1^st International

South Asian Society for Oral &
Maxillofacial Implantology
Conference

For the reconstruction of the mandible, a surgical guide was fabricated to aid the repositioning of the mandibular segments in their original locations, and a reconstruction bone plate was provided to support the fibula free flap. Final implant- supported prosthesis was fabricated after the reconstructed mandible.

In all steps of the whole procedures, we used 3D CAD/CAM models and cutting guides.

This presentation will review the evolution of digitally guided implant surgery and its expansion into immediate smiles with same day guided prosthesis. Techniques of traditional guided surgery will be reviewed along with stackable guides with prosthetic incorporation will be elaborated. A comparison with navigated implant surgery will be made to identify cases that will benefit from such digitally supported technology.

Recent innovations in the era of digital dentistry, such as computer-assisted surgical planning and intraoperative navigation, could improve the efficacy, precision, and predictability of surgical treatments of oral tumors, oral cancer resection and oral-maxillofacial reconstruction. Given the developments in high-definition imaging and three-dimensional (3D) printing, the bioengineer and the surgeon can together visualize the tumor on a screen and print a restorative prototype that reflects the individual needs of the patient. The precise location of osteotomy for segmental or marginal mandibulectomy can be determined and translated to the theatre as 3D-printed cutting guides, which greatly improves efficiency and accuracy. In addition, the contour and dimensions of the new defect can be transferred to donor sites, such as the fibula or the iliac crest. Another surgical guide can be used when harvesting and shaping donor tissue for the recipient area. Furthermore, the manufacture of individualized reconstruction plate systems is now possible.

In July 2020, the Japanese National Health Insurance commenced coverage of computer-aided patient-specific mandibular reconstruction plate system for cases with advanced benign and malignant pathologies. We immediately embraced this technology into our oral tumor patients as Japanese new frontier. Here, we would like to present the workflow associated with the resection of aggressive oral cancers and benign oral tumors such as ameloblastoma using the virtually precisely planned cutting guides, and the individualized patient-specific reconstruction plate system with/without vascularized flap reconstructions such as fibula flap/pectoralis major myocutaneous flap for oral-maxillofacial reconstruction. We have applied this innovative novel system for seven advanced oral cancer and oral tumor patients so far.

I am greatly honored and happy to share and discuss with you, SASOMI active surgeons, on “New Frontier in Digital-Computer-Assisted Oral Tumor Resection and Reconstruction”.

Zygoma Implants have become a predictable treatment option for patients with severe maxillary resorption. This also applies to syndromic patients such as Ectodermal Dysplasia.

This presentation will deal with management of such patients and also other challenging situations.

Dentistry has changed leaps and bounds since the advent of high resolution intraoral scanners. Whether one is intending to provide a simple crown and bridge restoration or a complex implant restoration, we can harness the ability of digital tools to provide not only a great restoration clinically, but also have superb patient acceptance. Virtually, we do not need to depend on the dimensional changes of impression material.

In combination with CBCT, one can combine the surface topography and hard bony anatomy which can result in a better restoration with less hassle to the team. In addition, their accuracy is second to none and is operator controlled rather than material controlled. We will look at a few cases to elaborate the above aspects.

Achieving an ideal aesthetic outcome around dental Implants is often challenging. This entails striking a perfect harmony between bone, soft tissues and the implants. The end result depends not only on proper case selection, ideal implant positions, and timing of implant placement, but to a major extent on effectively and predictably managing the bone and soft tissue deficiencies that are often a challenge in day to day clinical practice scenarios.

This presentation will discuss all these important aspects of decision making in single tooth, multiple teeth and full mouth rehabilitation with implants and thus help clinicians to achieve the key to success for optimal end results around dental implants.

Placement of an Implant and the provision of a subsequent implant retained crown is a challenging work for any clinician. Contemporary implantology is prosthetically driven. Therefore, more than often, clinicians will be encountering alveolar bone defects in the most optimal site for the implant placement. When encountered with such defects proper bone grafting techniques should be utilised to gain required bone volume for an implant. Prior planning and calculation is essential to have a detailed knowledge about the required bone volume replacement at the surgical site. CBCT usage along with relevant software in such cases is essential. This will prevent post operative complications and the clinician will be able to achieve excellent esthetic results. Correction of alveolar bone defects prolongs the treatment duration in implants and must be undertaken after proper evaluation of the patient as well as the treatment needs of the patient.

This presentation discusses block bone grafting, as well as particulate bone grafting techniques, in the anterior maxillary region of a patient to obtain optimal esthetic results.

Aim: To evaluate the clinical outcomes and quality of life in patients rehabilitated with dental implant supported fixed prosthesis in free fibula flaps used for the reconstruction of mandibular defects.

Methods: The present study aimed at evaluating the quality of life in 16 patients with benign maxillofacial tumours (10 males and 6 females), who underwent Maxillo-Mandibular reconstruction with free fibula flap and implant (49 in total) supported fixed prosthetic rehabilitation. The mean follow up period was 2 years.

Results: The postoperative evaluation of the patients was favourable. In all 16 patients, fibula flaps provided adequate bone stock for implant placement. Of the 49 implants placed 1 failed to Osseo integrate. All the patients were happy with the aesthetic and functional outcome. All of them reported to have a satisfactory outcome.

The industrial revolution had an enormous impact on global economics and social life. The next big revolution that can be expected to radicalize the global system is the techno-education. Though the teaching-learning systems have been constantly revisited, the actual technology enhancement has been felt during the current COVID 19 pandemic.

The worldwide educational system embraced technology to overcome the restrictions posed by the situation. The surge in transcontinental connectivity made the world a smaller place to live in. This connectivity has erased barriers among the disciplines,

time zones and age groups. Learning now is anytime and anywhere. Professional personnel can now explore new knowledge that may be interdisciplinary or even transdisciplinary. All this from the comfort of home or office with asynchronous timing. Dentistry is no exception.

This lecture is poised to showcase the newer technology applications that will open deeper and self-motivated learning possibilities in dentistry. The focus is on the skill development component of learning that remains a great challenge with technology-enhanced learning. How would this impact the future dental practice…?

Dental implant is a predictable prosthetic treatment option for missing teeth. However, with the development of implant technology, there are also various complications. During surgery, complications are perforations and damage to particular anatomical structures. Postoperative complications are esthetic problems and peri-implant inflammation because of wrong implant position, and even implant failure.

Computer-aided implant surgery, based on CT image data navigation, was introduced into the field of dental surgery to improve the accuracy of implant placement and avoid complication. This contains a static and dynamic navigation. A static navigation is based on the use of a computer-aided manufacturing to surgical template. It is the operator who plans the position of the implants in software and then this direction is replicated in a surgical template. A dynamic navigation is possible to change the position of the implants during surgery because the CT of the patient can be tracked in real time and done free-hand following the position of the drill on a monitor.

We have used the static navigation for over 15 years, however the dynamic guide technique was used for many cases recently. In this time, I present about the effectiveness of these navigation techniques for dental implant placement.

As every other space in our daily lives, technology is taking over our work space also. This paradigm change is happening due to advances in the field of software, Artificial intelligence Augmented reality, Internet of things and each and every new technology that is appearing in the ecosystem. The biggest advantages of the introduction to the innovations include, Better visualisation, better communication, safety and predictability of the procedures, decreased turnaround time, improved accuracies and ability to consistently produce life like restorations with amazing speed and accuracy. These changes have presented a challenge to practicing prosthodontists to stay in sync with these innovation and harness the advantages from these advances.

This lecture will attempt to give an overview of the relevant technologies for everyday restorative dental practice.

This presentation will cover the need for adequate soft tissue requirement around implant and procedures to enhance the soft tissue around implants. The procedures covered include (indications, advantages and applications of) Connective tissue grafts, Free gingival grafts and peddled grafts in various clinical situations.

Socket preservation in immediate implant placements and reconstruction of the lost buccal wall are often the two most challenging scenarios faced by oral implantologists in their routine clinical practice. The use of a revolutionary new double membrane technique helps to achieve excellent open wound healing along with maintenance of the soft tissue architecture and contours.

This presentation will provide a step-by-step guide to treatment protocol using this unique technique and will focus on delivering useful insights into the advantages, indications and contraindications of this technique. This presentation will also showcase a detailed clinical scenario on the predictable and clinically successful treatment outcome obtained by the adoption of this soft tissue preservation technique combined with delivery of digital prosthesis in Implant-based oral rehabilitation of patient requiring guided bone regeneration.

Digital Impressions have not only improved the quality of dental treatment procedures for the dentists but also has brought new level of comfort to the patients as digital impression technique are more comfortable and faster than the current impression techniques. Current digital impression techniques that use intraoral scanners (IOS) can accurately scan oral structures and satisfy the requirements of dental restorations with virtual dental casts. Though a lot is being talked about digital impressions by the dentists but yet many factors that actually affect the quality of digital impressions as different technologies used by different IOS, scanning lights , powdering, scanning strategies (scanning path), accuracy of impression (trueness and precision), partial arch or full arch accuracy, implants scanning strategies, time length and many more, has been ignored.

This discourse will throw the light on the basics of the digital impressions and also touch the latest in digital impressions, which will help to choose the best IOS for different uses and to achieve the best digital Impression. Digital impressions are just a part of CAD-CAM workflow where accuracy check at every level will lead to accurate restorations.

Implant placement in esthetic region is a challenging procedure. Long term studies have demonstrated single or multiple implants have survival and success rates similar to those reported for other segments of the jaws. However, most of these studies do not include well-defined esthetic parameters or criteria of patient satisfaction. Implant in esthetic zone requires comprehensive preoperative examination, treatment planning and precise surgical execution based on a prosthetically driven approach.

This lecture will address when to place immediate implants and when to do early implant placement and the various factors for achieving successful implants in esthetic zone.

Digitalization has not left any part of our lives untouched and dentistry is no exception to it. Digitalization has been the latest trend in various fields of science and technology including implant dentistry. Where precision is of utmost importance in complex implant procedures, traditional impressions and prosthesis may result in inaccuracies prosthetic outcome.

Digital dental workflow has gradually replaced the conventional dental workflow. The integration of technology and dentistry has given mind blowing results. While there are many avenues for adopting digital technology in clinical practice, facilitating dental implant surgical and restorative procedures is an interest of the general dentist and dental specialist. Historically only 2D radiography was included in implant dentistry but now digital technologies are utilized right from diagnosis to impression making and fabrication of the prosthesis.

With the advent of digital technology, there is less distortion, reduced chair side time, improved accuracy of the prosthesis thus leading to increased patient acceptance. Thus this lecture will throw a light on digital solutions in the prosthetic phase to achieve a precise final outcome.