biomaterials indicated for alveolar preservation without implant placement

• Treatment procedures when there is a bone deficit at the time of extraction, and criteria that indicate the impossibility to proceed with the immediate insertion of the implant
• Flap design and deficit access
• Alveolar preservation through the use of resorbable membranes and bone substitute
• Membrane choice

Lesson 5: The management of hard tissue in post-extraction sites: how and when to combine alveolar preservation techniques to place the implant even in absence of a vestibular wall

• Criteria to proceed with post-extraction implant installation even in the absence of the vestibular wall
• How to combine implant insertion with socket preservation techniques

Lesson 6: Soft tissue management as a key factor for long-term esthetic success: the learning curve of grafting techniques

• The importance of soft tissue volume increase
• Connective tissue graft harvesting techniques
• How to apply mucogingival surgery techniques to implantology

Lesson 7: Soft tissue management techniques around implants: the role of connective tissue graft in extraction, implant insertion or prosthetic phases

• Why - and when - perform tissue grafting around post-extraction implants
• Timing of insertion of the CTG according to the different clinical situations: immediate implantation or alveolar preservation with or without implant insertion.
• CTG around implants: surgical technique

Lesson 8: When to apply the delayed or immediate prosthetic protocol in single post-extraction implants

• Prosthetic protocol for deferred provisioning on single implants
• Indications and contraindications for deferred provisional prosthesis delivery
• Ovate pontic management of the non-implant-supported provisional
• The creation of the deferred provisional screwed-retained prosthesis and the transfer of information to the final crown

Lesson 9: Advantages and protocols for immediate provisionalization of the post-extraction implant on single teeth

• Immediate provisionalization prosthetic protocol of single implants
• The indications and contraindications for the immediate provisional delivery
• The creation of the immediate screwed-retained provisional prosthesis
• The transfer of information from the provisional to the final crown and the choice of the suitable material

Lesson 10: Surgical management of multiple teeth extractions

• The guidelines for the multiple placement of post-extraction implants: axis, position and depth of the implant head
• The protocol to follow to maintain the volumes of the alveolus during and after alveolar extraction

Lesson 11: Deferred or immediate prosthetic protocol in multiple post-extraction implants

• Immediate provisional prosthetic protocol in multiple implants
• The indications and contraindications for the delayed and immediate provisional in multiple edentulism
• The stage approach protocol and the creation of the immediate provisional screwed onto the implant
• How to transfer the information from the provisional to the final crown and the choice of the most suitable material in the most extensive cases