ADI Focus Meeting: Innovations in Dental Implantology by Dr Dominic O’Hooley

by Dr Dominic O’Hooley

A truly international lineup of six speakers at the ADI Focus Meeting 2019 gave us the opportunity to hear insights at the forefront of our exciting branch of dental surgery. Here is a brief synopsis of all six presentations.

Dr Ziv Mazor
Ridge Atrophy Treatment Concepts Utilizing Osseodensification and Blood Derived Growth Factors
Mazor described the benefits of osseodensification using counterclockwise rotating drills with a reverse quasi-Archimedean screw principle. Studies focused on pig tibia in vitro studies, animal studies with sheep, and humans. The same messages came through compared with traditional osteotomies: insertion torque up, a condensing layer, a slightly reduced osteotomy diameter due to the spring back effect, and up to three times the percentage of initial bone to dental implant contact.

I’m by nature a sceptical person, but I am going to explore this technology and techniques in my clinical practice. No technique is a panacea, but I think osseodensification will be judged as a paradigm shift.

Dr Karl Ulrich Volz
Bone-Growing Implants: Update on the Latest Protocols and Shapes in Ceramic Implants
This piqued my interest straight away—not because I have the urge to start offering zirconia instead of titanium, but because I genuinely believe that pre- and postoperative optimisation protocols for essential nutrients involved with ideal bone healing will become future best practice.

Volz’s presentation offered nuggets of gold within a path containing contentious opinions, strongly held subjective positions and a very different philosophy to what I’ve seen in the UK. He discussed ceramic dental implants and associated surgical techniques, considering closely placed one-piece products.

His presentation was innovative and thought-provoking and I’m sure that aspects will soon be widely adopted. I was left with my comfortable positions either reinforced or destabilised—the mark of a great lecture.

Dr Anas Aloum
From Planning to Execution: Novel Concepts and Techniques in Rehabilitations
This presentation asked, “Are we really going digital?” Themes of true digital workflow, comparisons of model and model-free protocols, full contour compared to layering, digital wax-ups and potential aesthetic compromises were ever-present. This was an impressive presentation, with high skill and innovative techniques at the forefront. I think adopting the full digital workflow as demonstrated here is not for every dental implantologist. That being said, Aloum made me reflect on many aspects of my current workflows and contemplate new opportunities, which for a self-confessed digital Luddite speaks volumes about the quality of his presentation.

Dr Costa Nicolopoulos
Immediate Loading with Permanent Restorations within 7 Days: Fact or Myth?
Nicolopoulos emphasised how site-specific dental implants, high-quality supporting studies and high primary stability support the reality that immediate-loaded dental implants can be predictable. He dismissed the widely reported minimum end insertion torque of 32ncm as too low, suggesting that 45ncm with an ISQ of 68 is more acceptable. There was much I agreed with, including the need for one abutment, one time in an internally clean dental implant; assurance of abutment seating; and the use of beta TCP and osseodensification drills. I struggled with the extremely high insertion torques and the assertion that the precise fit of external hex abutments precludes bacterial ingress into the gap. Again, this controversial lecture was fantastic at taking me out of my comfortable working patterns and making me think about what I do.

Dr Rana Al-Falaki
Light at the End of the Tunnel: Are Lasers the Answer to Peri-Implantitis?
Al-Falaki opened by discussing the new classification of peri-implant status for 2018 before taking us through nonsurgical and surgical treatment options.

Talking about lasers, she stated that no one type can do everything. This presentation really had to be literature-heavy but I didn’t find it heavy going; she succeeded in explaining topics in a way that allowed me to easily grasp the salient points.

She explored the lasers she does and doesn’t use often and showed her study of 28 dental implant cases to demonstrate bone regeneration. It was a fascinating lecture that left me feeling very intrigued about how these safe lasers can assist with the scourge of peri-implant disease.

Dr Howard Gluckman
Partial Extraction Therapies
Gluckman’s talk may have been last on the agenda, but both the topic and his great delivery style ensured rapt attention from the hall. He stated what’s true for everyone—we look for exceptional results, but we find that they’re not achievable every time. The themes were thus predictability and reproducibility for average oral surgeons, and not just giants of the world stage.

Howard covered partial extraction therapies specific modalities: submerged root techniques, pontic shield and socket shield. He demonstrated his failures, which I found refreshing; I love to see a confident clinician who appreciates that suboptimal outcomes happen to everyone and are usually the best opportunity for learning. For me, this was a technically brilliant presentation from a man who is highly regarded in the dental implant sphere and gave me much to think about. As implant dentists in a country with rigorous regulation, it was brilliant to see six innovative presentations. My mind was opened, much knowledge was gained, many questions burst forth and I was left intellectually stimulated and very proud of my friends at the ADI for organising this exceptional day.

For more information about the ADI, or to join, visit adi.org.uk.