Restorative Implant Residency

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Restorative Implant Residency

  1. 1. Restorative Implant Residency Aldo Leopardi, BDS, DDS, MS Prosthodontist Introduction The Restorative Implant Residency Program is a comprehensive approach to Dental Implant Continuing Education. It is a five part all day hands-on lecture series. The main objective is to empower participating doctors and staff in building their implant practices. This hands-on approach allows for real-world experience with implant components and clinical techniques. Auxiliaries are also trained in the support and marketing aspects of this treatment modality. All programs are 8 hours in length with 8 continuing education credits available. Session breakdown is as follows: Session 1: Overview of Dental Implant Therapy for Doctors AND Auxiliaries (2 Programs Running Concurrently!) DOCTOR’S PROGRAM: Doctors will work through a proven methodology for determining pre-surgical treatment planning, work with the most common prosthetic components and learn a proceduralized protocol for chairside procedures. Economics will be reviewed to help ensure the profitability for the practice. • Current Implant Situation • Conventional Dentistry vs. Implant Dentistry • The Hidden Implant Patient in Your Practice • Pre-Surgical Treatment Planning o Patient Expectation o Prosthetic Option o Biomechanics o The Team Concept • Pre-Surgical Work-Up • Implant Site Preparation • Patient Selection Criteria • Concepts of Prosthetic Implant Restorations (HANDS-ON) • The Economics of Implant Dentistry o Surgical Fees o Restorative Fees o Component Costs o Laboratory Costs • Sequential Appointments • Abutment Choices
  2. 2. Aldo Leopardi, DDS, MS Teaching Approach: The participants will typically have about the same experience with dental implants, novice (0-5 cases restored) to intermediate (10-15 cases restored). This allows for an environment where by the participants can openly ask basic questions and the pace of the program is set accordingly. It will combine, lecture and hands-on with the opportunity to interact with their chairside assistant(s) during the Chairside Guidelines portion of the program. Auxiliary Program (Session 1 continued): Presented by a separate speaker and concurrently with the doctor’s program, team members will receive an overview of the history of dental implants followed by a working understanding of the surgical protocol and common prosthetic options. A majority of the day will be focused on communication skills that will be beneficial to all aspects of the practice. Each team member will learn concepts pertinent to their own role (chairside assistants, hygienists, and front desk). Who Should Attend:  All team members (Administrative, Chairside Assistants and Hygienists) who would like to have a better understanding of the procedures involved with dental implants and how their patients can benefit from this type of treatment modality and very importantly, how to answer the most commonly asked questions regarding dental implants. In addition, each team member will enhance their knowledge of their role in Tooth Replacement Therapy. Teaching Approach:  It will combine, lecture and hands-on with the opportunity for the Chairside Assistants to interact with their doctors during the Chairside Guidelines portion of the program. Hygiene Care and home maintenance along with Administrative considerations will be covered during the afternoon break out session. Course Content:  History of Dental Implants  Overview of Surgical and Restorative Phases of Treatment  Understanding the Common Prosthetic Options  Communication/Verbal Skills for discussing Tooth Replacement Therapy  Increasing Case Acceptance o Pre-consultation preparation o Understanding the patient physiology o The ideal consultation o Patient motivation o Overcoming obstacles to treatment acceptance  Chairside Assisting Protocol (with the doctors)  Hygiene Maintenance and Home Care for Dental implants  Internal Marketing Concepts 2
  3. 3. Aldo Leopardi, DDS, MS Included in Session 1: o Lunch and refreshments o 8 hours CE Credits Session 1: Objectives 1. To understand the current situation of implant dentistry 2. To understand the differences between conventional dentistry and Implant dentistry 3. To understand the basic patient requirements for Implant dentistry 4. To establish and select specific criteria necessary to accept and recommend a patient for treatment 5. To determine surgical and restorative time parameters 6. To understand the complete fee structure for all involved in implant dentistry 7. To understand the restorative sequence involved in varied patient situations 8. To understand the concept of implant restorations retained to the abutment vs. the implant (Hands-on) 9. For auxiliaries to better understand the benefits of implant therapy and how to communicate these benefits to the patient 10. For Auxiliaries to feel more confident and competent with in their role in the treatment phase for dental implants 3
  4. 4. Aldo Leopardi, DDS, MS Session 2: Treatment Planning Doctor/Patient Participation Each Doctor will be required to bring to the program a private practice implant candidate* for diagnosis and treatment planning. The following is required for participants to bring to the program: o Doctor will complete “Patient Record” and “Implant Treatment Planning“ forms provided o Mounted study casts (preferable) o Full mouth series of radiographs and/or panoramic radiograph • Each case will be discussed in an informal seminar format together within the group under the direction of Dr. Leopardi, participating surgeons and dental laboratory • Surgical Stent Considerations: The dental laboratory will provide examples of surgical stents for implant site analysis and implant channel formation (hands- on) with burs/surgical twist drills • Economics: each case presented will be priced out *NOTE: The concept of this day is to take real life scenarios and implementing the information learned, develop a comprehensive treatment plan (including any non-implant related treatment needs) that will meet the expectations of the patient, restorative doctor and surgeon. It is not necessary that the patient complete the proposed treatment plan. Patient Implant Treatment Patient’s treatment planned in Session 2 will (should) undergo implant treatment as follows: • Radiological/Surgical guides constructed and fitted under the direction of Dr. Leopardi and/or participating surgeons • Implant placement by participating surgeons with dentist present during surgery (these surgical appointments are performed independent of the group) • Implant restorative treatment by participating Doctor under the guidance of Dr. Leopardi and dental laboratory 4
  5. 5. Aldo Leopardi, DDS, MS Session 3: Fixed Restorative Treatment Modalities Participants will work with the most comprehensive HANDS-ON models and prosthetics available to date. The majority of the day is dedicated to hands-on experience. • Review of Diagnosis and Treatment Planning o Restorative Knowledge of Surgical Considerations • Diagnostic Requirements o Review of Radiographic and Surgical Stents o Treatment from Stage One thru Stage Two surgery • Impression Procedures (HANDS-ON) o Open Tray o Closed Tray o Conventional o Splinted impression technique • 3 Unit Bridge: Cement and Screw-Retained (HANDS-ON) o Included are advantages and disadvantages of cement and screw retained bridge work, impression techniques, fabrication of diagnostic wax up, choice of transfer technique (e.g., abutment jig and/or orientation markings) from model to mouth (cement retained), try-in of metal framework, cut and solder if necessary, provisional restorations • Single tooth o Value and fabrication of surgical guides o Implant position o Custom casting of gold indexed abutment o Presentation of four restorative techniques • Occlusion and biomechanics of fixed implant therapy o Differences between natural teeth and fixed implant occlusion • Indexing the implant platform at time of first stage surgery Chairside assistants are encouraged to attend with their doctor. Space maybe limited to one assistant per doctor. 5
  6. 6. Aldo Leopardi, DDS, MS Session 3 Objectives: 1. To review proper diagnosis and treatment planning 2. To review and understand diagnostic needs not usually utilized in conventional dentistry, such as surgical/radiological stents 3. To review and understand the economics of tooth replacement therapy 4. To understand surgical limitations (quality, length, etc.) of the implant site 5. To gain knowledge of treatment between Stage 1 and Stage II surgeries, and beyond 6. To understand the difference between pick-up and transfer impression techniques and copings, and the benefits obtained from the accuracy of the splinted impression technique 7. To demonstrate proficiency in impression techniques 8. To expose participants to impression taking options, and the appropriate instrumentation necessary to make and take impressions (Hands-On) 9. To examine impressions to determine accuracy, quality and impression coping retention 10. Soft tissue model fabrication 11. To understand the clinical procedures involved in cement-retained fixed implant restorations 12. To understand the clinical procedures involved with conventional screw-retained fixed restorations 13. To understand the clinical procedures involved with the single tooth restoration, cement and screw retained 14. To understand the role of occlusion in the success of fixed dental implant therapy 15. To understand the biomechanics of fixed implant therapy 16. To understand the advantages and disadvantages of indexing the implant platform at time of first stage surgery 6
  7. 7. Aldo Leopardi, DDS, MS Session 4: Removable Restorative Treatment Modalities Participants will work with the most comprehensive HANDS-ON models and prosthetics available to date. The majority of the day is dedicated to hands-on experience. • Bar Overdenture o How to easily duplicate a denture for surgical guide o Advantages & disadvantages for Bar Overdentures o Biomechanics • Fabrication of Verification Jig (HANDS-ON) o Doctors will be fabricating and verifying on cast o How to correct the working laboratory cast • Impression Technique for Bar Overdenture (HANDS-ON) o Steps to follow for fabrication of Bar Overdenture o Wax Rims o Set up o Fabrication of bar (lab procedures) • Try in of the Bar Overdenture (HANDS-ON) o How to correct a non-fitting bar • Final Prosthesis (HANDS-ON) o Placement of transmucosal abutments o Torque of abutments o Seating of finished denture with attachments o Patient recall discussion • Retrofitting Existing Dentures to a Snap Attachment o Seating of attachments o Curing of attachments (optional hands-on procedure) • Overview of Full Arch Fixed Prostheses for the completely edentulous patient • Custom laboratory procedures (fixed and removable): techniques presented by participating dental laboratory • Introduction and overview of the Single Stage Implant System for Fixed and Removable Restorations 7
  8. 8. Aldo Leopardi, DDS, MS Chairside assistants are encouraged to attend with their doctor. Space maybe limited to one assistant per doctor. 8
  9. 9. Aldo Leopardi, DDS, MS Session 4 Objectives: 1. To review diagnosis and treatment planning for removable implant prosthetics 2. To review and understand the economics of removable overdenture implant therapy 3. To understand the biomechanical differences between fixed and removable implant therapy 4. To review impression techniques for removable implant therapy 5. To understand the purpose and techniques involved with the construction of a verification jig 6. To understand abutment selection for removable implant therapy 7. To understand the clinical procedures involved with removable bar- overdenture therapy 8. To understand the clinical procedures involved with snap abutment-attachment systems (O-Ring style) 9. To understand the techniques and indications for retrofitting an existing denture to implant overdenture abutments 9
  10. 10. Aldo Leopardi, DDS, MS Session 5: Case Presentation Following the completion of patient implant treatment, a final informal session will be devoted to case presentations by participating restorative doctors. The doctor will provide: • 35 mm slide photography, or digital PowerPoint (Microsoft) LCD presentations, or a combination of both • Radiographs (before and after) • Study casts (before and after) Each participant will present their case and describe any challenges they faced and how they overcame those challenges. The group will be encouraged to add input to the cases presented, with the goal of enhancing the process of implant treatment planning through completion for all participants. Certificates of completion, suitable for framing, will be presented to each participant. Auxiliaries will receive their certificates at the completion of Session 1. Questions: contact Aldo Leopardi, DDS, MS Practice Limited to Fixed, Removable and Implant Prosthodontics 7400 East Crestline Circle, Suite 235 Greenwood Village, CO 80111 Ph: 720 488 7677, Fax: 720 488 7717 aldoleopardi@eschelon.com 10

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