UPCOMING EVENTS
SURGICAL SESSIONS 1 ā 5
Rosen Shingle Creek Resort
Orlando , Florida
Session 1
Patient Evaluation, Treatment Planning, & Implant Placement into Abundant Bone
February 8-9, 2019
Session 2
Treatment of the Edentulous Arch
March 29-30, 2019
Session 3
Implant Placement & Bone Augmentation into Compromised Sites
May 17-18, 2019
Session 4
Treatment of the Posterior Maxilla:
Osteotome & Lateral Wall Technique
July 19-20, 2019
Session 5
Immediate Placement & Loading,
Soft Tissue Considerations
September 13-14, 2019
āDoctor, When Can I Drink Alcohol
After Dental Implant Surgery ?ā
By: Randolph R. Resnik, DMD, MDS
Ethyl alcohol is one of the most widely used mood-altering drugs in the world. Because of the adverse impact of alcohol on dental implants, screening for undiagnosed alcohol related disorders is beneficial. Excessive alcohol intake has been associated with surgical and dental implant-related issues such as liver and metabolic dysfunction, bone marrow suppression resulting in bleeding complications, predisposition to infection, and delayed soft tissue healing. 1
EFFECTS ON DENTAL IMPLANT PATIENTS
Bleeding problems. Alcohol interferes with coagulation on multiple levels leading to decreased platelet production (thrombocytopenia), impaired platelet function (thrombocytopathy),and diminished fibrinolysis. Patients who use alcohol on a regular basis are more susceptible to intra- and postoperative bleeding complications associated with dental implant surgery.
Wound Healing. Wound angiogenesis is reduced up to 61% following a single ethanol exposure. 2
Infection. Alcohol use leads to significant alterations of cell-mediated immune systems. Alcohol-induced immunosuppression results in a decrease in delayed-type hypersensitivity
(DTH), which is a preoperative indicator for postoperative infectious complications.3 Therefore, patients consuming alcohol (especially those who consume it immediately
after surgery) are more susceptible to incision line opening and infection.
Increased Bone Loss: Alcohol use also leads to decreased bone formation, increased resorption, and decreased osteoblast function, resulting in decreased bone density and integration issues. The use of alcohol has a direct effect on dental implant healing as studies have shown greater marginal bone loss and implant failure associated with alcohol
consumption. 4
PREVENTION OF COMPLICATIONS
Informed Consent: The patient must be well informed of potential consequences (e.g. incision line opening, infection, implant failure) of alcohol use, especially immediately after implant surgery. This information should be detailed in verbal and written informed consent along with post-operative instructions.
Cessation Program: Abstinence can reverse many of alcoholā s effects on hematopoiesis and blood cell functioning; the patient should be instructed on possible cessation treatments and programs. Ideally, patients should refrain from using alcohol for a minimum of two weeks or after incision line closure occurs.
1 Rees TD : Oral effects of drug abuse . Crit Rev Oral Biol Med 3 : 163 ā 184 , 1992 .
2 Guo, S. al, and Luisa A. DiPietro. “Factors affecting wound healing.” Journal of dental research 89.3 (2010): 219-229.
3 Tonnesen H : Alcohol abuse and postoperative morbidity. Dan Med Bull 50 : 139 ā 160 , 2003 .
4 GalindoāMoreno, Pablo, et al. “Influence of alcohol and tobacco habits on periāimplant marginal bone loss: a prospective study.” Clinical oral implants research 16.5 (2005): 579-586
Surgical Session 5
Immediate Placement & Loading,
Soft Tissue Considerations
NEWLY UPDATE CURRICULUM
March 1-2, 2019
Caesarās Palace Casino & Resort
Las Vegas, NV
Learn Indications and Procedures for:
ā¢ Immediate Placement
ā¢ Immediate Loading
ā¢ Treatment of Peri-implant Disease
ā¢ Treatment of Failed Implant
ā¢ Soft Tissue Augmentation
ā¢ Dermal Fillers
ā¢ Review of Sessions 1-5
ā¢ CBCT Interactive Treatment
ā¢ Integrating Implants into your practice
All New Comprehensive Hands-On
Lab Sessions
- Implant Placement (freehand)
- Guided Surgery Implant Placement (pilot, universal, fully guided)
- Bone Density Surgical Protocol for all 4 Bone Densities
- Socket Grafting (4 & 5 wall defects)
- Periosteal Reflection (stretching tissue)
- Suturing Techniques
- Atraumatic Extractions
#1: CBCT PATHOLOGY QUESTION
Upon CBCT radiographic evaluation, a radiopaque foreign body (antrolith) was found to be located in the maxillary right sinus.Ā What is this foreign body?
Hint: Patient had full mouth extractions with placement of an interim prosthesis
#2: PROSTHETIC QUESTION
A recent meta-analysis study evaluated the implant failure rate of splinting vs. non-splinted implant prostheses. Did splinted or non-splinted prosthesis have a greater implant failure rate?
#3: PATHOLOGY QUESTION
This coronal CBCT image depicts in the maxillary right and left sinus (green arrows) radiopaque lesions. This is often termed an air-fluid level.
What maxillary sinus disease process is this consistent with?
#4: IMPLANT STUDY OF THE MONTH
According to a University Connecticut School Of Dental Medicine study, what percentage of patients seeking dental implant treatment were diagnosed with carotid Of calcifications as seen on CBCT examinations?
Glidewell Laboratories is the largest dental lab in the world. How many digital impressions did the lab receive in December 2018 ?
a. 1061
b. 8623
c. 10,157
d. 28,167
ANSWERS:
#1: CBCT Pathology
Answer: Tissue Conditioner: After extraction, tissue conditioner was placed in the interim prosthesis for relining purposes.
Because of an undiagnosed communication with the sinus after extraction, the reline material, which was mixed with a low
viscosity, was extruded into the maxillary sinus. Note: Over 40% of maxillary molars have at least one root which extrude into
the maxillary sinus.
#2: Prosthetic
Answer: Non-Splinted Implant Prosthesis was associated with a higher implant failure rate.
de Souza Batista, Victor E., et al. “Should the restoration of adjacent implants be splinted or nonsplinted?
A systematic review and meta-analysis.” The Journal of prosthetic dentistry(2018)
#3: Pathology
Answer: Acute Rhinosinusitis (ARS): ARS is the most common condition encountered by primary care providers, and is the most
common reason for antibiotic prescriptions
#4: Implant Sudy of the Month Question
Answer: After evaluation of 1000 CBCT scans of patients seeking dental implant patients, 38% were diagnosed with carotid
calcifications.
Note: Patients with Carotid Calcifications should be referred to their physicians for evaluation and treatment if indicated.
Mutalik, S., & Tadinada, A. (2019). association Between Internal And External Carotid Artery Calcifications In Patients
Undergoing Dental Implant Therapy. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 127(1), e41.
Trivia Question of the Month
Answer: D
