Talk Title:Update on Growth Factors in Oral and Maxillofacial Surgery
Bone augmentation is an extremely common procedure in implant dentistry, where a large number of implant procedures require some form of grafting. With the advent and FDA approval of multiple sources of growth factors, clinicians and patients are requesting and utilizing growth factors in daily practice. Although singular recombinant (rhBMP-2 or rhPDGF-BB) or combined (platelet concentrates) growth factor products are available, do they predictably enhance quality and quantity of bone and soft tissue? Current literature has identified limitations for use of growth factors including cost, consistent and predictable techniques and preparation, long-term studies, and on-label vs. off-label use. This lecture will focus on the state-of-the art and science regarding growth factors for implant dentistry.
Dr. Tara Aghaloo is Professor in Oral and Maxillofacial Surgery at the UCLA School of Dentistry. She completed her dental training at the University of Missouri in Kansas City, and Oral and Maxillofacial Surgery residency and MD at UCLA. Subsequently, she completed a PhD in oral biology at UCLA.
She is a diplomate of the American Board of Oral and Maxillofacial Surgery. Her clinical practice focuses on bone and soft tissue regeneration for dental implants. She is also active in professional organizations where she is a board member of the Academy of Osseointegration, member of the Osteo Science Foundation Scientific Review Committee, fellow of the ITI, member of the AAOMS CRPTA and Research Committees, and section editor of IJOMI. She lectures nationally and internationally on dental implant surgery and tissue regeneration, including alveolar ridge augmentation, sinus grafting, growth factors, full archrehabilitation, and peri-implantitis.
Talk Title: Treatment of the Edentulous and Terminal Dentition Maxilla with Bone Grafts and Implants.
The presentation will review clinical evaluation, Radiological evaluation and comprehensive treatment planning.
Implant configurations that favor graft or native bone maintenance will be discussed in conjunction with prosthetic principles. The concept of guided implant and guide indexed prosthesis placement to gain accuracy and efficiency will be introduced. Objectives will include methods of Maxillary grafting or enhancement that prepare the Maxilla for a removable or fixed prosthesis. Grafting methods will be correlated with prosthetic options that achieve masticatory efficiency, and esthetic restoration.
Dr. Spagnoli is author of over 30 articles and book chapters. He has served as section editor of the Cleft Palate-Craniofacial Journal and AAOMFS Knowledge Update. In 2005 and 2006, he co-authored two award-winning papers published in the Journal of Periodontalology and the Journal of Oral and Maxillofacial Surgery. His most recent article, "Dental Implants and the Use of rhBMP-2," which appeared in the May 2011 issue of Oral and Maxillofacial Surgery Clinics of North America, was reprinted in Dental Clinics of North America that same year. His research, numerous lectures, and continuing education courses are focused on temporomandibular joint disorders and surger, tissue engineering, and preprosthetic surgery. Dr. Spagnoli, who was formerly the Chair at LSU-New Orleans, is now in private practice in North Carolina.
Talk Title: Demystifying the Options for the Compromised Maxilla with a Fixed Prosthesis.
In the maxilla, the volumetric loss of bone & soft tissues, enlarged maxillary sinuses, and presence of remaining compromised dentition pose unique surgical and restorative treatment challenges.
The successful fabrication & delivery of fixed implant supported prosthesis is dependent upon a systematic interplay between the surgical and prosthetic treatment planning objectives.
A paradigm shift has taken place as the graftless surgical approach has gained credibility. Reduced treatment time, a single stage surgical reconstructions and immediate loading has resulted in a higher degree of case acceptance.
Grafting procedures to replace the loss of bone and soft tissue are still viable options when the desired final restoration is a fixed prosthesis without pink porcelain. However, the prolonged treatment period with multiple staged procedures carries inherent risks and has to be analyzed carefully in advance and communicated to the patient.
Dr. Edmond Bedrossian graduated from the University of San Francisco in 1981. He completed his training in 1986 at the University of The Pacific, School of Dentistry and completed a four-year Oral & Maxillofacial Residency training program at the Alameda Medical Center. In addition to private practice, Dr. Bedrossian is the Director of the Surgical Implant training program for both the Oral and Maxillofacial (OMFS) residents at Highland Hospital, Alameda Medical Center and the undergraduate DDS/IDS students at the University of the Pacific Arthur A. Dugoni School of Dentistry.
Since he began teaching in 1990, Dr. Bedrossian has taught in multiple venues and to different levels of students from undergraduates to surgical residents. He conducts a weekly treatment planning conference at both locations. He has also directed the implant program for the AEGD residents. Since 2012, he has offered an annual selective course, “Fundamentals for Understanding Implant Treatment Planning and Techniques”, to the DDS/IDS students in San Francisco.
Dr. Bedrossian is recognized as an expert in the field of dental implants and has given numerous presentations on the subject both nationally and internationally between 2004 and the present. He has also led several long-running study clubs related to this topic. In addition, he has lectured internationally with Professor Brånemark on various topics, specially the rehabilitation of patients with maxillofacial defects.
Dr. Bedrossian is a Diplomate of the American Board of Oral & Maxillofacial Surgeons and a Fellow of the American College of Oral & Maxillofacial Surgeons. Dr. Bedrossian is on the Editorial Board of The International Journal of Oral and Maxillofacial Implants, The Journal of California Dental Association, as well as Clinical Implant Dentistry and Related Research.
Dr. Bedrossian has obtained fellowships in the following organizations: American Dental Association, the American Association of Oral & Maxillofacial Surgeons (1995), American College of Dentists(1993), International College of Oral and Maxillofacial Surgeons (1995), the Academy of Osseoinegration (2011) as well as the distinguished Pierre Fauchard Academy (1989).
Talk Title: Injectable, compression-resistant polymer/ceramic composite bone grafts for ridge augmentation
Mandibular bone defects can lead to significant morbidity if not properly repaired. Current surgical techniques to increase bone volume at deficient defect sites prior to dental implant placement include the use of autografts, distraction osteogenesis, and guided bone regeneration. The local placement of bone grafts augmented with growth factors is a promising treatment option for enhancing the alveolar ridge in patients preceding dental implant surgery. However, these common delivery systems rely upon the principle of guided bone regeneration and require space-maintaining protective polymeric or metal mesh to direct the growth of new bone. We have designed compression-resistant bone grafts augmented with recombinant human morphogenetic protein-2 (rhBMP-2) that promote lateral ridge augmentation without the use of protective mesh. Compression-resistant bone grafts were evaluated in canine models of vertical and lateral ridge augmentation. Ridge height and width and new bone formation were assessed by mCT, histology, and histomorphometry at 16 weeks. Ridge height and width increased in a dose-responsive manner with increasing rhBMP-2 concentration. Ridge height and width measured for compression-resistant grafts without the use of protective mesh was comparable to that measured for the absorbable collagen sponge carrier with protective mesh (clinical control). Thus, at the same dose of rhBMP-2, an injectable, compression-resistant bone graft resulted in an equivalent volume of new bone formation compared to the clinical control. These findings highlight the potential of compression-resistant bone grafts for ridge augmentation.
Title Talk: Grafting ablative defects—Which technique should I use?
Defects requiring reconstruction in the facial region can present challenges. Various techniques including various graft materials are available. Determining the type of missing tissue as well as the size of the defect are important for treatment planning. New technologies such as virtual surgical planning and navigation have improved reconstructive options.
Alan S. Herford, DDS, MD, is the Chairman of the department of Oral and Maxillofacial Surgery residency program at Loma Linda University School of Dentistry. Dr. Herford is a graduate of Loma Linda University School of Dentistry. His medical degree is from the University of Texas Southwestern Medical School in Dallas. Dr. Herford completed his training in Oral and Maxillofacial Surgery at Parkland Memorial Hospital at the University of Texas Medical Center in Dallas. In 2008 Dr Herford was named the Philip Boyne & Peter Geistlich Endowed Professor in OMFS.
Dr. Herford is actively involved in research. He has multiple publications and has presented his original research at both national and international meetings. He was recently awarded the Laskin Award which is given to the authors of the most outstanding article published in the Journal of Oral and Maxillofacial Surgery for that year. Dr Herford is the primary author on numerous peer-reviewed scientific publications on topics ranging from reconstructing skin cancer defects to the use of growth factors to rebuild jaw defects. He has recently authored book chapters on treatment of mandibular fractures, facial flaps, and treatment of soft tissue injuries. His clinical interests are reconstructive surgery and maxillofacial trauma. He is excited about being one of the founding members of Osteo Science Foundation.
Talk Title: Grafting the esthetic zone for implants
Speaker Abstract (1):
Numerous details are indispensable to achieve an excellent esthetic result in Implant Dentistry. Among them is the increasing need for bone and soft tissue augmentation in the esthetic area, in both vertical and horizontal aspects. However, these grafts can be applied at different moments of the treatment, according to the clinical situation. Immediate or delayed implant placement, socket preservation procedures and staged grafts and implant placement are the possible choices to rehabilitate the esthetic zone.
Talk Title: Graftless options post maxilla/mandible (short implants)
Speaker Abstract (2):
Several surgical techniques are employed to vertically reconstruct atrophic alveolar bone. However, these ancillary techniques have higher morbidity and are technique sensitive, prone to more complications with less experienced surgeons. The use of short implants is an alternative to adequately restore partially edentulous patients, and its use has grown exponentially on the last years due to great improvements on materials and techniques. Recently, ultra-short implants have been introduced, showing promising results for the rehabilitation of patients with severely resorbed alveolar ridges.
Talk Title: Grafting the posterior mandible/maxilla to facilitate implant placement
Clinicians reconstructing patients with dental implants are often faced with inadequate bone volume for conventional implant placement. This lecture will review the procedures available to the oral and maxillofacial surgeon to graft the posterior maxilla and mandible. Topics will include Ridge Preservation, Maxillary Sinus Augmentation (internal and external approach) , and Ridge Augmentation (horizontal and vertical) as well as a review of bone grafting principals. Technique videos will be highlighted as well as reviews of the literature and materials utilized for the procedures.
Dr. George R. Deeb is an Associate Professor in Department of Oral and Maxillofacial Surgery at Virginia Commonwealth University School of Dentistry, where he serves as the Director of the Graduate and Undergraduate Dental Implant Program.
Dr. Deeb earned his Doctor of Dental Surgery degree at the University of Colorado Health Sciences Center, graduating in 1995. He continued his education at Oregon Health Sciences University, where he graduated with a Doctor of Medicine in 1999 and completed his residency program in Oral and Maxillofacial Surgery in 2001. Prior to joining VCU in 2013, Dr. Deeb practiced in Tucson, Arizona as a partner in a large group practice.
Highly engaged in his profession, Dr. Deeb has published over 25 peer reviewed articles and book chapters, as well as lectured at national and international meetings. He is a Diplomate of the American Board of Oral and Maxillofacial Surgery, a Fellow of the American College of Surgeons and a Fellow in the Academy of Wilderness Medicine. In his spare time, he is an avid mountaineer and he enjoys glass casting and fusing.