Universitat Internacional de Catalunya
Clinical Oral Implantology
Other languages of instruction: Catalan, Spanish,
Teaching staff
Dra. Àngels Pujol Garcia (angels@santvidental.com
Dra. Kyrenia Medina Machuca (kyrenia@gmail.com)
Pre-course requirements
DDS in dentistry and students of Master en Periodoncia (UIC)
Knowledge of English language.
Competencies
Majo Competence:
Being competent to cross the fundamentals of Oral Implantology.
Be able to demonstrate knowledge and understanding of the basics of oral implantology as diagnosis, prognosis and different stages of oral implant treatment.
responsibilities:
Students should be able to:
Determining the evolution over the years about the use of dental implants.
Learn basic terminology, met the criteria for success and failure of a dental implant.
Oseointegration describe the stages of healing and bone around dental implants
Set all the structures surrounding the dental implant macroscopically and microscopically.
Described species of microbes that exist around the implants and compared with human teeth.
Learn different implant systems, surface treatment and different implant designs and their relationship to biomechanics.
Learning outcomes
There will be three exams during the academic year for students to develop questions or multiple choice. The note is approved by at least 7 out of 10. If not pass the exam the student has a period of one week to appear again. If the student does not approve the second call, it will be suspended from clinical activity in CUO to pass the exam.
Syllabus
1) Anatomy and characteristics of maxillary bones: features, physiologic and biomechanical differences between maxilla and mandible
- Classification
- Anatomy, physiology, bone healing
- Biomechanics of the bone (how to stimulate bone regeneration)
2) Gingival tissues: the architecture of the periodontal barriers. Tooth morphology and the periodontum surrounding it to understand the limitations when being substituted by an implant
- Clinical description
- Gingival tissue
- Supragingival apparatus (collagen fibers)
i. Blood supply
ii. Sulcus
iii. Long junctional epithelium
iv. Connective tissue and the inflammatory response
d. Periodontal ligament and biomechanical function
e. Alveolar bone
3) Tooth extraction I: anesthesia techniques
- Anatomy of V cranial nerve: ophthalmic nerve, maxillary nerve, mandibular nerve
- Local anesthesia: introduction
i. Types: amino esters and amino amides
ii. Vasoconstrictor
iii. Pharmacologic interactions
iv. Metabolism and excretion
v. Applying local anesthesia
- Instruments
- Pre-anesthesia
- Topical anesthesia
- Infiltration
- Block
- Complications
- Conventional and atraumatic techniques I: biologic, anatomic and esthetic consequences
i. Remodeling post-extractions: anterior and posterior sector
ii. Technique for atraumatic extraction
4) Tooth extraction II: when to extract
- Conventional and atraumatic techniques II
- Bone formation and remodeling, differences between anterior and posterior sector
5) Ridge preservation I
- Soft tissues, use or not of sutures, second intention healing
- Xeno-allografts
6) Ridge preservation II
- Bone grafting: osteoinduction, osteogenesis, osteoconduction
7) Grafts:
- Autogenous bone grafts
i. Endochondral and mesenchymal grafts
ii. Donor sites:
- Intraoral: chin, ramus, tuberosity,
- Extraoral: iliac crest, tibia, calvarian
- Heterogeneours bone grafts
i. Iliac cadaver
ii. DFDBA
iii. Xeno-allografts
iv. Bovines derived
v. Calcium phosphate
- alloplastic grafts
i. Polymers
ii. Bioceramics
iii. Calcium triphosphate
iv. Hydroxyapatite
v. Bioactive crystals
8) Membranes: introduction
- Non resorbable
- Resorbable
- Use in horizontal and vertical defects
9) Growth factors:
- PRP: obtaining and physiology
- PDFG
- PRF
- BMP
- Mechanism of action
- Carries
- Clinical uses: vertical augmentation, periimplantitis, functional load, sinus grafting
10) Types of implants I: implant characteristics, their influence on surgical protocol and indications
- Implant parts
- Implant design: straight, tapered
- Classification: one piece, two piece, platform switch
11) Types of implant II: platform switching, biologic width, consequences in BIC
12) Types of implants III: surfaces
- Macrostructure
- Microstructure
- Chemical treatment
13) Pre-operative study: implant guided by prostheses
- Diagnostic wax up
- Radiological and surgical guide
14) Pre-operative study II:
- Digital x-ray
- Guided surgery
15) Implant surgery I
- Seven essentials
- Surgery preparation
i. Patient dressing and position
ii. Surgeon and auxiliary personnel position
iii. Instruments
16) Implant surgery II: flap design
- Maxilla and mandible totally edentulous patients
- Partially edentulous patients
- Esthetic flap design, design for single implants
- Punch technique
17) Implant surgery III: drilling sequence, basic technique and possible modifications. Second stage
- Drilling and irrigation for tapered and parallel wall implants
- Insertion torque
- Position of interphase
- Placement in two times,. Branemark Protocol
18) Second Stage
- Wound healing. First and second intention healing
- Techniques
19) Periimplant tissues I: soft and hard tissue physiology from implant placement to functional loading
- osseointegration: pre-requisites,
- primary stability, phases: fibroreticular bone and lamellar bone subjected to loading. Bone modeling and remodeling. Histology of osseointegration cortical and spongy bone. Curve of osseointegration
20) Periimplant tissues II: biologic width, soft tissue architecture, the interphase, biologic dimensions, purpose of soft tissue
- Disruption of tissues and bone remodeling after abutment retrieval and functional load
- Maintenance and periimplantitis
21) Atraumatic second stage: gingival remodeling technique
22) Immediate vs delayed loading: benefits for soft and hard tissue
23) Prosthesis I
- Materials
- Impression taking
- Metal casting
24) Prosthesis II: fixed implant prosthesis
- Types: screw retained, cement retained
- Maintenance
i. Instruments, techniques
ii. Prosthesis retrieval,
iii. Timing, recall system
25) Prosthesis III: single unit prosthesis
- Cemented
i. Abutments: ucla, completely castable, prefabricated, temporary
ii. Gold, base metal,
iii. Importance of fit and cement space
iv. Complications when cementing very scalloped tissues, hot to remove cement
- Cement complications and its effect on soft tissues
- Cement implant failures
- Screw retained
i. Screw loosening, soft tissue effects
ii. Types of screw: gold, titanium…
iii. Screw torque and final insertion
26) Prosthesis IV: Screw retained vs. cement retained prosthesis
- Indications and contraindications for each
- Considerations:
i. Esthetics
ii. Make of implant, connection
iii. Occlusion, vertical dimension
iv. Implant position
27) Prosthesis V: Overdentures
- Number of implants
- Implant supported, implant retained,
- Abutment: locators, bars,
- Interaction of different abutments and denture types on soft tissue
- Maintenance
28) Prosthesis VI: biomechanics of implant supported oral prosthesis. Difference in biomechanics of tooth and implant
- Periodontal ligament
- Cross arch stabilization
- Cantilevers
- Crown root ration vs. osseointegrated implant- crown ratio
- Splinting implants and teeth
- Occlusion
29) Prosthesis VII: Cad-Cam
- In clinic or in lab, impression taking
- Zirconia, titanium frameworks
- Fit vs traditional approach
- Abutment selection and prosthesis design
30) Prosthesis IX: immediate loading
- Indications, contraindications
- Surgical technique, placement related to adjacent soft tissue
- Type of implant: tapered or not, surface morphology,
- temporarization
31) Oclusion I: Anatomy. Occlusal Factors. Mandibular movements. Mandibular position. Occlusal adjustment
32) Oclusion II: Bruxism. Occlusal sleeping device, Types, Occlusal adjustment
33) Sinus graft: Indications
- Anatomy
- Techniques and biomaterials
- Complications
34) Pterigoideal Implants
- Anatomy
- Indications
- Technique
- Complications
Teaching and learning activities
In person
For students in second Periodontics the seminar will be taught by Dr. Angela Pujol and Dr. Kyrenia Medina, Department of Periodontology and the official language is Spanish and English.
For students of the third year the seminar consist of the presentation of clinical cases by students with documented diagnosis, prognosis and treatment plan with different treatment options depending on the analyzed literature last year. Will discuss the various treatment options based on the scientific literature.