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Esthetics and immediate loading protocols: prosthetic considerations for predictable results

Sergio Piano, Alessandro Giacometti
Fig. 2: Implant placement with guided surgery, flapless approach

Implant therapy has been proven to provide not only long-term success, but also predictable treatment outcomes and pleasing esthetic results. Nevertheless, fully edentulous jaws still present significant challenges for successful oral rehabilitation.

In fact, when this type of treatment is required, several issues come into play: How to solve the esthetic problem of immediate implants in the anterior region? How to coordinate the ideal prosthetic plan with the availability of bone? How to reduce surgical invasiveness? How can a dentist address this class of patients while avoiding surgical and prosthetic complications and a loss of valuable time?

These are only a few of the questions you will be able to answer by attending the session on “Esthetics and immediate loading protocols: prosthetic considerations for predictable results” at the ITI Congress Italy 2022.

The advent of CAD/CAM in prosthetics and of computer-guided planning in surgery has changed the pattern that applies to clinical work. During the presentation, a specific workflow will be illustrated, showing some of the advantages of the digital approach.

The starting point is always the same: accurate pre-operative prosthetic planning based completely on the pre-visualization of the final result is the initial step and represents the real key to success.

This specific procedure has a mixed flow, both analog and digital. For a perfect rendering of the ideal wax-up in the patient’s mouth, a physical mock-up is needed. A virtual mock-up is not able to give us such meticulous and accurate detail – it can be successfully used only to share information with the patient.

Once the visual appearance of the restoration has been approved, the following steps will be completely based on virtual files: implant planning software will be able to drive implant placement, abutment choice, surgical guide fabrication in accordance with bone anatomy and the prosthetic planning outlined.

As shown in the following pictures, this approach allows the dentist to move from hopeless dentition to a successful result following a predictable protocol. Every step is under control, and, if the planning stage has been developed appropriately, the risk of mistakes is minimized.

In addition, new developments and improvements in digital dentistry will be highlighted in this presentation in order to further enhance and simplify the treatment of these cases.

A large number of fully documented clinical cases will contribute to clearly illustrating this technique by means of high-quality pictures and videos.

In conclusion, to learn more about this topic, make sure to attend the ITI Congress Italy 2022 where Sergio Piano and Alessandro Giacometti will present it in detail.

See you in Rome!

Authors

Sergio Piano
Dr. Sergio Piano
Sergio Piano lectures on digital implantology at the University of Padua, periodontology and implantology at the University of Naples “Federico II°”, implantology at the University of Genoa, and digital dentistry at the University of Brescia. He is an Active Member of IAO and of IAED, an Affiliate Member of EAED. Sergio Piano is an ITI Fellow and Education Delegate on the ITI Italian Section Leadership Team. He lectures regularly on surgical and prosthetic topics in implantology in more than 30 countries.
Giacometti
Alessandro Giacometti Dent. Tech.
Alessandro Giacometti has had a dental laboratory in Genoa since 1989. He is particularly interested in esthetic prostheses on natural elements and implants. He has attended numerous courses with oral design leaders, including Willy Geller, Michel Magne, Walter Ghebart, Marco Di Pietro, Yasuhiro Odanaka, Ulrich Werder and Roberto Iafrate. Since 2000 he has been a reporter and demonstrator for Ceramic Creation. He speaks at various Italian congresses on issues related to esthetics and the functionality of fixed prostheses on natural teeth and implants. He has worked with Straumann on the Wonder Bridge project as a speaker on various national courses since 2012. Alessandro Giacometti is an ITI Fellow.
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