3D Reconstruction of the Alveolar Ridge


Homa H. Zadeh, DDS, PhD

Course Description

Patients with atrophic alveolar bone have a variety of different presentations, including vertical versus horizontal atrophy, anatomic features such as flat vs. sloped defect walls or concavities, and various bone density (e.g., cortical vs. cancellous bone). Each of these features can affect the efficacy of bone augmentation, either in a favorable or unfavorable manner. The oral location (posterior vs. anterior maxilla, post vs. anterior mandible) requires special considerations. Therefore, the approach utilized needs to thoroughly analyze and classify the site and patient characteristics in order to select an appropriate technique, material and protocol. Another consideration is the potential of complications for the selected protocol and a risk assessment to determine the likelihood of encountering negative outcomes, based on patient features. Three-dimensional reconstruction of the alveolar bone requires several components for successful bone regeneration. The components for 3D reconstruction include 1) bone substitute (allograft or xenograft), 2) osteogenic cells, 3) osteogenic signals (growth factors), 4) blood supply, 5) and wound stabilization. Many controversies remain, including whether a) membranes are really necessary, b) primary closure or open healing concept. The protocol presented for 3D reconstruction of alveolar bone and mucosa will increase the likelihood of successful outcome and reduces the potential for complications.

Educational Objectives

Diagnosis:

  • Classification of alveolar ridge deficienices

Risk Assessment:

  • Patient and site characteristics
  • Management of patient and site risks

Material Selection:

  • Autogenous: methods & location of harvesting
  • Xenograft: effects of sintering temperature
  • Allograft: DFDBA, FDBA, cortical, cancellous
  • Alloplastic: HA, TCP, biphasic HA/TCP
  • Platelet-rich fibrin (PRF):
      Biology
      Protocol
      Applications
      Forms: liquid PRF, solid matrix PRF
  • Membrane selection:
      Resorbable vs. non-resorbable
      -linked vs. native collagen

Evidence-based therapy

  • Evidence on efficacy of GBR and other techniques

Biology

  • Biology of wound healing
  • Biology of osteogenesis
  • Biology of growth factors
  • Integration of various bone graft material
  • Phenotype conversion therapy with VISTA

Flap design:

  • Flap design in posterior maxilla
  • Flap design in posterior mandible
  • Flap design in anterior maxilla
  • Flap design in anterior mandible
  • Achieving tension-free flap
  • Management of failed sites with scarred periosteum
  • Pedicle flap
  • VISTA: vestibular access for bone augmentation

Regenerative techniques:

  • Block grafting
  • Cortical Shell technique
  • Guided bone regeneration (GBR)
  • Tent-pole technique

Suture Material & techniques:

  • Resorbable vs. non-resorbable suture
  • Suture techniques for effective flap adaptation
  • Prevention of graft exposure

 

Graft and membrane stabilization

    • Fixation system:
        MOD

fix

      • /UNI

fix

    • Tenting screws
      Membrane fixation

 

Decortication

  • Protocol and rationale

 

Soft tissue management

  • Timing & staging: before, during or after GBR
  • Material:
      Native xenogeneic collagen (Mucograft)
      Form-stable xenogeneic collagen (FibroGide)
      Connective tissue graft
      Free gingival graft
  • Vestibuloplasty
  • FIVE (Fibrin Immobilization Vestibular Extension)

 

Complications

  • Prevention and management

 

Pre- and postoperative Care:

  • Antibiotics and antiseptics
  • Surgical recovery and support material
  • Analgesics
  • Anti-inflammatory agents
  • Nutritional and herbal supplements

Regardless of mode of participation, online resources are available to supplement live lecture material. This information is accessible on an on-demand basis.

Hands-On Workshop Simulated Exercises

Flap design in
GBR in posterior maxilla
Flap design for lateral window antrostomy
Flap design for crestal osteotomy
Piezosurgery
Platelet-rich fibrin (PRF):
Preparation
Liquid PRF, solid matrix PRF
Membrane fixation
Fixation system:

  • MODfixUNIfix
  • Tenting screws
  • Membrane fixation

Suture techniques to prevent graft exposure
Graft and membrane stabilization
Decortication
Soft tissue management
Vestibuloplasty

Educational Format

This course offers a flexible educational format to accommodate all clinicians’ needs and interests.
Participation may take place either:

  • In-person or remotely (held over Zoom)
  • Live or on-demand
  • Lecture only or lecture plus hands-on workshops

Regardless of mode of participation, online resources are available to supplement live lecture material. This information is accessible on an on-demand basis.

Tuition

$1995 Live in-Person: Lecture + Workshop
$1495 Remote Learning: Lecture + Workshop
$995 Remote Learning: Lectures Only

Tuition for remote workshops includes two-way shipment of all supplies to allow participants to complete the workshops in their own facility. If course materials are not returned within two weeks, $2000 will be charged to the participant.

CE Units

  • 16 hours of live lecture + hands-on workshop and live surgery demonstration

Schedule for Live Sessions (Saturday September 10, 2022)

7:00 to 8:00 AM …….………Registration & Breakfast
8:00 to 10:00 AM ………..… Lecture
10:00 to 10:30 AM …………. Break
10:30 to 12:30 PM …….…… Lecture
12:30 to 1:30 PM …..….…… Lunch
1:30 to 3:30 PM ……….….…Hands-On Workshop
3:30 to 5:00 PM ……….……. Live Surgery Demo

Sunday September 11, 2022

VISTA Provider Certification

Clinicians who complete this course will receive official VISTA certification. VISTA-certified providers will receive a VISTA official certificate and logo and can professionally promote themselves as official VISTA-certified providers.

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