Decision Making in Implant Therapy: Evidence-based protocols

Improving Predictability for Experienced and Novice Clinicians

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Homa H. Zadeh, DDS, PhD
Fereidoun Daftary, DDS, MSD
Shahram Ghanaati, MD, DMD, PhD
Fernando Rojas-Vizcaya, DDS, MS
Kia Karimi, DMD, DDS

Course Description

Osseo-integrated dental implants have over half a century of history. Over this period, a great deal has been learned about dental implants through scientific studies, as well as clinical experience. Survival and success of dental implants has varied anywhere from 60% to 100%. What has differentiated treatment outcomes have been differences in decision-making for material and protocol selection, as well as technical execution. Moreover, multiple studies have demonstrated that the level of experience of the clinician is correlated with negative outcomes. Perhaps the most important determinant of success is “decision making.” When appropriate decisions are made, grounded in best available evidence, a higher degree of predictability is expected. It is most effective that a systematic approach is adopted utilizing a decision tree model, beginning with diagnosis, risk assessment, and thoughtful planning of steps and sequence of therapy. Other important aspects of decision making include material and protocol selection. Awareness of the biologic basis of the processes is also helpful in making better decisions. In view of the fact that despite best efforts complications occur in a proportion of cases, it is important to be prepared to manage those complications.

Educational Objectives:

Diagnosis:

  • 3D imaging: CBCT
  • Scan templates
  • Prosthetic assessment: occlusion, arch form, tooth form
  • Aesthetic assessment
  • Quantitative and qualitative assessment of bone
  • Classification of bone quantity and density
  • Quantitative and qualitative evaluation of soft tissues

Risk Assessment:

  • Systemic and local risk factors and indicators
  • Modifiable and non-modifiable risks

Implant Site Planning:

  • Surgical and prosthetic planning
  • Analogue protocol: diagnostic wax-up
  • Virtual implant planning software utilization
  • Analogue and digital surgical guide

Evidence Based Therapy:

  • Expected outcomes in various situations

Transitioning of Hopeless Teeth to Implants:

  • Biology of extraction socket healing
  • Minimally invasive tooth extraction
  • Immediate implant placement
  • Piezosurgery
  • Ridge preservation socket grafting for delayed implant placement
  • Biology of Ridge preservation socket grafting

Prosthetic Protocols:

  • Cement-retained, screw-retained, screw accessible
  • Abutment selection: stock, ti-base, castable, CAD/CAM
  • Fixed vs. removable prosthetic
  • Prosthetic material selection
  • Digital vs. analogue protocol
  • Provisionalization options
  • Restorative space
  • Lip support

Material Selection:

  • Implant material:
    • Commercially pure titanium (CPT)
    • Titanium alloy
    • Ceramic implants: zirconia
  • Implant macro, micro and nano design
  • Implant diameter: standard, short, ultra-short
  • Implant length: wide, regular, narrow, mini

Loading Protocols:

  • Immediate, early, delayed loading

Implants in Atrophic Sites:

  • Horizontal and vertical alveolar ridge augmentation
  • Implant therapy in posterior maxilla: short implant, crestal and lateral sinus augmentation
  • Implant therapy in posterior mandible: short implant, horizontal and vertical augmentation
  • Implant therapy in anterior maxilla: narrow diameter, horizontal and vertical augmentation

Material Selection:

  • Bone grafts
  • Autogenous bone: sources and harvesting technique
  • Bone substitutes: allogenic, xenogeneic, alloplastic
  • Barrier membranes
  • Platelet rich fibrin (PRF)
    • PRF isolation protocol
    • PRF biology
    • PRF role as biologic response modifier

Peri-implant soft tissue:

  • Significance of peri-implant mucosa
  • Mucosa phenotype modification therapy
  • Soft tissue graft options:
    • Autogenous soft tissue graft
    • Acellular dermal matrix (ADM)
    • Xenogeneic collagen matrix (CM)

Surgery:

  • Flap design in various oral regions
    • Single, multiple, full-arch implants
    • Alveolar ridge augmentation
  • Suturing material and techniques
  • Osteotomy protocol
    • Free-hand
    • Guided surgery
    • Intra-operative navigation
  • Piezosurgery:
    • Bone crest harmonization
    • Sinus augmentation
    • Implant site preparation

Complications:

  • Biologic, inflammatory, infectious, technical, surgical and prosthetic complications
  • Neurosensory deficits
  • Human factors: avoidable errors
  • Prevention and management
    • Diagnosis of peri-implant diseases
    • Treatment of peri-implant diseases

Pre- and post-operative care:

  • Antibiotics and antiseptics
  • Anti-inflammatory agents & Supplements

Peri-implant maintenance therapy

Hands-on Workshop Simulated Exercises

Live Surgery Demo

Tuition

Tuition for each module: $1795 Live In-Person: Lecture + Workshop

Tuition for each module: $1495 Remote Learning: Lecture + Workshop

Tuition for each module: $995 Remote Learning: Lectures Only

Tuition for all 3 modules: $3995 Live In-Person: Lecture + Workshop

Tuition for all 3 modules: $2995 Remote Learning: Lecture + Workshop

Tuition for all 3 modules: $1995 Remote Learning: Lectures Only

Continuing Education

Each module: 16 hours of live lecture + hands-on workshop and live surgery demonstration
Each module: 8 hours of on-demand online education

Educational Format

Each module is designed as a free-standing educational event. Participants may choose individual modules or take all three.

The hybrid education model provides some of the information in online format so that, prior to the first sessions, participants have an opportunity to review the content and gain basic background information

This course offers 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.

This course appropriate for:

  • Both experienced and novice clinicians because the course offers important updates of the most significant decisions that are to be made in implant therapy.
  • Clinicians who exclusively perform surgery, exclusively perform prosthetics, or perform both surgery and prosthetics.
  • Dental clinical assistants who will participate in the delivery of implant care along with the dentist.

The most effective manner to increase the predictability of outcomes is to make decisions that are based on solid scientific and clinical evidence.

Schedule for Live event:

Sat March 6, April 10, May 22, 2021 (PST Los Angeles time)
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 3:00 PM ………. Lecture
3:00 to 3:30 PM ……..…Break
3:30 to 5:00 PM ………. Hands-on Workshop

Schedule for Live event:

Sun March 7, April 11, May 23, 2021 (PST Los Angeles time)
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 3:00 PM ……… Hands-on Workshop
3:00 to 3:30 AM …….…Break
3:30 to 5:00 PM ……… Live Surgery Demo

Presenters

Homa H. Zadeh, DDS, PhD (Course director)
Dr. Zadeh is a diplomate of the American Board of Periodontology and fellow, American Academy of Esthetic Dentistry. He received his Doctor of Dental Surgery from the University of Southern California (USC) Ostrow School of Dentistry. He has also completed advanced clinical education in Periodontology and earned a PhD degree in immunology from the University of Connecticut, Schools of dental medicine and medicine. Dr Zadeh directs the VISTA Institute for Therapeutic Innovations and maintains a private practice limited to periodontology and implant surgery in Southern California.

Fereidoun Daftary, DDS, MSD
Dr. Daftary received his prosthodontics training at Boston University (BU). He has held a position as an assistant professor at New York University (NYU) and was associate professor and chair of the Department of Fixed Prosthodontics at USC from 1982 to 1992. He is a pioneer in the field of implant dentistry and has developed and patented more than 20 devices, which have been utilized in the development of hundreds of products commonly used in implant dentistry. Dr. Daftary engages in private practice limited to prosthodontics in Southern California.

Shahram Ghanaati, MD, DMD, PhD (Remote faculty)
Dr. Ghanaati has triple doctorate degrees in medicine, dentistry and science (MD, DMD, PhD) from Johannes Gutenberg University, Mainz and Johann Wolfgang Goethe University, Frankfurt. Germany. He has a degree of specialist in oral and maxillofacial surgery and is leading the head and neck oncology section at the University Cancer Center, Goethe University. He is an associate professor at the Clinic of Oral, Cranio-Maxillofacial and Plastic Surgery and a faculty member at the Goethe University, Frankfurt. He is the chief senior physician and deputy clinical director. Dr Ghanaati is a spokesperson of the German chapter of Young Scientist Forum of the European Society for Biomaterials, and he has received the Isiah Lew Memorial research award from the American Academy of Implant Dentistry in recognition of his important contribution to research in dental implantology.

Fernando Rojas-Vizcaya, DDS, MS (Remote faculty)
Dr. Rojas is an adjunct assistant professor in the department of prosthodontics at the University of North Carolina. He is the founder and director of the Mediterranean Prosthodontic Institute and BoneModels and maintains a private practice limited to dental implant surgery and prosthodontics in Castellon, Spain. Dr. Rojas received his doctorate in buccal surgery and his University Specialty Degrees in both oral medicine and implant surgery at the University Complutense in Madrid, as well as a certificate in oral surgery at Gregorio Marañon Hospital in Madrid. Dr. Rojas completed his post-graduate specialty degree in prosthodontics along with a Master of Science and a fellowship in oral implantology at the University of North Carolina.

Kia Karimi, DMD, DDS
Dr. Kia Karimi is a faculty member at UCLA School of Dentistry in the postdoctoral restorative program. He received his DMD degree from University of Szeged, Hungary, and DDS from the Colorado School of Dental Medicine. His postgraduate training includes advanced clinical training in restorative dentistry at UCLA School of Dentistry and an advanced prosthodontics residency at USC School of Dentistry. A board eligible prosthodontist, Dr. Karimi’s practice is focused on full-mouth rehabilitations, implants and minimally invasive adhesive dentistry.

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