Management of Atrophic Posterior Maxilla:

Guided Bone Regeneration vs Sinus Augmentation

 
Homa H. Zadeh, DDS, PhD
Stephen S Wallace, DDS
Pascal Valentini, DDS

Educational Format

This course offers flexible educational format to accommodate all clinicians.
All participants will have access to all online course resources, which can be accessed on-demand, including:

  • Lectures on background, scientific evidence and clinical case management
  • Clinical videos demonstrating surgical and prosthetic protocols
  • References: PDF files of publications and manuals
  • Material list

Live In-Person Education: Lectures and Hands-On Workshop

We have taken extraordinary measures to ensure the safety of all participants:

  • Attendance is strictly limited to allow physical distancing
  • “Surgically Clean Air” filtration system available
  • Masks will be required at all times
  • No food or beverage consumption will be allowed within the institute
  • All breaks will take place outside

Remote Live Synchronous Education: Lectures and Hands-On Workshop

Participants will have access to all online educational resources and will participate in all live sessions. Recordings of live lectures will be made available for later reference.

All instruments and workshop material will be shipped to participants to allow completion of all simulated exercises at participants’ homes or offices. The workshops can be completed synchronously during live sessions, where live feedback can be requested from the instructor. Alternatively, recordings can be watched on-demand for completion or repeat of workshop exercises.

Remote Live Synchronous Education: Lecture Only

Participants will have access to all didactic educational material, including live participation in lectures, live surgeries, and watching the hands-on exercises. Recordings of live lectures will be made available for later reference.

Remote Asynchronous Education: Lectures and Hands-On Workshop

Participants will have access to all online educational material and can access the material as on-demand basis.

All instruments and workshop material will be shipped to participants to allow completion of all simulated exercises at participants’ home or office.

Remote Live Asynchronous Education: Lecture Only

Participants will have access to all online educational material and can access the material (lectures, live surgeries and watching the hand-on exercises) as on-demand basis.

Tuition

$1995 Live In-Person: Lecture + Workshop

$1495 Remote Learning: Lecture + Workshop

$995 Remote Learning: Lectures Only

  • 4 hours of on-demand online education
  • 16 hours of live lecture + hands-on workshop and live surgery demonstration
  • Live event: Saturday to Sunday Dec 12-13, 2020

Course Description

The atrophic posterior maxilla has unique anatomic and structural features, including proximity to the maxillary sinus and low-density bone. The atrophic ridge can either be managed through regenerative or non-regenerative approaches. Sinus augmentation and alveolar ridge augmentation are examples of regenerative therapies. Several factors have to be considered in order to decide whether sinus or ridge augmentation or both should be employed for optimal bone volume and contour. These include: 1) full vs partially-edentulous patient, 2) position of the edentulous alveolar crest relative to the bone level on adjacent teeth, and 3) esthetic requirement. Flap management in the posterior maxilla requires specific considerations and provides unique opportunities to protect the graft and at some point, to augment the mucosa and extend the vestibule. Implant therapy in this region may also be managed through non-regenerative approaches, such as application of short or tilted implants. This course provides a comprehensive approach for managing patients with atrophic posterior maxilla.

Educational Objectives:

Classification of alveolar ridge deficiencies
Risk Assessment:

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

Material Selection:

  • Autogenous: methods & location of harvesting
  • Xenograft: is sintering temperature important?
  • Alloplast: HA, TCP, biphasic
  • Allograft (Processing)
  • Platelet Rich Fibrin (PRF):
    • Biology
    • Protocol
    • Applications
    • Forms: liquid PRF, solid matrix PRF
  • Membrane Selection:
    • Resorbable vs non-resorbable
    • Cross-linked vs native collagen
  • Fixation system:
    • MODfix/UNIfix
    • Tenting screws
    • Membrane fixation

Antrostomy:

  • Lateral sinus augmentation
  • Antrostomy design:
    • Instrumentation and devices
    • Piezosurgery
    • Rotary instruments
  • Transcrestal sinus augmentation

Technique and instrumentation
Flap design:

  • Flap design for GBR and sinus augmentation
  • Achieving tension-free flap
  • Management of failed sites with scarred periosteum

Suture material & techniques:

  • Prevention of graft exposure

Graft and membrane stabilization
Decortication
Soft tissue management:

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

    Complications:

    • Prevention and management

    Pre- and post-operative care:

    • Antibiotics and antiseptics
    • Analgesics
    • Anti-inflammatory agents
    • Nutritional and herbal supplements

    Simulated Hands-on Workshop:

    • Flap design:
      • 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
    • Lateral vs transcrestal sinus augmentation
    • Sinus antrostomy design
    • Suture techniques: to prevent graft exposure
    • Graft and membrane stabilization
    • Decortication
    • Soft tissue management
    • Vestibuloplasty

    Live Surgery Demonstration:

    • Lateral window sinus augmentation
    • GBR: posterior maxilla
    • Platelet Rich Fibrin (PRF):
      • Preparation
      • Liquid PRF, solid matrix PRF

    Schedule for Live Synchronous Participation

    Saturday December 12, 2020
    7:00 to 8:00 AM ………………….. Registration and Breakfast
    8:00 to 10:00 AM ………………….. Homa Zadeh Lecture
    10:00 to 10:30 AM …………..…….. Break
    10:30 to 12:30 PM ……………….. Homa Zadeh 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: GBR

    Sunday December 13, 2020
    7:00 to 8:00 AM ………………….. Breakfast
    8:00 to 10:00 AM ………………….. Stephen Wallace Lecture
    10:00 to 10:30 AM …………..…….. Break
    10:30 to 12:30 PM ……………….. Hands-on workshop: Sinus augmentation
    12:30 to 1:30 PM …………… Lunch
    1:30 to 3:30 PM …………………. Live Surgery: Lateral window Sinus augmentation
    3:30 to 5:00 PM …………………. Pascal Valentini Lecture

    Class Brochure