Successful tissue management in focus at the 15th DENTYPLY Friadent World Symposium

Mannheim, March 17, 2012 – The Congress Center in Hamburg was the destination for over 2,500 dentists and dental technicians with an interest in implantology from around 60 countries across the world, who attended the 15th DENTSPLY Friadent World Symposium from March 15 to 17, 2012. More than 100 internationally renowned speakers representing science and practice discussed topics revolving around the conference motto "Mastering Tissue Response Successfully", under the scientific chairmanship of Dr. David Garber (USA) and Professors Fouad Khoury (Germany) and Ye Lin (China).

The importance of stable peri-implant tissue conditions for a successful long-term implantological outcome was underlined in the welcome speech by Dr. Werner Groll, Managing Director of DENTSPLY Friadent. It is not without reason that the company has focused the greater part of its research and development work on this topic. For only if all components and treatment steps are linked optimally, according to Dr. Groll, will it be possible to fulfill the increasing esthetic demands of patients for a prosthetic restoration on implants and long-term stable tissue conditions.

The World Symposium commenced on Thursday, March 15 with a pre-congress: two workshops on augmentation techniques and soft tissue management, and the "Dental Implants in Practice Forum". In the workshop on soft tissue management, the participants were able to practice various mucosal grafting techniques on pig jaws following a theoretical introduction to the topic under the guidance of Asst. Prof. Dr. Wolfram Hahn and Dr. Stephan Klotz. Dr. Thomas Hanser demonstrated techniques for bone block harvesting and augmentation in his workshop on bone transplantation, which was also followed by practical training on anatomical models. In the "Forum", experienced users presented successful treatment solutions and advanced concepts from their own dental practice to a larger audience for the first time.

On the Friday and Saturday mornings, the World Symposium started with joint presentation sessions lasting for one and a half hours each. The program then divided into several parallel sessions. While Podium 1 covered a broad, effectively "all inclusive", mix of topics including all clinical and scientific aspects of tissue maintenance, the parallel podia focussed on the main surgical or prosthetics points. To this end, DENTSPLY Friadent provided visitors with a "Program Navigator", offering individual program suggestions depending on personal interests.

Tissue integration and long-term esthetics
In line with the key theme "Mastering Tissue Response Successfully", the various sessions covered the major elements of successful tissue maintenance and esthetic long-term solutions in depth. Professor John Davies, an internationally acclaimed specialist on biomaterials, dealt with the interaction between the implant surface and the peri-implant tissue. The following presentations by Professor German Gómez-Román and Dr. Nigel Saynor gave impressive insights into the excellent long-term results in tissue integration using the two implant systems, ANKYLOS und XiVE. In the "Between Bone and Implants" session, the speakers highlighted the effect of the implant surface on stable osseointegration. The healing of implants in bone is more difficult, particularly in patients with systemic diseases, especially diabetes mellitus. Professor Christopher McCulloch discussed critical factors in the wound healing response, with a focus on changes in the extracellular matrix in patients with diabetes. Professor Karl Schlegel linked with this topic and discussed the influence of the implant surface during osseointegration in patients with diabetes. The development of biofunctionalized surfaces means that better healing results can be anticipated in the future. Using well-documented cases as examples, Dr. Gerd Koerner demonstrated the importance of intelligent measures in hard and soft tissue management for a long-term esthetic outcome.

The importance of the collaboration between prosthodontist and the dental laboratory for good predictable implant-prosthetic restorations was discussed in a parallel session. In their presentation, Dr. Orcan Yueksel and Bjoern Roland, MDT, illustrated how close communication between the dentist and the technician can result in excellent prosthetic results using computer-guided treatment planning. A further session presented the scientific background and well-documented patient cases for ceramic implants. While Asst. Prof. Dr. Dietmar Weng presented a comparison of the material properties of zirconium dioxide ceramics and titanium and their effects on tissue healing, Dr. Urs Brodbeck concluded that ceramic implants could prove to be a reliable alternative to titanium for well-defined indications in the near future.

The effect of the implant-abutment connection on tissue stability and long-term success was also discussed. Dr. Paul Weigl reported on long-term stable esthetic outcomes, especially in the anterior region, when using the tapered TissueCare connection of the ANKYLOS implant system. The physicist Holger Zipprich offered a highly descriptive demonstration of why this is so.

In the well-attended "Open Forum", Dr. Marco Degidi presented the technique of intraoral welding for fabricating tension-free fitting temporary dentures – from immediate loading of small bridges up to complex screw-retained prostheses on XiVE and ANKYLOS implants. He discussed the technical requirements and mechanical properties of the structures as well as the opportunities and limitations with critical participants. He pointed out fast processing, long-term stability and cost-efficiency of this treatment concept, which appeared somewhat extraordinary at first glance.

Reconstructive treatment principles
During the afternoon, Podium 1 was fully devoted to successful restoration concepts on implants. At the beginning of this program block, Professor Heiner Weber attuned to the audience of the differences between tooth and implant-supported prosthetic reconstructions and the possible effects of the design principles on the long-term success of restorations. Dr. Frank Kistler and Dr. Steffen Kistler pointed out that patients are often reluctant to accept grafting procedures as part of implantological restorations. The optimal use of existing bone volume is therefore of critical importance. The new angled abutments of the XiVE and ANKYLOS implant systems offer considerable support in the treatment of such cases. Their use can often avoid the need for sinus augmentation and can extend the prosthetic support polygon in the mandible distally, protecting the alveolar nerve.The presentations by Professors Anders Örtorp and Ignace Naert looked at aspects of CAD/CAM-fabricated prosthetic structures. They demonstrated the digital workflow from intraoral impression taking to the accurate and, at the same time, cost-efficient fabrication of dentures. Here, above all, the excellent fit and the exceptional material properties of the frameworks were emphasized. Besides today’s various fabrication techniques, from milling to laser sintering, the few components were also mentioned that are still missing to close the digital processing chain. In his presentation, Dr. Maurice Salama described the necessity for extensive pretreatment of the hard and soft tissue as an indispensable requirement for an esthetically appealing prosthetic restoration. In parallel with the prosthetic sessions, surgically-oriented visitors could choose to attend a presentation block on bone regeneration and biomaterials. This included various detailed presentations on surgical techniques for the regeneration of bone defects using autogenous bone. Professor Mostafa Farmand reported on long-term clinical experience with the bone regeneration material, FRIOS Algipore. Derived from algae and thus phycogenic, this material offers a range of good properties, such as high osseoconduction, dimensional stability and a low risk of infection.

Patient-individual prosthetic solutions
Numerous lectures on the Saturday morning were devoted entirely to esthetics. Dr. Galip Gurel presented examples of how a well-established, multidisciplinary team can deliver top-class esthetic results even in the most demanding cases and how this can be further supported by computer-guided planning and surgery and suitable techniques for soft tissue management. He described basic guidelines for esthetic reconstructions, even in cases of extensive bone- and soft tissue-loss. In their lectures, Dr. Arndt Happe and Dr. Krzysztof Chmielewski presented the indications and esthetic possibilities of customized CAD/CAM-fabricated ceramic abutments which were bonded to ready-made titanium bases. In addition, Asst. Prof. Dr. Wael Att outlined the indications and prospects of customized single-component CAD/CAM abutments made from titanium or zirconium. Dr. Barry Goldenberg presented on the role of the shape, color and contour of the peri-implant tissue for the design of the abutment-crown complex. Presenting esthetic long-term results, he compared prefabricated and individually designed abutments. In his contribution, Professor Christian Stappert presented a comparison of different ceramic materials and their applications and limitations in conjunction with suitable soft tissue surgery methods.While these lectures were mainly concerned with restorations in the anterior region, Dr. Alessandro Ponte focused on new techniques with individually fabricated CERCON all-ceramic abutments in the posterior region. Based on an ongoing prospective study, he was able to confirm the good peri-implant tissue integration associated with the One-Abutment-One-Time concept with first data.

 Another major topic of the morning session was the management of peri-implantitis. In his contribution, Professor Marc Quirynen showed that the pathogens causing periodontitis were also responsible for causing peri-implantitis. Therefore, implants placed next to periodontally compromised teeth are subject to an increased risk of peri-implant inflammation. The necessity for thorough periodontal pretreatment and maintenance treatment to prevent peri-implantitis was also underlined by Professor Joerg Meyle. He was able to demonstrate a success rate of 97.2 percent for implants in a ten-year study, where periodontal treatment had been performed consistently. In his lecture, Dr. Getulio Nogueira looked at the diagnosis, prognosis and treatment planning of peri-implantitis, while Dr. Ann-Marie Roos-Jansaker focused on treatment options and methods.

Future perspectives and new technologies
Finally, the Saturday afternoon was devoted to future-oriented concepts in implantology. Dr. Sven Rinke gave a comprehensive overview on today's common possibilities for digital treatment support. Prosthetic superstructures can be milled from homogenous, pore-free blanks made from cobalt chrome or titanium using CAD/CAM technology with a precision that far exceeds the fitting accuracy of conventionally cast frameworks using precious metals. He also impressively demonstrated new options for prosthetic restorations using Compartis ISUS. Prosthetic reconstructions in the posterior region made from high-strength, monolithic ceramics can also be fabricated employing this technology. With the advent of digital intraoral impression taking, the next step in the digital workflow of patient treatment has been reached. Professor Juergen Hoffmann gave an impressive presentation on the possibilities of complex implant-prosthetic reconstructions, particularly in major craniofacial bone defects. Professor Georgios Romanos reported on the interaction between functional immediate restoration and crestal bone stability based on long years of experience. Professor Lyndon F. Cooper presented integrated digital solutions using simple and complex case studies and underlined the opportunities of employing digital data in planning, surgery and prosthetic rehabilitation.

In parallel, Professor Georg-H. Nentwig and Dr. Fred Bergmann chaired presentations on the long-term results of the ANKYLOS and XiVE systems by DENTSPLY Friadent. ANKYLOS has been successfully used in implantology for 25 years, and XiVE celebrated its tenth anniversary on the market in 2011. Numerous clinical studies have confirmed the excellent quality of the two implant systems. In a retrospective study, Professor Stefanos Kourtis presented the results for a total more than 4,000 implants which had been placed over 20 years in four clinical practices. The implant systems used were IMZ, FRIALIT-2 and XiVE. The success rate of XiVE after ten years was over 95 per cent and was thus superior to the values of the two other systems. The XiVE implants also performed considerably better in terms of prosthetic complications and the incidence of peri-implantitis. Dr. Mischa Krebs presented the study results of more than 12,000 ANKYLOS implants, which were placed between 1991 and 2011 at the University Clinic in Frankfurt am Main. The absolute survival rate in all patients and over all indications was an excellent 97.3 per cent – the most frequent losses occurred during the first year after placement and were largely due to peri-implant inflammation.

Intensive networking among colleagues
Besides the presentations on the different podia, visitors had variety of other opportunities to discuss current topics, such as in the Poster Gallery. Scientific posters in the "Clinical Studies" and "Basic Research", "Clinical Cases and Documentation" categories, were displayed here along with "Student Posters". Overall, more than 150 posters were presented and the winner of the Poster Award for each category was selected by a scientific jury chaired by Dr. Marco Esposito. The winner in the "Clinical Studies" category was Michele D’Errico, Italy, with the topic "Immediate loading with SynCone in edentulous mandible: long-term result", in the "Basic Research" category, the winner was Julie Lamure, France, with the topic "Cone-Beam Computer Tomography and dental implants. An ex-vivo study on the ability to assess the integrity of the buccal cortical plate around dental implants". The best case report was presented according to the jury, by Karl J. Zeren, USA. Two awards were conferred in the "Student Poster" category: to Rustam Aghazada, Azerbeijan, and to Ioannis Papadopoulos, Greece. The jury had selected posters in all categories which were presented and discussed in brief presentations at the "Speakers' Corner". The award ceremony was held on Saturday at the beginning of the main program. Here, the winners had the opportunity of presenting their poster topics to a wider audience in ten-minute presentations.

Treatment solutions "From Root to Crown"
On both days, attendees at the Symposium had the opportunity to experience innovations and successful treatment solutions by DENTSPLY Friadent live in the "Marketplace". Several of the activities allowed participants to gain practical experience with the solutions presented during the scientific program. Numerous intelligent treatment techniques were presented to interested conference

participants for ANKYLOS and XiVE, for example, in conjunction with the ExpertEase guided surgery concept or the DENTSPLY Friadent range for CAD/CAM-fabricated, customized prosthetics, and these could even be tried out by the participants in "Clinical Classrooms", under the guidance of experienced practitioners – an opportunity that met with a lively interest from many of the delegates. The topics of practice marketing and how to bind patients were the focal points in the stepps Lounge. Presentations in the program on online marketing were absolutely up-to-date. In addition, a number of experts from the various fields of practice marketing and management were available for personal consultation. The atmosphere at the congress was truly stimulating: during breaks, the attendees discussed the presentations and used the opportunity to share experiences and meet up with friends and acquaintances.

And finally – celebrating with friends As always, the evening event, a traditional part of the DENTSPLY Friadent World Symposium, was popular. The guests experienced the atmosphere of Hamburg's harbor and a living part of mercantile tradition in "Schuppen 52". Today, this classic Wilhelmine period storage shed is one of the hottest event locations in Hamburg. The shanty choir, "De Klaashahns", the brass band, "schraeg", and the show band, "Szenario", three completely different groups, each stars in their genre, provided excellent entertainment value.

In summary, the DENTSPLY Friadent World Symposium has again proven highly successful for the 15th time. Yet again, DENTSPLY Friadent presented itself as an innovative premium supplier with topics and speakers of a high-class international standard. The wealth of clinical studies presented in the lectures confirms the consistent orientation of the company towards user- and patientfriendly treatment solutions with a scientific basis.

In addition to the professional information, the social aspect was also appreciated, and friendly exchange among colleagues was fostered. Many of the participants are already looking forward to the next World Symposium, which will be held in Vienna in 2014.

As a special service, DENTSPLY Friadent is making abstracts of the presentations at the 15th World Symposium available at www.dentsply.friadent.com/symposium. All information has also been available since the World Symposium via an optimized mobile website for smartphones. 

Publisher:
DENTSPLY Friadent, Friadent GmbH, Steinzeugstr. 50, 68229 Mannheim, Germany, www.dentsply-friadent.com

Contact:
Johannes Lerch, Senior Manager Communications, Tel. +49 621 4302-1346, Fax +49 621 4302-1346, johannes.lerch@dentsply.com