Clinicians open up about their 'nightmare' scenarios at EuroPerio10

One of the highlights of the scientific programme for EuroPerio10 will be the two “nightmare” sessions in which clinicians will talk about surgeries and procedures that did not go according to plan and how they handled the resulting problems.

On Thursday, June 16 (14.30-15.55), there will be a session devoted to dental implants. Chaired by Adrián Guerrero (Spain), it will feature contributions from Øystein Fardal (Norway), Tiernan O’Brien (Ireland), and Luca Landi (Italy).

"The nightmare session in implant dentistry has been designed with the aim of sharing real clinical cases, from real clinical practice and from very experienced clinicians who found unexpected difficulties during the process of implant therapy in their own patients," said Adrián Guerrero. "This session will  focus on serious complications in implant therapy – issues such as unintended adjacent tooth damage, early implant loss right after prosthetic load, multiple late failures, and the occurrence of severe peri-implantitis in theoretically well-maintained patients."

Tiernan O’Brien (chair of the EFP communications committee 2016-2022) said that the session would serve to "counterbalance all the other talks that will focus on the very positive results that can be achieved in contemporary periodontal practice. Our session is to remind people that not everything works out as planned in every case.  In fact, we have been asked not just to present cases that have not been successful, but cases that went very wrong and turned into a nightmare in one way or another.”

His own presentation will focus on two cases that have “turned into nightmares for me and my patient.”  One case involved a mistake at the outset of treatment that created a problem “that has continued to haunt both me and the patient up to 17 years later.”   The second case is one where evidence-based treatment was provided in the correct way but nonetheless did not work and the patient had to be provided with a compromised end-result.

The second nightmare session, related to periodontitis treatment, will take place on Friday, June 17 (14.30-16.00). Former EFP president Lior Shapira (pictured) will be in the chair and there will be presentations by Moshe Goldstein (Israel, chair of EFP postgraduate education committee), Pierpaolo Cortellini (Italy), and Giulio Rasperini (Italy).

“The ‘nightmare in periodontal therapy’ session aims to show that expert periodontists and key opinion leaders may have problems during the healing following periodontal surgery,” explained Lior Shapira. “The biological and technical reasons for the failure need to be analysed, understood, and lead to modifications in the techniques.  We can all benefit from the learning process and need to follow the words of Albert Einstein: “The only sure way to avoid making mistakes is to have no new ideas.’”

In this session, Pierpaolo (“Sandro”) Cortellini will focus on the management of complications in regenerative therapy and how various treatment strategies and techniques have been modified to achieve more predictable results. He will explore surgery that was done improperly, the compromised outcomes that resulted, and the possible solutions as well as cases where regeneration therapy was done perfectly.

Moshe Goldstein will discuss the management of complications in mucogingival surgery, explain how the surgical approaches involved are all “technique sensitive”, present some cases that went wrong and explain the reasons.  There will be a discussion with the panel and audience about the mistakes and the possible solutions. Prof. Goldstein will also describe the expert approach and cases where techniques in mucogingival surgery were performed correctly.

Finally, Giulio Rasperini will explain one of the most challenging procedures in periodontal therapy: papilla reconstruction, which has been developed in response to growing aesthetic demands. One of the inventors of this technique, Prof Rasperini will explain the reasons for papilla loss and explore cases whose outcome resulted in papilla loss, discussing both mistakes and solutions.

EuroPerio10 takes place in Copenhagen, Denmark, on June 15-18. To avoid paying late or on-site registration fees, register before May 18 and pay the regular registration fee.