Dental CE Course: November 2008 Seminar: The Ernest J Muszynski Memorial Lecture

The predictability of osseo-intregation coupled with the ability of implant supported restorations to cosmetically equal that of conventional crown and bridge has made implants a viable treatment choice even in the demanding partially edentulous environment. However, to be a practical choice in day to day practice, the focus must move towards expediting the process with simplification and predictability. Fortunately, evolving 3D cone imaging and computer technologies, innovative products and new techniques allow for ever-increasing efficiencies.
Preservation of the extraction site is a clinical key in expediting the process and updated and creative techniques for tooth removal allow for maximal preservation of the ridge anatomy.
Definitive and prognostic diagnostic guidelines allow today's practitioner to effectively forecast the esthetic outcome based on a specific classification of the potential implant sites.A remaining issue in implant esthetics remains augmentation and the creation of an "esthetic framework" in the previously compromised soft tissue "restorative site." The three-dimensional reconstruction of the alveolar ridge comprises two deliberate aspects:
1) development of the hard tissue, and
2) reconstruction of the soft tissue.
Today, surgical plastic "layering" techniques include soft tissue enhancement, bone regeneration, bioactive modifiers and a plethora of osseous graft materials which can be combined with orthodontic tooth movement to effectively establish an optimal foundation for the functional and esthetic implant restoration.